Modified Pingwei Baohe decoction improves postoperative recovery in gastric cancer patients

doi:10.4240/wjgs.v17.i12.113364

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Randomized Clinical Trial

World J Gastrointest Surg. Dec 27, 2025; 17(12): 113364
Published online Dec 27, 2025. doi: 10.4240/wjgs.v17.i12.113364

Modified Pingwei Baohe decoction improves postoperative recovery in gastric cancer patients

Hong-Yu Ma, Yuan-Wu Chen, Xin Liu, Ming-Ming Zhang, Bi-Bo Tan

Hong-Yu Ma, Yuan-Wu Chen, Department of Traditional Chinese Medicine Rehabilitation, Hebei General Hospital, Shijiazhuang 050011, Hebei Province, China

Xin Liu, Graduate School, Hebei Medical University, Shijiazhuang 050011, Hebei Province, China

Xin Liu, Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang 050011, Hebei Province, China

Ming-Ming Zhang, Clinical Medicine Research Center, Hebei General Hospital, Shijiazhuang 050011, Hebei Province, China

Bi-Bo Tan, Third Department of General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China

Author contributions: Conceptualization and study design were performed by Ma HY; patient recruitment, clinical implementation, and data collection were carried out by Ma HY, Chen YW, and Tan BB; laboratory testing and data analysis were conducted by Liu X and Zhang MM; the original draft of the manuscript was written by Ma HY and critically revised by Chen YW and Tan BB; all authors reviewed and approved the final version of the manuscript.

Supported by Research Program of the Hebei Provincial Administration of Traditional Chinese Medicine, No. 2025271.

Institutional review board statement: This study was conducted in accordance with the Declaration of Helsinki and was reviewed and approved by the Medical Ethics Committee of Hebei Provincial People’s Hospital and The Fourth Hospital of Hebei Medical University. All procedures involving human participants were performed only after ethical approval was obtained.

Clinical trial registration statement: This study is an exploratory clinical investigation and was not prospectively registered on a public clinical trial platform.

Informed consent statement: Written informed consent was obtained from all individual participants and their family members included in the study. Patients were fully informed about the study’s purpose, procedures, potential risks, and benefits, and they participated voluntarily.

Conflict-of-interest statement: The authors declare that they have no competing interests or financial relationships that could inappropriately influence or bias the work reported in this manuscript.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request, in accordance with ethical standards and participant confidentiality protections.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Hong-Yu Ma, MD, Department of Traditional Chinese Medicine Rehabilitation, Hebei General Hospital, No. 348 Heping West Road, Shijiazhuang 050011, Hebei Province, China. 505992294@qq.com

Received: August 26, 2025
Revised: September 24, 2025
Accepted: October 28, 2025
Published online: December 27, 2025
Processing time: 120 Days and 17.8 Hours

Abstract

BACKGROUND

Gastric cancer is a major global health issue, especially in East Asia. Radical gastrectomy, the primary treatment, often leads to complications like malnutrition and infection, impairing recovery. Traditional Chinese medicine may offer benefits in regulating gastrointestinal function and immunity. This study investigated the effects of a modified Pingwei Baohe decoction (MPBD) on postoperative immune function and nutritional status in gastric cancer patients.

AIM

To explore the influence of MPBD on the postoperative immune function and nutritional status of patients with gastric cancer.

METHODS

A total of 55 gastric cancer patients who underwent radical proximal gastrectomy in Hebei Provincial People's Hospital and The Fourth Hospital of Hebei Medical University from June 2023 to June 2025 were selected as the research objects and divided into the observation group (28 cases, receiving chemotherapy plus MPBD) and the control group (27 cases, receiving chemotherapy alone) at a ratio of 1:1 according to the random number table method. Inflammatory indicators, immune function, nutritional status, and gastrointestinal function recovery time were compared before and 28 days after intervention.

RESULTS

After 28 days, the observation group showed significantly lower levels of inflammatory markers (IL-6, IL-4, IL-2, IL-17A, IFN-γ, TNF-α, IL-10), neutrophil-to-lymphocyte ratio (NLR), and proportion of CONUT score > 2, alongside significantly higher levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺ ratio, absolute lymphocyte count (ALC), lymphocyte percentage (LYM%), and TNF-α/IL-4 ratio compared to the control group (P < 0.05). In both groups, post-intervention levels of the aforementioned inflammatory markers, NLR, and proportion of CONUT score > 2 were significantly lower than baseline, while the immune parameters (CD3⁺, CD4⁺, CD4⁺/CD8⁺ ratio, ALC, LYM%, TNF-α/IL-4 ratio) were significantly higher (P < 0.05). Additionally, gastrointestinal function recovery times (first flatus, bowel sounds recovery, abdominal distension relief) in the observation group were significantly shorter than in the control group (P < 0.05).

CONCLUSION

MPBD significantly enhances postoperative immune function, mitigates inflammatory responses, improves nutritional status, and accelerates gastrointestinal function recovery in gastric cancer patients.

Keywords: Pingwei Baohe decoction; modified; Gastric cancer; Immune function; Nutritional status; Inflammatory response; Gastrointestinal function; Integrated traditional Chinese and Western medicine therapy

Core Tip: This randomized clinical trial demonstrates that adjunctive modified Pingwei Baohe decoction (MPBD), a traditional Chinese medicine formulation, significantly improves postoperative outcomes in gastric cancer patients. Compared to chemotherapy alone, MPBD combined with chemotherapy enhanced immune function (increased CD3⁺, CD4⁺, CD4⁺/CD8⁺ ratio), reduced inflammatory cytokines (IL-6, TNF-α), improved nutritional status (lower CONUT score), and accelerated recovery of gastrointestinal function (shorter time to first flatus and bowel sounds). MPBD represents a promising integrative therapy to support recovery after radical gastrectomy.