血府逐瘀汤治疗结直肠癌伴抑郁、焦虑的临床疗效分析  

Effect of Xuefu Zhuyu Decoction on Colonrectal Cancer Patients with Depression and Anxiety and Analysis of Intestinal Metabolism

作　　者：吕玲玲[1] 郑岚[1] 沈小珩[1] 朱伟嵘[1] 陈敬贤[1] LV Lingling;ZHENG Lan;SHEN Xiaoheng(Ruijin Hospital Affiliated to Medical College of Shanghai Jiaotong University,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院中医科,200025

出　　处：《医学研究杂志》2023年第6期83-86,90,共5页Journal of Medical Research

基　　金：上海市市科委2019年度科技创新行动计划项目(19401971900)。

摘　　要：目的观察血府逐瘀汤对血瘀证的结直肠癌伴抑郁、焦虑患者的临床疗效及肠道代谢产物的影响。方法将2019年1月~2022年1月上海交通大学医学院附属瑞金医院收治的120例血瘀证型Ⅲ期结直肠癌伴抑郁、焦虑患者,随机分为治疗组和对照组,每组60例。治疗组给予血府逐瘀汤口服,对照组给予安慰剂口服。3个月后比较分析两组心理量表(包括SDS、SAS、HAMD、HAMA)、中医症状评分、无疾病生存期(disease free survival,DFS)及代谢组学。结果治疗后,组内比较,治疗组的乏力得分较前增加(P<0.05),量表(SDS、SAS、HAMD、HAMA)、不寐、脘腹胀满、心烦易怒得分较前明显下降(P<0.01);对照组HAMD、HAMA、不寐、乏力得分较前明显下降(P<0.01)。两组间比较,治疗组SDS、HAMD、不寐、心烦易怒得分均低于对照组(P<0.05),HAMA、脘腹胀满得分明显低于对照组(P<0.01)。治疗组DFS为38.72±2.22个月,较对照组延长2个月(P>0.05)。两组肠道代谢产物差异分析主要为脯氨酸、6-羟基烟酸、丝氨酸、肌醇、丙二酸、阿魏酸、吲哚丁酸、丁酸等。结论中药血府逐瘀汤可改善结直肠癌的抑郁、焦虑,调节肠道代谢,延长无疾病生存期。Objective To observe the clinical effect of Xuefu Zhuyu Decoction on colorectal cancer patients with blood stasis syndrome with depression and anxiety and the effect of intestinal metabolites.Methods From January 2019 to January 2022,120 patients with stageⅢcolorectal cancer with depression and anxiety were randomly divided into treatment group and control group,with 60 cases in each group.The treatment group was given Xuefu Zhuyu Decoction granules orally,and the control group was given placebo orally.After 3months,the changes of psychological scale(including SDS,SAS,HAMD and HAMA),traditional Chinese medicine(TCM)syndrome score,disease-free survival(DFS)and intestinal metabolites were compared between the two groups.Results After treatment,the fatigue score in the treatment group increased(P<0.05),psychological scale(SDS,SAS,HAMD,HAMA),insomnia,epigastric fullness and irritability score decreased significantly(P<0.01);HAMD,HAMA,insomnia and fatigue score in the control group decreased significantly(P<0.01).Compared with the treatment group,SDS,HAMD,insomnia,upset and irritability score were lower in the control group(P<0.05),and HAMA and epigastric fullness score were significantly lower in the control group(P<0.01).DFS was 38.72±2.22months in the treatment group,and 2months longer than the control group(P>0.05).There were significant differences of intestinal metabolites between the two groups,including proline,6-hydroxynicotinic acid,serine,inositol,malonic acid,ferulic acid,indole butyric acid,and butyric acid.Conclusion Xuefu Zhuyu Decoction can alleviate the depression and anxiety of colorectal cancer patients with blood stasis syndrome,regulate intestinal metabolism,improve TCM symptoms and prolong the DFS.

关 键 词：血府逐瘀汤 结直肠癌 血瘀证 抑郁焦虑状态 肠道代谢 

分 类 号：R273[医药卫生—中西医结合]