| Objective:To observe therapeutic effect and explore possible mechanism of magnesium isoglycyrrhizinate on preventing chemical peritonitis and other side effects caused by intraperitoneal chemotherapy with sustained-release fluorouracil for implant in gastric cancer surgery, provide experimental and theoretical basis on collaborative treating of tumor with traditional Chinese medicine.Methods:60 cases operated and diagnosed with advanced gastric cancer were divided into A, B and C groups according to chronological admission,20 patients in each group. A group is given intraoperative intraperitoneal chemotherapy with sustained-release fluorouracil for implant and dripped magnesium isoglycyrrhizinate about a week after surgery.For B group, only is received intraoperative intraperitoneal chemotherapy with sustained-release fluorouracil for implant.In C group, neither is adopted intraperitoneal chemotherapy with sustained-release fluorouracil for implant and not dripped magnesium isoglycyrrhizinate after surgery. Observe three groups of celiac infection and anastomotic leakage, postoperative fever and duration, gastrointestinal reaction,the time of anus exhaust,quantity of celiac drainage fluid;test the change in content of protein and the count of white blood cell in peritoneal drainage fluid and the content of tumor necrosis factorα,interleukin-1,prostaglandin E2 in serum in 1,3 and 5 days after operation and the changes of liver and kidney function,routine blood in 7 and 21 days after surgery.Results:1. Three groups of patients all do not appear celiac infection and anastomotic leakage;the patients in B group on duration of fever, the incidence of gastrointestinal reactions, time of anus exhaust and peritoneal fluid drainage are significantly prolonged or increased than these in A and C groups (P<0.05), but there is no significant difference in A and C groups (P>0.05).2.The changes of content on protein in the peritoneal fluid drainage:there are no obvious difference in content of protein in the peritoneal fluid drainage in land 3 days after surgery among three groups(P>0.05).In 5 day, the content of protein in the peritoneal fluid drainage in group B are significantly increased than it in A and C groups (P<0.01),but A and C groups have no obvious difference (P>0.05).3.The changes of count on White blood cell in the peritoneal fluiddrainage:In 1 days after surgery among three groups, there are no obvious differenceabout the count of White blood cell in the peritoneal fluid drainage (P>0.05). In 3 and 5 days, the count of White blood cell in group B are significantly increased than it in A and C groups (P<0.05), but have no obvious difference in A and C groups (P>0.05).4.The changes of content on TNF-a in serum: there are no significant difference about TNF-a in serum in 1 and 3 days after surgery among three groups(P>0.05),but in 5 days, the serum concentrations of TNF-a in group B are obvious increased than it in A and C groups(P<0.05), but there are no statistically significant difference in A and C groups(P>0.05).5.The changes of content on IL-1 in serum:there are no significant difference about IL-1 in serum in land 3 days after surgery among three groups(P>0.05).In 5 days, compared with the C group,the serum content of IL-1 in A and B groups are significantly increased (P<0.01), but there have no obvious difference in A and B groups (P>0.05).6.The changes of content on PGE2 in serum:there are no significant difference about PGE2 in serum in 1 days after surgery among three groups(P>0.05). In 3 and 5 days after surgery, the serum concentrations of PGE2 in group B are obvious increased than it in A and C groups (P<0.01), but there have no obvious difference in A and C groups (P>0.05).7.It have no obvious difference about changes of liver and kidney function and routine blood in 7and 21 days after operation among three groups (P>0.05).Conclusions:1.The main side effects about intraperitoneal chemotherapy with sustained- release fluorouracil for implant in gastric cancer surgery are chemical irritant peritonitis.2. Magnesium isoglycyrrhizinate can reduce chemical peritonitis and other side effects caused by intraperitoneal chemotherapy with sustained-release fluorouracil forimplant.3.The mechanism of anti-inflammatory effects about magnesium isoglycyrrhizinate may inhibit the inflammatory mediators TNF-a and PGE2 express and release. |
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