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Article(id=1322923837221908934, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.06.034, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339221530, onlineDateStr=2026-10-30, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339221530, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339221530, creator=13701087609, updateTime=1793339221530, updator=13701087609, issue=Issue{id=1322923782029062261, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='6', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1749484800000', pubDateStr='2025-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339208371, creator='13701087609', updateTime=1793340556755, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929437859258468, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929437859258469, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=172, endPage=175, ext={EN=ArticleExt(id=1322923838912213448, articleId=1322923837221908934, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Application of Shenqi Fuzheng Injection（参芪扶正注射液）in Laparoscopic Radical Resection of Rectal Cancer in Elderly Patients with Qi Deficiency and Its Anesthetic Recovery Effect, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To observe the application of Shenqi Fuzheng Injection（参芪扶正注射液）in laparoscopic radical resection of rectal cancer in elderly patients with Qi deficiency and its effect on anesthesia recovery.

Methods

A total of 68 elderly patients with Qi deficiency who underwent laparoscopic radical resection of rectal cancer from January 2021 to December 2022 were selected as the research objects.According to the random number table method，they were divided into two groups，34 cases in each group.The control group underwent laparoscopic radical resection of rectal cancer under general anesthesia.The observation group was given intravenous infusion of Shenqi Fuzheng Injection（250 mL）30 min before the end of the operation，and other operations were the same as that in the control group.The postoperative vital signs，recovery time，pain，immune function and adverse reactions of the two groups were observed.Vital signs included blood pressure and heart rate，recovery time indicators included wake-up recovery time，anal exhaust time，liquid food intake time and defecation time were observed.Pain indicators included visual analogue scale（VAS）scores at 12，24 and 48 hours after surgery.Immune function indicators included peripheral blood lymphocyte subsets（CD+4，CD+4/CD+8）and natural killer（NK）cells.

Results

There was no significant difference in diastolic blood pressure，systolic blood pressure or heart rate between the two groups before operation（P>0.05）.There was no significant difference in diastolic blood pressure，systolic blood pressure or heart rate between the two groups on the first day after operation（P>0.05）.The recovery time，anal exhaust time，feeding time and defecation time of the observation group were shorter than those of the control group，and the differences were statistically significant（P<0.05）.The VASscores of the observation group at 12，24 and 48 h after operation were significantly lower than those of the control group（P<0.05）.There was no significant difference in the levels of CD+4，CD+4/CD+8 or NK between the two groups before operation（P<0.05）.The levels of CD+4，CD+4/CD+8 and NK in the observation group were significantly higher than those in the control group（P<0.05）.The incidence of adverse reactions in the observation group and the control group was 8.82%（3/34）and 14.71%（5/34），respectively and the difference was not statistically significant（P>0.05）.

Conclusion

The application of Shenqi Fuzheng Injection in laparoscopic radical resection of rectal cancer in elderly patients with Qi deficiency is satisfactory.It can promote the recovery of anesthesia，reduce the degree of postoperative pain，improve the immune function of the body，and facilitate the postoperative rehabilitation of patients.

, authors=Lianzhong LIU, Jinlan XIE, Jingxia LIANG, authorsList=Lianzhong LIU, Jinlan XIE, Jingxia LIANG, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322923840749318620, articleId=1322923837221908934, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=参芪扶正注射液对老年气虚患者行腹腔镜下直肠癌根治术的麻醉复苏及镇痛效果评价, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

观察参芪扶正注射液对老年气虚患者行腹腔镜下直肠癌根治术的麻醉复苏及镇痛效果。

方法

以2021年1月—2022年12月行腹腔镜下直肠癌根治术的老年气虚患者68例作为研究对象，根据随机数字表法均分为两组，各34例，对照组常规行全身麻醉腹腔镜下直肠癌根治术，观察组手术结束前30 min静脉滴注参芪扶正注射液250 mL，其他操作同对照组，两组术后生命体征、恢复时间、疼痛、免疫功能及不良反应情况，生命体征指标包括血压、心率，恢复时间指标包括术毕唤醒恢复时间、肛门排气时间、进流食时间、排便时间，疼痛指标包括术后12、24、48 h视觉模拟评分法（visual analogue scale，VAS）评分，免疫功能指标包括外周血淋巴细胞亚群（cluster of differentiation，CD）、CD4+/CD8+、自然杀伤（natural killer cell，NK）细胞水平。

结果

术前两组患者舒张压、收缩压、心率差异无统计学意义（P>0.05），术后1 d两组患者舒张压、收缩压、心率差异无统计学意义（P>0.05）。观察组唤醒恢复时间、肛门排气时间、进流食时间、排便时间均短于对照组，差异有统计学意义（P<0.05）。观察组术后12、24、48 h VAS评分均显著低于对照组（P<0.05）。术前两组CD4+、CD4+/CD8+、NK水平差异无统计学意义（P<0.05），术后3 d观察组CD4+、CD4+/CD8+、NK水平明显高于对照组（P<0.05）。观察组、对照组不良反应发生率分别为8.82%（3/34）、14.71%（5/34），差异无统计学意义（P>0.05）。

结论

参芪扶正注射液在老年气虚患者行腹腔镜下直肠癌根治术中的应用效果满意，能够促进麻醉恢复，降低术后疼痛程度，改善机体免疫功能，利于患者的术后康复。

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刘连忠（1968-），男，山东莱芜人，副主任医师，学士，研究方向：临床麻醉。

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刘连忠（1968-），男，山东莱芜人，副主任医师，学士，研究方向：临床麻醉。

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刘连忠（1968-），男，山东莱芜人，副主任医师，学士，研究方向：临床麻醉。

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People’s Hospital，Jinan 271100，Shandong，China), AuthorCompanyExt(id=1322923840996782560, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923837221908934, companyId=1322923840975811038, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=济南市人民医院，山东 济南 271100)])], figs=[ArticleFig(id=1322923845753123337, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923837221908934, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数男/女年龄/（岁）身体质量指数（kg/m2）/Dukes病理分期/（例）
A期B期C期
观察组3420/1462.3±4.522.4±2.011176
对照组3421/1361.9±5.122.1±1.813165
χ2/t值0.0610.3440.6500.288
P值0.8040.7330.5180.866
), ArticleFig(id=1322923845811843595, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923837221908934, language=CN, label=表1, caption=

两组行腹腔镜下直肠癌根治术的老年气虚患者一般资料比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数男/女年龄/（岁）身体质量指数（kg/m2）/Dukes病理分期/（例）
A期B期C期
观察组3420/1462.3±4.522.4±2.011176
对照组3421/1361.9±5.122.1±1.813165
χ2/t值0.0610.3440.6500.288
P值0.8040.7330.5180.866
), ArticleFig(id=1322923845878952460, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923837221908934, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间舒张压/（mm Hg）收缩压/（mm Hg）心率/（次/min）
观察组34术前84.51±4.90104.72±9.8173.48±5.22
术后1 d83.74±5.03102.57±8.1672.09±4.96
t值0.6390.9831.126
P值0.5250.3300.264
对照组34术前83.97±4.63105.07±8.4274.01±5.70
术后1 d82.85±5.40103.92±7.2572.29±4.83
t值0.9180.6041.342
P值0.3620.5480.184
两组术前比较t值0.4670.1580.400
P值0.6420.8750.691
两组术后1 d比较t值0.7030.7210.168
P值0.4840.4730.867
), ArticleFig(id=1322923845950255629, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923837221908934, language=CN, label=表2, caption=

两组行腹腔镜下直肠癌根治术的老年气虚患者生命体征情况比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间舒张压/（mm Hg）收缩压/（mm Hg）心率/（次/min）
观察组34术前84.51±4.90104.72±9.8173.48±5.22
术后1 d83.74±5.03102.57±8.1672.09±4.96
t值0.6390.9831.126
P值0.5250.3300.264
对照组34术前83.97±4.63105.07±8.4274.01±5.70
术后1 d82.85±5.40103.92±7.2572.29±4.83
t值0.9180.6041.342
P值0.3620.5480.184
两组术前比较t值0.4670.1580.400
P值0.6420.8750.691
两组术后1 d比较t值0.7030.7210.168
P值0.4840.4730.867
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组别例数唤醒恢复时间/（min）肛门排气时间/（d）进流食质时间/（d）排便时间/（d）
观察组3414.37±3.092.03±0.641.49±0.463.92±0.94
对照组3416.98±4.362.95±0.521.68±0.294.76±0.87
t值2.8486.5052.0373.824
P值0.006<0.0010.046<0.001
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两组行腹腔镜下直肠癌根治术的老年气虚患者恢复时间比较（±s）

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组别例数唤醒恢复时间/（min）肛门排气时间/（d）进流食质时间/（d）排便时间/（d）
观察组3414.37±3.092.03±0.641.49±0.463.92±0.94
对照组3416.98±4.362.95±0.521.68±0.294.76±0.87
t值2.8486.5052.0373.824
P值0.006<0.0010.046<0.001
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组别例数术后12 h术后24 h术后48 h
观察组343.71±0.984.05±1.203.28±0.85
对照组344.50±1.144.97±1.363.91±0.48
t值3.0642.9583.763
P值0.0030.004<0.001
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两组行腹腔镜下直肠癌根治术的老年气虚患者术后12、24、48 h VAS评分比较（±s）

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组别例数术后12 h术后24 h术后48 h
观察组343.71±0.984.05±1.203.28±0.85
对照组344.50±1.144.97±1.363.91±0.48
t值3.0642.9583.763
P值0.0030.004<0.001
), ArticleFig(id=1322923847929967123, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923837221908934, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间 NK
观察组34术前28.18±2.7912.79±2.3811.49±1.31
术后3 d35.64±3.1020.36±2.9716.19±1.76
t值10.43011.59812.491
P值<0.001<0.001<0.001
对照组34术前27.91±2.9013.08±3.0110.94±1.43
术后3 d32.31±3.0517.20±2.7413.87±1.55
t值6.0965.9028.419
P值<0.001<0.001<0.001
两组术前比较t值0.3910.4411.731
P值0.6970.6610.088
两组术后3 dt值4.4654.5605.768
比较P值<0.001<0.001<0.001
), ArticleFig(id=1322923848018047508, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923837221908934, language=CN, label=表5, caption=

两组行腹腔镜下直肠癌根治术的老年气虚患者免疫功能指标比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间 NK
观察组34术前28.18±2.7912.79±2.3811.49±1.31
术后3 d35.64±3.1020.36±2.9716.19±1.76
t值10.43011.59812.491
P值<0.001<0.001<0.001
对照组34术前27.91±2.9013.08±3.0110.94±1.43
术后3 d32.31±3.0517.20±2.7413.87±1.55
t值6.0965.9028.419
P值<0.001<0.001<0.001
两组术前比较t值0.3910.4411.731
P值0.6970.6610.088
两组术后3 dt值4.4654.5605.768
比较P值<0.001<0.001<0.001
), ArticleFig(id=1322923848101933590, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923837221908934, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数皮疹寒战恶心呕吐胸闷合计
观察组341（2.94）0（0.00）1（2.94）1（2.94）3（8.82）
对照组341（2.94）1（2.94）2（5.88）1（2.94）5（14.71）
χ2值0.142
P值0.707
), ArticleFig(id=1322923848185819671, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923837221908934, language=CN, label=表6, caption=

两组行腹腔镜下直肠癌根治术的老年气虚患者不良反应发生情况比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数皮疹寒战恶心呕吐胸闷合计
观察组341（2.94）0（0.00）1（2.94）1（2.94）3（8.82）
对照组341（2.94）1（2.94）2（5.88）1（2.94）5（14.71）
χ2值0.142
P值0.707
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参芪扶正注射液对老年气虚患者行腹腔镜下直肠癌根治术的麻醉复苏及镇痛效果评价
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刘连忠 , 谢金兰 , 梁京霞
中华中医药学刊 | 国家项目点击 2025,43(6): 172-175
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中华中医药学刊 |国家项目点击 2025 , 43 (6) : 172 -175
参芪扶正注射液对老年气虚患者行腹腔镜下直肠癌根治术的麻醉复苏及镇痛效果评价
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[Author(id=1322923841068085730, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923837221908934, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1322923841135194597, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923837221908934, authorId=1322923841068085730, language=EN, stringName=Lianzhong LIU, firstName=Lianzhong, middleName=null, lastName=LIU, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Jinan People’s Hospital，Jinan 271100，Shandong，China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322923841206497766, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923837221908934, authorId=1322923841068085730, language=CN, stringName=刘连忠, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=济南市人民医院，山东 济南 271100, bio={"content":"

刘连忠（1968-），男，山东莱芜人，副主任医师，学士，研究方向：临床麻醉。

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刘连忠（1968-），男，山东莱芜人，副主任医师，学士，研究方向：临床麻醉。

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刘连忠, 谢金兰, 梁京霞
作者信息
  • 济南市人民医院，山东 济南 271100
作者简介:

刘连忠（1968-），男，山东莱芜人，副主任医师，学士，研究方向：临床麻醉。

Application of Shenqi Fuzheng Injection（参芪扶正注射液）in Laparoscopic Radical Resection of Rectal Cancer in Elderly Patients with Qi Deficiency and Its Anesthetic Recovery Effect
Lianzhong LIU, Jinlan XIE, Jingxia LIANG
Affiliations
  • Jinan People’s Hospital，Jinan 271100，Shandong，China
出版时间: 2025-06-10 doi: 10.13193/j.issn.1673-7717.2025.06.034
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摘要
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目的

观察参芪扶正注射液对老年气虚患者行腹腔镜下直肠癌根治术的麻醉复苏及镇痛效果。

方法

以2021年1月—2022年12月行腹腔镜下直肠癌根治术的老年气虚患者68例作为研究对象，根据随机数字表法均分为两组，各34例，对照组常规行全身麻醉腹腔镜下直肠癌根治术，观察组手术结束前30 min静脉滴注参芪扶正注射液250 mL，其他操作同对照组，两组术后生命体征、恢复时间、疼痛、免疫功能及不良反应情况，生命体征指标包括血压、心率，恢复时间指标包括术毕唤醒恢复时间、肛门排气时间、进流食时间、排便时间，疼痛指标包括术后12、24、48 h视觉模拟评分法（visual analogue scale，VAS）评分，免疫功能指标包括外周血淋巴细胞亚群（cluster of differentiation，CD）、CD4+/CD8+、自然杀伤（natural killer cell，NK）细胞水平。

结果

术前两组患者舒张压、收缩压、心率差异无统计学意义（P>0.05），术后1 d两组患者舒张压、收缩压、心率差异无统计学意义（P>0.05）。观察组唤醒恢复时间、肛门排气时间、进流食时间、排便时间均短于对照组，差异有统计学意义（P<0.05）。观察组术后12、24、48 h VAS评分均显著低于对照组（P<0.05）。术前两组CD4+、CD4+/CD8+、NK水平差异无统计学意义（P<0.05），术后3 d观察组CD4+、CD4+/CD8+、NK水平明显高于对照组（P<0.05）。观察组、对照组不良反应发生率分别为8.82%（3/34）、14.71%（5/34），差异无统计学意义（P>0.05）。

结论

参芪扶正注射液在老年气虚患者行腹腔镜下直肠癌根治术中的应用效果满意，能够促进麻醉恢复，降低术后疼痛程度，改善机体免疫功能，利于患者的术后康复。

直肠癌  /  腹腔镜  /  根治术  /  老年  /  气虚  /  参芪扶正注射液  /  根治术  /  麻醉
Objective

To observe the application of Shenqi Fuzheng Injection（参芪扶正注射液）in laparoscopic radical resection of rectal cancer in elderly patients with Qi deficiency and its effect on anesthesia recovery.

Methods

A total of 68 elderly patients with Qi deficiency who underwent laparoscopic radical resection of rectal cancer from January 2021 to December 2022 were selected as the research objects.According to the random number table method，they were divided into two groups，34 cases in each group.The control group underwent laparoscopic radical resection of rectal cancer under general anesthesia.The observation group was given intravenous infusion of Shenqi Fuzheng Injection（250 mL）30 min before the end of the operation，and other operations were the same as that in the control group.The postoperative vital signs，recovery time，pain，immune function and adverse reactions of the two groups were observed.Vital signs included blood pressure and heart rate，recovery time indicators included wake-up recovery time，anal exhaust time，liquid food intake time and defecation time were observed.Pain indicators included visual analogue scale（VAS）scores at 12，24 and 48 hours after surgery.Immune function indicators included peripheral blood lymphocyte subsets（CD+4，CD+4/CD+8）and natural killer（NK）cells.

Results

There was no significant difference in diastolic blood pressure，systolic blood pressure or heart rate between the two groups before operation（P>0.05）.There was no significant difference in diastolic blood pressure，systolic blood pressure or heart rate between the two groups on the first day after operation（P>0.05）.The recovery time，anal exhaust time，feeding time and defecation time of the observation group were shorter than those of the control group，and the differences were statistically significant（P<0.05）.The VASscores of the observation group at 12，24 and 48 h after operation were significantly lower than those of the control group（P<0.05）.There was no significant difference in the levels of CD+4，CD+4/CD+8 or NK between the two groups before operation（P<0.05）.The levels of CD+4，CD+4/CD+8 and NK in the observation group were significantly higher than those in the control group（P<0.05）.The incidence of adverse reactions in the observation group and the control group was 8.82%（3/34）and 14.71%（5/34），respectively and the difference was not statistically significant（P>0.05）.

Conclusion

The application of Shenqi Fuzheng Injection in laparoscopic radical resection of rectal cancer in elderly patients with Qi deficiency is satisfactory.It can promote the recovery of anesthesia，reduce the degree of postoperative pain，improve the immune function of the body，and facilitate the postoperative rehabilitation of patients.

rectal cancer  /  laparoscopy  /  radical surgery  /  old age  /  Qi deficiency  /  Shenqi Fuzheng Injection（参芪扶正注射液）  /  radical surgery  /  anesthesia
刘连忠, 谢金兰, 梁京霞. 参芪扶正注射液对老年气虚患者行腹腔镜下直肠癌根治术的麻醉复苏及镇痛效果评价. 中华中医药学刊, 2025 , 43 (6) : 172 -175 . DOI: 10.13193/j.issn.1673-7717.2025.06.034
Lianzhong LIU, Jinlan XIE, Jingxia LIANG. Application of Shenqi Fuzheng Injection（参芪扶正注射液）in Laparoscopic Radical Resection of Rectal Cancer in Elderly Patients with Qi Deficiency and Its Anesthetic Recovery Effect[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (6) : 172 -175 . DOI: 10.13193/j.issn.1673-7717.2025.06.034
正文
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据报道我国消化道恶性肿瘤的发病率及病死率逐年升高，直肠癌是消化道恶性肿瘤的重要组成部分，严重危害患者身心健康，而且随着经济高速发展，人们生活方式逐渐西方化，中晚期直肠癌患者占比也逐渐升高[1]。对于直肠癌患者，以手术为主的综合治疗是直肠癌主要治疗方法之一，随着微创治疗技术与理念的发展，腹腔镜下直肠癌手术成为主要手术方案[2-3]。患者在麻醉和手术过程中丢失津血导致气血亏虚，不利于麻醉苏醒和术后康复，尤其老年患者，受其年龄条件的限制本来机体状况不如青壮年人，多存在气虚，再加之疾病的危害、麻醉及手术的刺激和损伤，其术后恢复更值得关注[4-5]。本研究观察参芪扶正注射液对老年气虚患者行腹腔镜下直肠癌根治术的麻醉复苏及镇痛效果，现将相关病例资料总结报道如下。
1　资料与方法
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1.1　一般资料
将2021年1月—2022年12月行腹腔镜下直肠癌根治术的老年气虚患者68例作为研究对象，纳入标准：①均由病理学检查结果确诊直肠癌；②符合《中药新药临床研究指导原则》[6]中气虚证诊断标准；③符合腹腔镜下根治术适应证；④美国麻醉医师协会（American Society of Anesthesiologists，ASA）分级Ⅰ～Ⅲ级；排除标准：①严重心肝肾功能不全患者；②凝血系统异常患者；③伴发消化道大出血患者。所有患者根据随机数字表法均分为两组各34例，两组患者的性别、年龄、身体质量指数、Dukes分期差异均无统计学意义（P>0.05），具有均衡可比性，见表1。所有患者和/或其家属知情同意研究内容，此次研究经单位医学伦理委员会审核批准进行。
1.2　方法
对照组行全身麻醉腹腔镜下直肠癌根治术，患者常规监测，丙泊酚0.5～2 mg/kg、芬太尼3～4μg/kg、维库溴胺0.1～1 mg/kg进行麻醉诱导，做好气管内插管，潮气量8～10 mL/kg、呼吸频率12次/min，建立气腹后调节呼吸参数，术中吸入异氟醚维持麻醉，根据麻醉需求可间断给予维库溴铵，常规进行手术操作，术中滴注林格氏液及130/0.5羟乙基淀粉溶液维持患者心率、血压稳定。观察组在以上基础上于手术结束前30 min静脉滴注参芪扶正注射液（丽珠集团丽珠制药厂，批准文号：国药准字Z19990065）250 mL，20 min左右滴完，手术结束观察患者复苏效果。
1.3　观察项目
①生命体征，观察并记录术前、术后1 d两组患者舒张压、收缩压、心率。②恢复时间，记录两组患者的术后唤醒恢复时间、肛门排气时间、进流食时间、排便时间。③疼痛情况，术后12、24、48 h采用视觉模拟评分法（visual analogue scale，VAS）评估，以0～10分表示无痛到剧痛，分值越高表示疼痛越严重。④免疫功能，于术前、术后3 d取患者肘静脉血3 mL进行离心处理，全自动细胞分析仪检测外周血T淋巴细胞亚群（cluster of differentiation，CD）、CD+4/CD+8、自然杀伤细胞（natural killer cell，NK）水平并如实记录。⑤不良反应，包括皮疹、寒战、恶心呕吐、胸闷等，不良反应发生率＝（皮疹+寒战+恶心呕吐+胸闷）例数/总例数×100%。
1.4　统计学分析
数据资料借助SPSS 23.0软件包进行统计学分析，计数资料以例（%）表示，采用χ2检验或秩和检验，计量资料正态分布，以均数±标准差（）表示、采用t检验，若P<0.05表示差异有统计学意义。
2　结果
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2.1　两组生命体征情况比较
术前两组患者舒张压、收缩压、心率差异无统计学意义（P>0.05），术后1 d两组患者舒张压、收缩压、心率差异无统计学意义（P>0.05）。见表2。
2.2　两组恢复时间比较
观察组唤醒恢复时间、肛门排气时间、进流食时间、排便时间均短于对照组，差异有统计学意义（P<0.05）。见表3。
2.3　两组疼痛情况比较
观察组术后12、24、48 h VAS评分均显著低于对照组，两组比较，差异均有统计学意义（P<0.05）。见表4。
2.4　两组免疫功能比较
术前两组CD4+、CD4+/CD8+、NK水平差异无统计学意义（P<0.05），术后3 d观察组CD4+、CD4+/CD8+、NK水平明显高于对照组，两组比较差异均有统计学意义（P<0.05）。见表5。
2.5　两组不良反应发生情况
观察组、对照组不良反应发生率分别为8.82%、14.71%，差异无统计学意义（P>0.05）。见表6。
3　讨论
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直肠癌属中医学的“脏毒便血”“肠蕈”“癥瘕”“锁肛痔”“便血”“下痢”“肠癖”等范畴，主要是由于正虚感邪，内伤饮食以及情志失调所引起，以湿热、瘀毒蕴结于肠道，传导失司为基本病机[7-8]。手术是重要的治疗手段之一，能直接切除病灶，短期内使病情得到有效控制，但手术也有一定的弊端，麻醉和手术操作过程中均会对患者机体产生损伤，导致患者免疫功能下降，不利于麻醉复苏和术后康复[9]。中医可以作为一种辅助治疗手段，在直肠癌手术治疗中发挥减毒增效、调整免疫、增强体力的作用[10-11]。
老年人脏腑功能减退，气的生化不足，气虚成了生理常态，老年直肠癌患者还存在各器官功能衰退，并且进行腹腔镜手术治疗术前需要禁食、灌肠等，容易气血不足，而腹腔镜手术过程中麻醉因素会阻抑气机的升降出入，手术创伤因素会耗气伤血，以上共同作用于患者机体导致内环境紊乱并影响气血津液的生成，患者可能发生术后苏醒延迟[12]。本研究中观察组手术结束前30 min静脉滴注参芪扶正注射液250 mL，能够促进患者麻醉复苏，利于术后康复。而且研究中生命体征血压、心率的情况以及不良反应数据说明了用药的安全性。中医认为气为血之帅，血为气之母，两者可以互相转化为用，强调各个脏器之间是互相联系的，需要帮助患者达到人体阴阳、气血津液、五脏六腑的动态平衡[13-14]。参芪扶正注射液的主要成分是党参、黄芪，具有益气、扶正的作用。党参是我国传统的药食两用补益类药物，具有生津止渴、降血压、养血、补中益气作用[15]。现代药理学研究证实党参的化学成分主要为生物碱、黄酮类、糖类、萜类等，对人体神经、内分泌、免疫、消化等系统均有一定作用，具有免疫调节、改善胃溃疡、抗炎、抗氧化、调节糖脂代谢及抗肿瘤等多种药理作用[15-16]。黄芪味甘而微温，归肺脾两经，具有补气升阳、益气固表、利水消肿、行滞通痹、脱毒排脓、敛疮生肌等功效。近年来随着实验技术的发展，发现黄芪中的多糖类、皂苷类、黄酮类、氨基酸类、生物碱类等多种成分在抗肿瘤、保护心脑血管、提高机体免疫功能、保护呼吸功能、保护代谢组织、抗衰老等方面具有可靠功效[17-19]。观察组患者麻醉复苏及胃肠功能恢复时间缩短考虑与参芪扶正注射液的有效成分能促进心脑肾及胃肠道等器官血流灌注有关[20-22]。参芪扶正注射液益气健脾，可增加患者的中气，增加患者的细胞免疫功能[23-26]，本研究中体现在免疫指标CD+4、CD+4/CD+8、NK水平的改善方面，这也保证了老年患者行腹腔镜下直肠癌根治术的顺利复苏和机体恢复。
综上所述，参芪扶正注射液在老年气虚患者行腹腔镜下直肠癌根治术的应用效果满意，能够促进麻醉恢复，降低术后疼痛程度，改善机体免疫功能，利于患者的术后康复。
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  • 国家中医药管理局中医药行业科研项目(201908003)
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参考文献 引证文献
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2025年第43卷第6期
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doi: 10.13193/j.issn.1673-7717.2025.06.034
  • 首发时间：2026-10-30
  • 出版时间：2025-06-10
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国家中医药管理局中医药行业科研项目(201908003)
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    济南市人民医院，山东 济南 271100
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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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