基于血清代谢组学探讨健脾生津中药辅助三维适形放疗治疗局部晚期鼻咽癌患者的作用机制  

Mechanism of Three-Dimensional Conformal Radiotherapy Assisted by Jianpi Shengjin Prescription in Treating Local Advanced Nasopharyngeal Carcinoma Based on Serum Metabolomics

作　　者：刘畅[1] 郑荣华[1] LIU Chang;ZHENG Ronghua(Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032

出　　处：《中医药信息》2023年第4期49-56,共8页Information on Traditional Chinese Medicine

基　　金：上海市卫生健康委员会科研课题(202040156)。

摘　　要：目的:基于血清代谢组学研究健脾生津中药辅助三维适形放疗治疗局部晚期鼻咽癌相较于单用三维适形放疗患者血清差异代谢物的变化情况,从而揭示健脾生津中药的作用机制。方法:将符合纳入标准的鼻咽癌患者随机分为两组,对照组单用三维适形放疗,观察组采用健脾生津中药辅助三维适形放疗,两组均治疗6周。比较两组临床疗效差异;比较两组患者治疗前后中医症状评分和急性放射反应评分变化情况;采用气相色谱-质谱联用法(gas chromatography-mass spectrometry,GC-MS)分析对照组和观察组患者血清代谢物水平,利用主成分分析(PCA)和正交偏最小二乘判别分析(OPLS-DA)筛选出血清中差异性代谢物并分析其可能涉及的通路和机制。结果:观察组临床获益率为90%,明显高于对照组临床获益率60%(P<0.05)。治疗后,两组患者中医症状积分明显降低(P<0.05),急性放射反应评分均明显升高(P<0.05),且观察组中医症状积分较对照组改善明显,急性放射反应评分低于对照组,临床获益显著。健脾生津中药辅助治疗下改变了三维适形放疗单用治疗患者的血清代谢谱,其中上调了9种差异代谢物,下调了5种差异代谢物,主要与精氨酸和脯氨酸代谢、色氨酸代谢、半胱氨酸和甲硫氨酸代谢、精氨酸的生物合成4条代谢通路有关。结论:健脾生津中药能够明显提高鼻咽癌患者临床疗效,改善中医症状,并对接受三维适形放疗的局部晚期鼻咽癌患者的代谢谱进行调节,其调节作用可能与氨基酸代谢、能量代谢等多条途径有关。Objective:To study the changes of serum differential metabolites between three-dimensional conformal radiotherapy assisted by Jianpi Shengjin prescription and single three-dimensional conformal radiotherapy in treatment of local advanced nasopharyngeal carcinoma,thus to reveal the mechanism of Jianpi Shengjin prescription.Methods:The patients with nasopharyngeal carcinoma were randomly divided into the control group and the observation group.The control group was given three-dimensional conformal radiotherapy;on which basis,the observation group was also treated with Jianpi Shengjin prescription.Both groups were treated for 6 weeks.Clinical efficacy was compared between the two groups.TCM symptoms scores and acute radiation reaction scores were compared between before and after the treatment in the two groups.Gas chromatography-mass spectrometry(GC-MS)was used to analyze the serum levels of metabolites.Principal component analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)were used to screen out differential metabolites and then analyze their possible pathways and mechanisms involved.Results:The clinical benefit rate of the observation group was 90%,which was significantly higher than 60%of the control group(P<0.05).The TCM symptoms scores were significantly decreased(P<0.05),and the acute radiation reaction scores were significantly increased after the treatment in the two groups(P<0.05);the improvement of the TCM symptoms scores was more significant in the observation group than that in the control group(P<0.05),the acute radiation reaction scores were lower in the observation group than those in the control group(P<0.05).The serum metabolic profile of the patients treated with three-dimensional conformal radiotherapy alone was altered by Jianpi Shengjin prescription.9 differential metabolites were up-regulated and 5 differential metabolites were down-regulated,which were mainly related to the pathways of arginine and proline metabolisms,tryptophan metabolism,cysteine and methionine

关 键 词：鼻咽癌 代谢组学 气相色谱-质谱联用 差异代谢物 

分 类 号：R739.63[医药卫生—肿瘤]