Published online May 16, 2023. doi: 10.4253/wjge.v15.i5.376
Peer-review started: December 6, 2022
First decision: February 28, 2023
Revised: March 7, 2023
Accepted: April 12, 2023
Article in press: April 12, 2023
Published online: May 16, 2023
Gastroscopy is of great significance in the clinical diagnosis, treatment, follow-up review and other aspects of gastric cancer patients, it can also be used to evaluate patients with reflux esophagitis, esophageal cancer, gastroduodenal ulcer, etc. In clinical practice, painless gastroscopy is a widely accepted examination means. The use of propofol in combination with naborphine painless treatment has become a safer anesthesia regimen commonly used in clinical practice. However, patients with gastric cancer have a poor physique and are often more prone to anesthesia-related adverse reactions and gastrointestinal-related complications during examination. At present, combining other methods to further reduce the impact of examination on gastrointestinal function in gastric cancer patients has become an area of exploration in current research.
In order to explore a new intervention plan to optimize the anesthesia drug plan for painless gastroscopy and reduce the anesthesia related complications and postoperative discomfort of patients during the examination.
Modified ShengYangYiwei decoction is related to Li Dongyuan's theory, which has the effect of replenishing Qi and rising Yang, clearing heat and detoxification, and removing dampness and turbidity. It has gradually achieved fine effects in the field of digestive endoscopy. Therefore, this study observed the treatment interventions of gastric cancer patients and observed the impact on patients' gastrointestinal function, related complications and immune function during and after painless gastroscopy.
A total of 106 gastric cancer patients from January 2022 to September 2022 who were selected for painless gastroscopy in Xiamen Hospital of Traditional Chinese Medicine, were divided into a treatment group (n = 56) and a control group (n = 50) by the random number table method. Before the examination, all patients fasted for 8 h, provided their health education, and confirmed if there were contraindications to anesthesia and gastroscopy. During the examination, for the control group, the protocols followed the Expert Consensus on Sedation and Anesthesia in the Diagnosis and Treatment of Digestive Endoscopy in China. The patients in the treatment group began oral Modified Sheng
There was no difference in the patients’ general information, American Society of Anesthesiologist classification or operation time between the two groups. In terms of painless gastroscopy, the total dosage of propofol in the treatment group was lower than that in the control group (P < 0.05), and the time of awakening and autonomous activity was faster than that in the control group (P < 0.05). During the examination, the incidence of hypoxemia, hypotension and hiccups in the treatment group was lower than that in the control group (P < 0.01). After examination, the incidences of nausea, vomiting, abdominal distension and abdominal pain were lower than those in the control group (P < 0.01). In terms of immune function, in both groups, the number of CD4+ and CD8+ cells decreased significantly (P < 0.05), and the number of natural killer (NK) cells increased (P < 0.05) at T1 and T2, compared with T0. The number of CD4+ and CD8+ cells in the treatment group at the T1 and T2 time points was higher, while the number of NK cells was lower than that in the control group (P < 0.05). In terms of inflammatory factors, the level of IL-6 at T1 and T2 in the treatment group was lower than that in the control group (P < 0.05).
The preoperative use of Modified ShengYangYiwei decoction can optimize the anesthesia program during painless gastroscopy, improve the gastrointestinal function of patients after the operation, reduce the occurrence of examination-related complications.
At present, combining other methods to further reduce the impact of examination on gastrointestinal function in gastric cancer patients has become an area of exploration in current research. The preoperative use of Modified ShengYangYiwei decoction can improve the gastrointestinal function of patients after the operation. This trial showed that the expression levels of IL-6 and TNF-α at T1 and T2 were significantly lower than those in the control group, preventing the excessive inflammatory response in the body, and the potential antitumor effect is also worth further study.