| Clinical nutrition contain parenteral nutrition(PN)and enteral nutrition(EN) contemporaneity. It is also called surgical nutrition due to surgical doctor apply clinical nutrition in the beginning. The patient after received abdominal operation often has gastro-intestinal functional disorder, malabsorption and losing wight too much, so for those patients received stronger nutrition supporting is more eager than those patient whom suffered from the other diseases and trauma. Nutrition supporting in earlier stage after operation would be benefit for the patients recovering from the desease, healing of the would .EN has the more merit than PN, such as making the metabolism more like the nature processes, and being very convenience for clinical using, maintaining the structure and function integrality of the intestinal mucosa cells, protecting the barrier of the intestinal mucosa layer, preventing bacterial shifting invading, promoting the gastrointestinal motility, increasing the splanchnic blood flow, decreasing the incidence of liver damage.According to the traditional Chinese medicine (TCM) theory, "Spleen is the basis of the whole body after birth" .The patient whom suffered from abdominal operation often showes "splenic asthenia, Qi stagnant and congestion ". Strengthening spleen and promoting Qi in post-operative patient can eliminate gastrointestinal depression and stagnation of QI, nourish Jinye , advance the recovering of the patient. So the Strengthening spleen and promoting Qi movement would be good for the patients which show weakness after abdominal surgery.In the animal experiment Observe the effect of spleen-strengtheningand Qi-promoting method in GH(growthing hormone) and other nutritional indexes on enteral nutrition (EN) in abdominal operated SD rats model.This experiment is aimed to explore the function of the prescriptions of traditional Chinese medicine in the abdominal post-operation patients which received EN combined with TCM method, and do some primary research in the probable ways of the TCM combined with EN in the future.The first part: Literature reviewBy referencing literature from our country and abroad, we overview the concept and development of the clinical nutrition,the merit and application of EN after abdominal surgery,the application of TCM and growth hormones(GH) , realize that it is effective and safe to use TCM and combined with EN after abdominal surgery.The second part: The affections after using "strengthening spleen and promoting Qi movement" method with EN in postoperative patients Purpose: This experiment is aimed to explore the function of TCM in the abdominal post-operation patients which were treated EN combined with TCM "strengthening spleen and promoting Qi movement" method, explore its position and action of EN, and do some primary researches in the probable ways of the TCM combined EN in the near future.Methods: Using compared method which compared experiment group with contrast group and self-compared in the same group before and after experiment. All cases were come from the Sur. Dept. of 1st affiliated hospital of Guangzhou TCM university from 02/2006—03/2007 which had received abdominal surgical operation, totally 36 patients. The patients were divided into experiment and contrast group randomized, each group had 18 patients. The laboratory indexes and clinical data showed no significant difference between two groups after balanced(P＞0. 05). The experiment group was given EN+TCM after operation and the contrast group was given EN only in the same time in same way. All patients of two groups were taken blood from sample 1 day before and after treatment to measuring the volume of Hemoglobin(HB),Total protein(TP) Albumin(Alb) and prealbumin (PA) .The whole data' s were analysis by computer with SPSS11.0 software bag.Results: The volume of HB,Alb,TP and PA of two groups were all increased greatly after nutrition supporting than before(P＜0. 05). Compared between experiment group and contrast group, the result of experiment group was better than contrast group (P＜0. 05) except TP volume(P＞0. 05). The whole patients of two groups didn't complain any side reactions, and been discharged from hospital with the disease healing.Conclusions: Giving the patient EN would change patient' s general conditions and elevate some laboratory index. The ways of "strengthening spleen and promoting Qi movement" would enhance the effecting of EN, and have no obviously side reaction. Such results showed TCM formula that "strengthen spleen and promote Qi movement" having some promoting function in EN, increasing absorption capacity of gastro-intestinal tract to EN material, and the TCM method of "strengthening spleen and promoting Qi movement" become a possible way in the treatment of TCM combined with EN, and then become a part of EN components.The third part: Observing the effect of "spleen-strengthening and Qi-promoting method" in GH on enteral nutrition (EN) SD rats model afterabdominal surgeryPurpose: To observe the effect of spleen-strengthening and Qi-promoting method in GH and other nutritional indexes on EN SD rats model after abdominal surgery.Methods: Thirty abdominal surgery SD rats model were randomized divided into three groups: EN group,EN combined with low dosage TCM soup,EN combined with high dosageTCMsoup. The three groups received same volume nutrition, but two Chinese herbal medicine groups received different dosage spleen-strengthening and Qi-promoting soups on the bases of EN. Venous blood was collected to detect the levels of total protein (TP),albumin(Alb),prealbumin (PA),growth hormone (GH) before and after nutrition supporting.Results: The PAand GH were significantly increased in EN combined with TCM soup group compared with EN group (P＜0. 05) ; The changes of other items were not significantly (P＞0. 05).Colusions:Spleen-strengthening and Qi-promoting recipe can improve the level of prealbumin and growth hormone and exert a promoting action on those after abdominal surgery EN rats models. |
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