参苓白术散化裁对胃癌术后化疗患者肠道菌群、肠屏障和免疫功能的调节作用分析  

Regulation of Shenling Baizhu Powder on Intestinal Microflora,Intestinal Barrier and Immune Function in Gastric Cancer Patients with Chemotherapy After Operation

作　　者：李华[1] 郭丽 憨镔 李雷 李丽[3] LI Hua;GUO Li;HAN Bin;LI Lei;LI Li(Anyang Hospital of Traditional Chinese Medicine,Anyang,Henan,455000,China;The People’s Hospital of Anyang City,Anyang,Henan,455002,China;Anyang Maternal and Child Health Care Hospital,Anyang,Henan,455000,China)

机构地区：[1]安阳市中医院,河南安阳455000 [2]安阳市人民医院,河南安阳455002 [3]安阳市妇幼保健院,河南安阳455000

出　　处：《肿瘤药学》2020年第4期477-482,共6页Anti-Tumor Pharmacy

摘　　要：目的分析参苓白术散化裁对胃癌术后化疗患者肠道菌群、肠屏障和免疫功能的调节作用。方法选择2016年10月—2018年10月我院接受术后化疗的晚期胃癌患者112例为研究对象,按照随机数字表法分为观察组和对照组,各56例。两组患者均成功进行全麻下胃癌根治术,术后接受FOLFOX4方案化疗,观察组在此基础上联合应用参苓白术散化裁。比较两组患者化疗前、化疗3个周期和化疗结束后的生活质量量表(QOL)评分、辅助性T细胞17(Th17)、调节性T细胞(Treg)、Th17/Treg、人血浆二胺氧化酶(DAO)、D-乳酸、内毒素、肠道菌群数量的差异。结果两组患者化疗前、化疗3个周期的QOL评分均无显著差异(P>0.05),化疗结束后,观察组QOL评分显著高于对照组(P<0.05)。化疗3个周期后,观察组Th17、Treg水平均显著低于对照组(P<0.01),但两组间Th17/Treg水平无显著差异(P>0.05)。化疗结束后,观察组Th17、Treg和Th17/Treg水平均显著低于对照组(P<0.01);观察组乳杆菌、双歧杆菌及杆菌/球菌的比例均显著高于对照组(P<0.01),而大肠杆菌、肠球菌、葡萄球菌和消化链球菌数均显著低于对照组(P<0.01)。化疗期间,观察组患者恶心呕吐、腹泻和食欲下降的发生率均显著低于对照组(P<0.05)。结论参苓白术散化裁有利于调节胃癌术后化疗患者肠道菌群的平衡,改善其免疫和肠屏障功能,在一定程度上减轻了消化道不良反应,这可能是使得患者生活质量获得改善的重要机制。Objective To analyze the regulatory effects of Shenling Baizhu powder on intestinal microflora,intestinal barrier and immune function of gastric cancer patients with chemotherapy after operation.Methods A total of 112 patients with advanced gastric cancer who received postoperative chemotherapy in our hospital between October 2016 and October 2018 were enrolled in this study,and they were randomly divided into control group(n=56)and observation group(n=56).All patients successfully underwent radical gastrectomy under general anesthesia,and received FOLFOX4 chemotherapy after operation.Patients in observation group were additionally treated with Shenling Baizhu powder.The quality of life(QOL)scores,helper T cell 17(Th17),regulatory T cell(Treg),Th17/Treg,human plasma diamine oxidase(DAO),D-lactate,endotoxin and intestinal flora were compared between the two groups before and after chemotherapy.Results There was no significant difference in QOL score between the two groups before chemotherapy and after three cycles of chemotherapy(P>0.05).After six cycles of chemotherapy,the QOL score in the observation group was significantly higher than that in the control group(P<0.05).After three cycles of chemotherapy,the levels of Th17 and Treg in the observation group were significantly lower than those in the control group(P<0.01),but there was no significant difference in Th17/Treg between the two groups(P>0.05).After six cycles of chemotherapy,the Th17,Treg levels and the Th17/Treg in the observation group were significantly lower than those in the control group(P<0.01).The numbers of Lactobacillus and Bifidobacterium and the ratio of bacterium/coccus in the observation group were all significantly higher than those in control group(P<0.01),while the numbers of Escherichia coli,Enterococcus,Staphylococcus and Peptostreptococcus were significantly lower than those in control group(P<0.01).During the chemotherapy period,the incidences of nausea,vomiting,diarrhea and loss of appetite in the observation group were significant

关 键 词：参苓白术散 胃癌 根治术 化疗 肠道菌群 肠屏障功能 免疫功能 

分 类 号：R735.2[医药卫生—肿瘤]