To investigate the effects of modified Huangqi Jianzhong Decoction combined with conventional treatment on intestinal function, intestinal barrier, and immune-inflammatory status in patients after laparoscopic colorectal cancer surgery, and to provide evidence-based support for enhanced recovery.

A total of 96 patients who underwent laparoscopic radical resection for colorectal cancer at Wujin Affiliated Hospital of Nanjing University of Chinese Medicine from February 2022 to March 2025 were randomly divided into an observation group and a control group, with 48 cases in each group. The control group received conventional treatment. On this basis, the observation group was additionally given modified Huangqi Jianzhong Decoction starting from the first day after surgery, one dose per day for 7 consecutive days. Clinical efficacy was compared between the two groups. Traditional Chinese Medicine (TCM) syndrome scores, intestinal barrier function indicators (diamine oxidase [DAO], D-lactic acid [D-Lac], intestinal fatty acid-binding protein [IFABP]), immune-inflammatory indicators (CD4⁺/CD8⁺ ratio, natural killer [NK] cell activity, regulatory T cells [Treg], IL-10/IL-6 ratio), and the Gastrointestinal Symptom Rating Scale (GSRS) scores were compared before surgery and 7 days after surgery. Postoperative complications and adverse events were also recorded.

On postoperative day 7, the total effective rate in the observation group was 95.83% (46/48), which was significantly higher than that in the control group (72.92%, 35/48) (P<0.01). Compared with postoperative day 1, the levels of DAO, D-Lac, and IFABP in both groups decreased on postoperative day 7 (P<0.05), and the levels in the observation group were significantly lower than those in the control group (P<0.05). The CD4⁺/CD8⁺ ratio, NK cell activity, Treg percentage, and IL-10/IL-6 ratio increased significantly in both groups (P<0.05), with the observation group showing significantly higher values than the control group (P<0.05). The scores for abdominal pain, abdominal distension, difficulty in passing flatus, nausea/reflux, and defecation disorder in the observation group were significantly lower than those in the control group (P<0.01). In the control group, one patient experienced postoperative nausea and dizziness, and one patient developed pruritic erythema; in the observation group, one patient experienced nausea and decreased appetite. There was no significant difference in adverse events between the two groups (P>0.05). The incidence of complications in the observation group was 6.25% (3/48), which was significantly lower than that in the control group (20.83%, 10/48) (P<0.05).

Adding modified Huangqi Jianzhong Decoction to conventional treatment can significantly improve intestinal barrier function, immune-inflammatory balance, and gastrointestinal symptoms in patients after laparoscopic colorectal cancer surgery, and reduce the incidence of complications, with a favorable safety profile.