健脾解毒方对结直肠癌术后脾虚证疗效、免疫功能及肠道微生态的影响  

Efficacy of Jianpi Jiedu Prescription in the treatment of spleen deficiency syndrome and its ffeffects on the immune function and intestinal microecology in patients after a colorectal cancer surgery

作　　者：陈晓燕 刘志华[1] 卢敏洁 郁晓瑜 CHEN Xiaoyan;LIU Zhihua;LU Minjie;YU Xiaoyu(Taicang Hospital of Traditional Chinese Medicine,Suzhou 215400,China)

机构地区：[1]太仓市中医医院,江苏苏州215400

出　　处：《吉林中医药》2023年第10期1170-1173,共4页Jilin Journal of Chinese Medicine

基　　金：江苏省自然科学基金面上项目(BK20201491)。

摘　　要：目的 研究健脾解毒方对结直肠癌术后脾虚证疗效、免疫功能及肠道微生态的影响。方法 选取2018年10月-2022年10月本院收治的结直肠癌术后脾虚证患者114例,术后均采用改良型FOLFOX6方案化疗,以随机法分为常规组(常规西药治疗)、联合组(常规西药治疗联合健脾解毒方),各57例。检测中医证候积分、临床疗效、肠道微生态、免疫功能、生存质量及不良反应。结果 联合组临床总有效率、卡氏功能状态量表(KPS)评分升高率、疼痛减轻率及体质量增加率高于常规组(P <0.05)。治疗后,2组中医证候积分、肠道大肠杆菌数量、肠球菌数量、血清白介素-10(IL-10)水平降低(P <0.05),乳酸杆菌数量增加(P <0.05),自然杀伤(NK)细胞活性增强(P <0.05),血清干扰素-γ(IFN-γ)水平升高(P <0.05),以联合组更明显(P <0.05)。联合组3~4度白细胞减少、中性粒细胞减少及呕吐发生率低于常规组(P <0.05),但转氨酶升高、乏力、皮肤感染、脱发、出血发生率比较,差异无统计学意义(P> 0.05)。结论 健脾解毒方可改善结直肠癌术后脾虚证患者治疗效果、肠道微生态及生存质量,增强免疫功能,且可减少化疗所致的不良反应。Objective To study the efficacy of Jianpi Jiedu Prescription in the treatment of spleen deficiency syndrome and its effects on the immune function and intestinal microecology in patients after a colorectal cancer surgery.Methods A total of 114 patients with the spleen deficiency syndrome after a colorectal cancer surgery admitted to our hospital from October 2018 to October 2022 were selected as the study subjects and they were all treated with FOLFOX6 chemotherapy.They were randomly divided into a convention group(receiving a conventional western medicine treatment)and a combination group(receiving a conventional western medicine treatment combined with Jianpi Jiedu Prescription),with 57 cases in each group.Their TCM syndrome scores,clinical efficacy,intestinal microecology,immune function,quality of life and toxic side effects were detected.Results The total effective rate,KPS score increase rate,pain reduction rate and weight gain rate were higher in the combination group than those in the convention group(P<0.05).After treatment,the TCM syndrome scores,the number of enteric E.coli,the number of enterococci,the level of serum interleukin-10(IL-10)were decreased(P<0.05),while the number of lactobacilli were increased(P<0.05),the activity of natural killer(NK)cells was enhanced(P<0.05),and the level of serum interferon-γ(IFN-γ)was increased in both groups(P<0.05),and all the above indicators were more pronounced in the combination group(P<0.05).The incidence of 3-4 degree leukopenia,neutropenia and vomiting in the combination group was lower than that in the convention group(P<0.05),but there was no statistical significance in the incidence of elevated transaminase,fatigue,skin infection,alopecia and bleeding(P>0.05).Conclusion Jianpi Jiedu Prescription can improve the therapeutic effect,intestinal microecology and quality of life in patients with the spleen deficiency syndrome after a colorectal cancer surgery,enhance their immune function,and reduce the toxic side effects caused by chemotherapy.

关 键 词：结直肠癌 术后脾虚证 健脾解毒方 免疫功能 肠道微生态 

分 类 号：R735.3[医药卫生—肿瘤]