益肠散结方治疗脾虚痰瘀证转移性结直肠癌化疗患者的临床研究  

Clinical Study of Yichang Sanjie Prescription Combined with Chemotherapy in Treating Patients with Metastatic Colorectal Cancer of Spleen Deficiency with Phlegm and Blood Stasis Type

作　　者：戴玲玲 侯爱画 窦欢欢 孟鹏 谭松 司文涛 徐文娟[2] DAI Ling-ling;HOU Ai-hua;DOU Huan-huan;MENG Peng;TAN Song;SI Wen-tao;XU Wen-juan(Department of Oncology,Yantai Hospital of Traditional Chinese Medicine,Yantai 264001 Shandong,China;School of Integrative Medicine,Binzhou Medical College,Yantai 264001 Shandong,China)

机构地区：[1]烟台市中医医院肿瘤科,山东烟台264001 [2]滨州医学院中西医结合学院,山东烟台264001

出　　处：《中医肿瘤学杂志》2023年第4期33-40,共8页Journal of Oncology in Chinese Medicine

基　　金：山东省重点研发项目(编号:2019GSF108245);山东省中医药科技项目(编号:2020M132);烟台市科技创新发展计划项目(编号:2021MSGY050)。

摘　　要：目的观察益肠散结方联合化疗治疗脾虚痰瘀证晚期结直肠癌患者的临床疗效及安全性,并探讨肠道菌群、血清黑色素瘤缺乏因子2(absent in melanoma 2,AIM2)、免疫功能之间相关性。方法将晚期结直肠癌脾气亏虚、痰瘀互结证患者84例,随机分为治疗组、对照组,治疗组采用益肠散结颗粒联合化疗,对照组采用安慰剂联合化疗,14天为1个疗程,共8个疗程。观察两组治疗前后中医证候、卡氏评分、免疫功能、血清AIM2表达水平、肠道菌群等方面及安全性分析。结果治疗后两组比较,治疗组能够提高中医证候治疗有效率(P<0.01);提高KPS评分,组间比较差异有统计学意义(P<0.05);治疗前后组内比较,治疗组NK细胞计数、CD^(4+)显著升高(P<0.01),CD^(8+)、CD^(4+)/CD^(8+)变化不明显(P>0.05);对照组CD^(4+)显著升高(P<0.01),NK细胞计数、CD^(8+)、CD^(4+)/CD^(8+)变化不明显(P>0.05)。组间比较,治疗后治疗组NK细胞计数改善情况优于对照组(P<0.05),其他的观察指标组间比较差异无统计学意义(P>0.05);治疗组化疗后血清AIM2 m RNA转录水平明显高于治疗前(P<0.05)。4周期化疗后与8周期化疗后相比,血清AIM2 m RNA水平组内比较差异没有统计学意义(P>0.05);肠道菌群检测,治疗组化疗后的多样性比治疗组化疗前、对照组化疗前后均有提高,但差异无统计学意义(P>0.05);且Romboutsia、Intestinibacter能提高肠道的防御能力。结论益肠散结方联合化疗可以改善晚期结直肠癌患者中医证候,提高化疗后体能状况,调整肠道菌群,提高机体免疫力,增强抵抗感染的能力,且安全有效。Objective To observe the clinical efficacy and safety of Yichang Sanjie Prescription combined with chemotherapy for the treatment of patients with advanced colorectal cancer of spleen deficiency with phlegm and blood stasis type,and to explore the correlation between intestinal flora,serum AIM2 level and immune function of the patients.Methods A total of 84 patients with advanced colorectal cancer of spleen deficiency with phlegm and blood stasis type were randomly divided into treatment group and control group.The treatment group was treated with Yichang Sanjie granules combined with chemotherapy,and the control group was treated with placebo granules combined with chemotherapy.Fourteen days constituted one course of treatment,the treatment for the two groups lasted for a total of 8 courses.The TCM symptoms,KPS score,immune function,serum AIM2 expression level,and intestinal flora of the two groups were observed before and after the treatment.Meanwhile,the clinical safety of the two groups was also evaluated.Results The post-treatment intergroup comparison showed that the treatment group had higher effective rate for improving TCM symptoms(P<0.01)and was more effective on increasing KPS score(P<0.05),and the difference was statistically significant.After treatment,NK cell count and CD^(4+)level in the treatment group were significantly increased(P<0.01),while CD^(8+)level and CD^(4+)/CD^(8+)showed no changes compared with those before treatment(P>0.05);CD^(4+)level in the control group was significantly increased(P<0.01)while NK cell count,CD^(8+)level,and CD^(4+)/CD^(8+)showed no changes compared with those before treatment(P>0.05).After treatment,the NK cell count in the treatment group was significantly higher than that in the control group(P<0.05),and there was no significant difference in the other observation indicators between the two groups(P>0.05).The serum AIM2 mRNA transcription level in the treatment group after chemotherapy was significantly higher than that before treatment(P<0.05).There was no sig

关 键 词：益肠散结方 脾虚痰瘀证 转移性结直肠癌 临床研究 

分 类 号：R735.35[医药卫生—肿瘤] R273[医药卫生—临床医学]