益气养阴方对胃肠道肿瘤化疗后患者肠道菌群及免疫功能的影响  

Effect of Yiqi Yangyin Recipe on Intestinal Flora and Immune Function of Patients with Gastrointestinal Cancer After Chemotherapy

作　　者：张玉星 朱凯 俞仲贤[3] 凌云[1] 周春祥[1] ZHANG Yuxing;ZHU Kai;YU Zhongxian;LING Yun;ZHOU Chunxiang(Nanjing University of Chinese Medicine,Nanjing Jiangsu China 210000;Zhangjiagang Hospital of Chinese Medicine,Jiangsu Suzhou China 215000;Changshu First People's Hospital,Suzhou Changshu China 215000)

机构地区：[1]南京中医药大学,江苏南京210000 [2]张家港市中医医院,江苏张家港215000 [3]常熟市第一人民医院,江苏常熟215000

出　　处：《中医学报》2021年第1期176-181,共6页Acta Chinese Medicine

基　　金：国家自然科学基金面上项目(81774021)。

摘　　要：目的:观察益气养阴方对胃肠道肿瘤化疗后患者免疫功能和肠道菌群的影响。方法:100例气阴两虚型胃肠道肿瘤患者随机分为益气养阴方高剂量组、益气养阴方低剂量组和安慰剂组,每组分别为34例、32例和34例,各组均治疗30 d。比较各组患者治疗前后肿瘤指标、骨髓抑制指标、肝肾功能指标、细胞免疫指标及肠道菌群变化。另取30位健康志愿者的粪便作为肠道菌群指标的健康组。结果:(1)益气养阴方对患者肝肾指标、骨髓抑制指标和肿瘤指标均无显著影响。(2)服药后,益气养阴方高剂量组CD3~+由(61.59±7.73)%提高至(64.04±8.45)%(t=-2.1304,P=0.0409),CD4~+/CD8~+由1.21±0.41提高至1.47±0.76(t=-2.0489,P=0.0499)。益气养阴方低剂量组CD4~+/CD8~+由1.27±0.50提高至1.70±0.92(t=-2.3840,P=0.0234)。(3)胃肠道肿瘤化疗后患者肠道菌群多样性显著低于健康组;菌群组成:厚壁菌门(56.69±27.99)%显著低于健康组(70.73±12.01)%(t=-3.8129,P=0.0002),变形菌门(20.52±26.44)%显著高于健康组(4.92±6.98)%(t=-5.1129,P=0.000001),放线菌门(3.77±7.69)%显著高于健康组(1.40±1.22)%(t=2.8206,P=0.0058),拟杆菌门(18.25±22.78)%与健康组(22.91±11.41)%无显著差异。(4)服药后,益气养阴方高剂量组变形菌门由(29.37±31.80)%降低至(18.70±25.67)%(t=2.2154,P=0.0354),该门的埃希-志贺菌属由(10.74±16.66)%降低至(3.66±7.71)%(t=2.0916,P=0.0477);安慰剂组埃希-志贺菌属由(4.01±6.76)%升高至(4.61±6.77)%(t=-2.0724,P=0.0476);进一步分析发现,益气养阴方高剂量、低剂量均能显著降低高变形菌门(≥12%)个体肠道中变形菌门(t=2.3040,P=0.0359)、埃希-志贺菌属(t=2.2831,P=0.0455)的比例,而安慰剂组中低变形菌门(<12%)个体肠道中变形菌门(t=-2.4379,P=0.0237)、埃希-志贺菌属(t=-2.1616,P=0.0436)比例显著升高。结论:益气养阴方能提高胃肠道肿瘤化疗后患者的免疫功能,抑制变形菌门及埃希-志贺菌属的增殖,益气养阴Objective:To observe the effect of Yiqi Yangyin Recipe on immune function and intestinal flora of patients with gastrointestinal cancer after chemotherapy.Methods:100 patients with gastrointestinal cancer of qi and yin deficiency type were randomly divided into high-dose Yiqi Yangyin Recipe group,low-dose Yiqi Yangyin Recipe group and placebo group,with 34 cases in each group,and 34 cases in each group.The changes of tumor index,bone marrow suppression index,liver and kidney function index,cellular immunity index and intestinal flora before and after treatment were compared.The feces of 30 healthy volunteers were taken as the index of intestinal flora in healthy group.Results:(1)Yiqi Yangyin Recipe had no significant effect on liver and kidney index,bone marrow suppression index and tumor index.(2)After taking the medicine,CD3~+in the high-dose Yiqi Yangyin Recipe group was significantly higher than that in the control group(61.59±7.73)%was significantly increased to(64.04±8.45)%(t=-2.1304,P=0.0409),and the ratio of CD4~+/CD8~+increased from 1.21±0.41 to 1.47±0.76(t=-2.0489,P=0.0499).CD4~+/CD8~+in low-dose Yiqi Yangyin Recipe group increased significantly from 1.27±0.50 to 1.70±0.92(t=-2.3840,P=0.0234).(3)The results showed that the diversity of intestinal flora in patients with gastrointestinal cancer after chemotherapy was significantly lower than that in healthy group;the composition of flora:firmicum(56.69±27.99)%was significantly lower than that of healthy group(70.73±12.01)%(t=-3.8129,P=0.0002),proteus(20.52±26.44)%was significantly higher than that in healthy group(4.92±6.98)%(t=-5.1129,P=0.000001),actinomycetes(3.77±7.69)%was significantly higher than that in healthy group(1.40±1.22)%(t=2.8206,P=0.0058).There was no significant difference between Bacteroides(18.25±22.78)%and healthy group(22.91±11.41)%;(4)After treatment,proteus was significantly decreased from(29.37±31.80)%to(18.70±25.67)%(t=2.2154,P=0.0354)in high-dose Yiqi Yangyin Recipe group,and the genus of Shigella was significantly

关 键 词：益气养阴方 胃肠道肿瘤 化疗 肠道菌群 免疫功能 

分 类 号：R273[医药卫生—中西医结合]