结直肠癌患者肠道菌群特点及对手术和化疗的影响  

Characterization of Intestinal Flora in Patients with Colorectal Cancer and Its Therapeutic Effect of Postsurgery and Chemotherapy

作　　者：平贯芳 熊万成 贺德栋[1] 赫鹏[1] PING Guan fang;XIONG Wan cheng;HE De dong;HE Peng(First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453003,China)

机构地区：[1]新乡医学院第一附属医院,河南新乡453100

出　　处：《河南科技大学学报（医学版）》2017年第4期278-281,共4页Journal of Henan University of Science & Technology:Medical Science

基　　金：河南省高等学校重点科研项目(17A310022)

摘　　要：目的探讨结直肠癌患者肠道菌群的特点,并观察其对结直肠癌手术后和保守化疗的临床治疗效果的影响。方法采用前瞻性病例对照分析,选取经病理学证实的结直肠癌患者136例,其中手术治疗者82例,随机分为A组、B组;保守治疗者54例,随机分为C组、D组。同期经我院体检健康者100例为对照组。A组、C组均在术后或化疗期间口服肠道菌群调节药物(双歧杆菌乳杆菌三联活菌片)。治疗前后留取各组患者粪便标本,分离培养肠道菌,计算单位重量标本中不同菌种的活菌数,并比较各组临床治疗效果的情况。结果与对照组比较,肿瘤患者肠道中乳酸杆菌、双歧杆菌、类杆菌数量减少(均P<0.05),而肠杆菌、肠球菌、梭杆菌增多(均P<0.05)。给予双歧杆菌乳杆菌三联活菌治疗后,A、C组肠道菌群获得显著改善,优于B、D组(均P<0.05)。C组化疗有效率优于D组(P<0.05)。随访12个月,A组肿瘤复发率低于B组(P<0.05);C组化疗后不良反应发生率明显低于D组。结论结直肠癌患者存在明显的肠道菌群失调,调节肠道菌群有助于提高其结直肠癌根治手术后和保守化疗的治疗效果,降低肿瘤复发率。ObjectiveTo explore characterization of intestinal flora in patients with colorectal cancer and its therapeutic effect of postsurgery and chemotherapy.MethodsIn this study,136patients with colorectal cancer confirmed by pathology were selected,including82cases which randomly divided into group A and group B,and54cases of conservative treatment which were randomly divided into group C and group D.At the same time,100cases of healthy people were selected as control group.Groups A and C were all taken orally intestinal flora regulating drugs(Live Combined Bifidobacterium and Lactobacillus tablets)during postsurgery or chemotherapy.The fecal specimens were collected from each group before and after surgery or chemotherapy.The bacteria were isolated and cultured,and the number of living bacteria of different strains in the unit weight specimen was calculated in specimens from four groups.The clinical effect of postsurgery and chemotherapy was compared in patients of four groups.ResultsCompared with the control group,the number of lactobacillus,bifidobacterium and bacilli in the intestinal tract of tumor patients was decreased(all P<0.05),while intestinal bacilli,enterococcus and clostridium were increased(all P<0.05).After Live Combined Bifidobacterium and Lactobacillus tablets treatment,the probiotics significantly were improved the intestinal flora of group A and C,and it was superior to group B and group D(all P<0.05).Group C was more effective than group D(P<0.05).After12months of follow up,neoplasm recurrence rate of group A was lower than that of group B(P<0.05).After chemotherapy,the adverse reaction rate of group C was significantly lower than that of group D(P<0.05).ConclusionPatients with colorectal cancer had obvious disorders of intestinal flora,probiotics could help improve the therapeutic effect of postsurgery and chemotherapy,and reduce neoplasm recurrence rate in patients.

关 键 词：结直肠癌 肠道菌群 化疗 肿瘤复发 

分 类 号：R735.3[医药卫生—肿瘤]