复方斑蝥胶囊对肝门部胆管癌患者术后胃肠激素水平、Th1/Th2免疫平衡的影响  

Effect of Compound Cantharis Capsules on Gastrointestinal Hormone and Th1/Th2 Immune Balance in Patients with Hilar Cholangiocarcinoma After Surgery

作　　者：施喆 赵国栋[1] 韩艳珍[1] 周丽媛 毕育学[2] 孙旭 于宁 SHI Zhe;ZHAO Guodong;HAN Yanzhen;ZHOU Liyuan;BI Yuxue;SUN Xu;YU Ning(Dept.of General Surgery,Affiliated Hospital of Hebei University of Engineering,Hebei Handan 056002,China;School of Public Health,Xi’an Jiaotong University,Shaanxi Xi’an 710061,China;Guizhou Yibai Pharmaceutical Co.,Ltd.,Guizhou Guiyang 550008,China)

机构地区：[1]河北工程大学附属医院普外科,河北邯郸056000 [2]西安交通大学公共卫生学院,陕西西安710061 [3]贵州益佰制药股份有限公司,贵州贵阳550008

出　　处：《中国医院用药评价与分析》2021年第11期1327-1330,1334,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河北省中医药管理局科研计划项目(No.2020227)。

摘　　要：目的:探讨复方斑蝥胶囊对肝门部胆管癌患者术后胃肠激素水平、Th1/Th2免疫平衡的影响。方法:选取2018年6月至2020年7月河北工程大学附属医院收治的接受手术治疗的肝门部胆管癌患者86例,采用随机数字表法分为观察组和对照组,每组43例。对照组患者术后实施常规处理,观察组患者在对照组的基础上于术后第2日给予复方斑蝥胶囊治疗,共治疗2周。观察两组患者术后胃肠功能恢复情况,治疗前后胃肠激素水平,外周血Th1类细胞因子[包括白细胞介素2(IL-2)、γ干扰素(IFN-γ)和肿瘤坏死因子α(TNF-α)]水平,Th2类细胞因子[包括白细胞介素4(IL-4)、白细胞介素10(IL-10)]水平,Th1细胞占比、Th2细胞占比和Th1/Th2,术后并发症及治疗期间的不良反应。结果:胆管癌根治术治疗后,观察组患者肠鸣音恢复时间、首次肛门排气及排便时间均明显短于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者胃动素(MTL)、胃泌素(GAS)水平较治疗前明显升高,观察组患者MTL、GAS水平较对照组明显更高;两组患者血管活性肠肽(VIP)水平较治疗前明显降低,观察组患者VIP水平较对照组明显更低,上述差异均有统计学意义(P<0.05)。治疗后,两组患者外周血IL-2、IFN-γ和TNF-α水平,Th1细胞占比、Th1/Th2较治疗前明显升高,观察组患者较对照组明显更高;两组患者IL-4、IL-10水平和Th2细胞占比较治疗前明显降低,观察组患者较对照组明显更低,上述差异均有统计学意义(P<0.05)。观察组患者并发症发生率为32.56%(14/43),略低于对照组的41.86%(18/43),差异无统计学意义(P>0.05)。治疗期间,观察组、对照组患者不良反应发生率分别为60.47%(26/43)、58.14%(25/43),差异无统计学意义(P>0.05)。结论:肝门部胆管癌患者术后应用复方斑蝥胶囊可促进胃肠道功能恢复,调节胃肠激素水平,增加Th1类细胞因子及Th1细胞占比,降低Th2类细胞因子及Th2细�OBJECTIVE: To probe into the effect of Compound cantharis capsules on gastrointestinal hormone and Th1/Th2 immune balance in patients with hilar cholangiocarcinoma after surgery. METHODS: Totally 86 patients with hilar cholangiocarcinoma received surgery admitted into the Affiliated Hospital of Hebei University of Engineering from Jun. 2018 to Jul. 2020 were selected and divided into observation group and control group via random number table,with 43 cases in each group. The control group was given conventional processing after surgery,while the observation group was treated with Compound cantharis capsules for 2 weeks since the second day after treatment based on the control group. Recovery of gastrointestinal function after surgery,levels of gastrointestinal hormone,peripheral blood Th1-like cytokines[including interleukin 2( IL-2),interferon-γ( IFN-γ) and tumor necrosis factor α( TNF-α) ],Th2-like cytokines[including interleukin 4( IL-4) and interleukin 10( IL-10) ],proportion of Th1 cell and Th2 cell,Th1/Th2,incidences of postoperative complications and adverse drug reactions during treatment were observed.RESULTS: After surgery of cholangiocarcinoma,the recovery time of bowel sounds,the first anal venting and defecation time of patients in the observation group were shorter than those in the control group,with statistically significant differences( P < 0. 05). After treatment,the motilin( MTL) and gastrin( GAS) levels of both groups were significantly higher than those of before treatment,the MTL and GAS levels of observation group were significantly higher than those of the control group;the vasoactive intestinal peptide( VIP) levels of both groups were significantly lower than those of before treatment,and the VIP level of observation group was significantly lower than that of the control group,with statistically significant differences( P < 0. 05). After treatment,the peripheral blood IL-2,IFN-γand TNF-α levels,proportion of Th1 cell and Th1/Th2 value of both groups were significantly higher than th

关 键 词：复方斑蝥胶囊 肝门部胆管癌 胃肠激素 Th1/Th2免疫平衡 

分 类 号：R932[医药卫生—生药学] R979.1[医药卫生—药学]