调肠消瘤方对结直肠腺瘤术后患者复发率及结肠组织Beclin1、p53、Cox-2表达的影响  

Effect of Tiaochang Xiaoliu Formula(调肠消瘤方)on the Recurrence Rate of Patients with Colorectal Adenoma and the Expression of Beclin1,p53 and Cox-2 in Colon Tissue

作　　者：李叶 钟彩玲 杨四萍 张北平 LI Ye;ZHONG Cailing;YANG Siping;ZHANG Beiping(The Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Province Traditional Chinese Medical Hospital,Guangzhou,510120)

机构地区：[1]广州中医药大学第二附属医院/广东省中医院,广东省广州市510120

出　　处：《中医杂志》2021年第5期424-427,共4页Journal of Traditional Chinese Medicine

基　　金：广东省省级科技计划(2017A020213005);广东省中医院临床研究专项(1010专项)重点研发计划(YN10101914)。

摘　　要：目的观察调肠消瘤方对结直肠腺瘤术后复发的影响,并探讨可能的作用机制。方法结直肠腺瘤患者84例随机分为治疗组和对照组各42例,两组患者均予内镜下息肉切除术,治疗组术后每天口服调肠消瘤方,每日1剂,连服3个月;对照组不进行中西药物干预。术后1年复查肠镜,观察腺瘤性息肉复发情况并计算复发率。治疗前及术后1年采用免疫组化法检测结肠组织Beclin1、p53、环氧化酶2(Cox-2)表达。结果最终81例患者完成临床试验,治疗组脱落1例,对照组脱落2例。术后1年治疗组41例患者复发5例,复发率为12.2%,对照组40例患者复发16例,复发率为40.0%,治疗组复发率显著低于对照组(t=8.15,P=0.04)。治疗组复发腺瘤平均每人(1.80±1.30)个,对照组平均每人(2.19±1.56)个,两组复发腺瘤人均个数差异无统计学意义(t=0.501,P=0.622)。术后1年两组患者结肠组织Beclin1、p53、Cox-2表达均较治疗前降低(P<0.05),且治疗组较对照组降低更明显(P<0.05)。结论调肠消瘤方能有效降低结直肠腺瘤术后的复发率,其可能通过抑制细胞自噬、减少异常细胞增殖、减轻结肠黏膜炎症而发挥疗效。Objective To explore the effect of Tiaochang Xiaoliu Formula(调肠消瘤方)on the postoperative recurrence of colorectal adenoma,as well as the possible underlying mechanism.Methods Eighty-four patients with colorectal adenoma were randomly divided into treatment group and control group,with 42 patients in each group.All patients underwent endoscopic polypectomy;additionally,Tiaochang Xiaoliu Formula was administered in treatment group,one dose daily,for three months.Colonoscopy was used to check whether there was recurrence of adenomatous polyps one year after the polypectomy,and the recurrence rate was calculated.The expression of Beclin1,p53 and cyclooxygenase 2(Cox-2)in colon tissue were detected by immunohistochemical method before treatment and one year after operation.Results Eighty-one patients completed the trial,while one case in treatment group and two cases in control group dropped out.The 1-year recurrence rate was 12.2%(5 of the 41 patients)in treatment group,significantly lower than 40.0%(16 of the 40 patients)in control group(t=8.15,P=0.04).The average number of recurrent adenomas per person was 1.80±1.30 in the treatment group and 2.19±1.56 in the control group,with no significant difference between groups(t=0.501,P=0.622).The expression of Beclin1,p53,and Cox-2 in the colon tissue significantly decreased in both treatment and control group one year after the operation when compared to those before treatment(P<0.05),and more changes were seen in the treatment group(P<0.05).Conclusion Tiaochang Xiaoliu Formula may help decreasing the recurrence rate of colorectal adenoma after operation,possibly by inhibiting autophagy,decreasing abnormal cell proliferation,and relieving inflammation of the colonic mucosa.

关 键 词：结直肠腺瘤 调肠消瘤方 肿瘤复发 细胞自噬 结肠组织 炎症 

分 类 号：R273[医药卫生—中西医结合]