健脾化瘀方治疗结直肠癌脾虚瘀毒型的疗效及对肠道菌群和免疫功能的影响  

Curative effect of Jianpi Huayu Decoction on colorectal cancer patients with spleen deficiency and blood stasis toxin type and its influence on intestinal flora and immune function

作　　者：孟春芹 刘先勇 吴皞 马玲 MENG Chunqin;LIU Xianyong;WU Hao;MA Ling(Department of Integrative Chinese and Western Medicine,the Affiliated Jiangning Hospital of Nanjing Medical University,Nanjing,Jiangsu 211100;Department of Oncology,the Affiliated Jiangning Hospital of Nanjing Medical University,Nanjing,Jiangsu 211100)

机构地区：[1]南京医科大学附属江宁医院中西医结合科,江苏南京211100 [2]南京医科大学附属江宁医院肿瘤科,江苏南京211100

出　　处：《河北中医》2023年第6期944-947,951,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：2019年江苏省双创博士项目(县级医院创新类);南京市中医药青年人才培养计划(编号:JNYYRC202007);2019年南京医科大学科技发展基金项目(编号:NMUB2019238);南京医科大学康达学院2019年科研发展基金课题(编号:KD2019KYJJZD023)。

摘　　要：目的 观察健脾化瘀方治疗结直肠癌(CRC)脾虚瘀毒型的疗效及对肠道菌群和免疫功能的影响。方法 将46例CRC脾虚瘀毒型患者按照随机数字表法分为2组,对照组23例予常规抗肿瘤治疗及对症治疗,治疗组23例在对照组治疗基础上予健脾化瘀方。2组均治疗12周。比较2组疗效;比较2组治疗前后肠道菌群变化;比较2组治疗前后血清炎症因子变化;比较2组治疗前后免疫功能指标变化;比较2组治疗前后Toll样受体4(TLR4)、核因子κBp65(NF-κBp65)水平变化。结果 治疗组总有效率86.96%(20/23),对照组总有效率56.52%(13/23),治疗组疗效优于对照组(P<0.05)。治疗组治疗后双歧杆菌、乳酸杆菌均较本组治疗前升高(P<0.05),肠杆菌、粪肠球菌均较本组治疗前降低(P<0.05);治疗后治疗组双歧杆菌、乳酸杆菌均高于对照组(P<0.05),肠酸杆菌、粪肠球菌均低于对照组(P<0.05)。对照组治疗前后肠道菌群比较差异均无统计学意义(P>0.05)。治疗组治疗后白细胞介素(IL)1β、IL-6、肿瘤坏死因子α(TNF-α)水平均较本组治疗前降低(P<0.05),治疗后治疗组IL-1β、IL-6、TNF-α水平均低于对照组(P<0.05);对照组治疗前后IL-1β、IL-6、TNF-α水平比较差异均无统计学意义(P>0.05)。治疗组治疗后CD3^(+)、CD3^(+)CD4^(+)、CD19^(+)水平均较本组治疗前升高(P<0.05),治疗后治疗组CD3^(+)、CD3^(+)CD4^(+)、CD19^(+)水平均高于对照组(P<0.05)。对照组治疗前后CD3^(+)、CD3^(+)CD4^(+)、CD19^(+)水平比较差异均无统计学意义(P>0.05)。治疗组治疗后TLR4、NF-κBp65 mRNA水平均较本组治疗前降低(P<0.05),治疗后治疗组TLR4、NF-κBp65 mRNA水平均低于对照组(P<0.05)。对照组治疗前后TLR4、NF-κBp65水平比较差异均无统计学意义(P>0.05)。结论 健脾化瘀方治疗CRC脾虚瘀毒型,可有效改善患者临床症状,调节肠道菌群,增强免疫功能,减轻炎症水平,可能与调控TLR4/NF-κB有关。Objective To observe the curative effect of Jianpi Huayu Decoction on colorectal cancer(CRC)patients with spleen deficiency and blood stasis toxin type and its influence on intestinal flora and immune function.Methods Forty-six patients with CRC(spleen deficiency and blood stasis toxin type)were randomized 1∶1 to receive conventional anti-tumor therapy(the control group)or Jianpi Huayu Decoction+conventional therapy(the treatment group)for 12 weeks.The aim was to compare efficacy,intestinal flora,serum inflammatory factors,immune function indexes,Toll-like receptor 4(TLR4),as well as nuclear factorκBp65(NF-κBp65)between groups before and after treatment.Results After treatment,the total effective rate in the treatment group was superior to the control group(86.96%[20/23]vs 56.52%[13/23],P<0.05).The increased Bifidobacterium and Lactobacillus and decreased Enterobacter and Enterococcus faecalis were found in the treatment group than those before treatment(all P<0.05).There were significant differences in the above parameters between the both groups after treatment(all P<0.05),while there was no significant difference in the intestinal flora in the control group before and after treatment(P>0.05).The levels of interleukin-1β(IL-1β),IL-6 and tumor necrosis factor-α(TNF-α)in the treatment group were lower than those before treatment(P<0.05),which were lower in the treatment group than the control group(P<0.05).No differences were significant in the control group before and after treatment(P>0.05).The levels of CD3^(+),CD3^(+)CD4^(+)and CD19^(+)in the treatment group were higher than those before treatment(P<0.05),and which were higher in the treatment group than the control group(P<0.05).There was no significant difference in the control group before and after treatment(P>0.05).The levels of TLR4 and p65 mRNA in the treatment group were lower than those before treatment(P<0.05),which were lower in the treatment group than the control group(P<0.05).The differences were not significant in the control group befo

关 键 词：肠肿瘤 中药疗法 

分 类 号：R735.3[医药卫生—肿瘤] R289.6[医药卫生—临床医学]