董氏奇穴联合丁沉扶正汤改善胃癌术后患者肠道菌群紊乱的作用机制研究  

Research on the Mechanism of Dong′s Unique Acupoints and Dingchen Fuzheng Tang in the Improvement of Postoperative Intestinal Flora Disorder in Patients with Gastric Cancer

作　　者：张静 高晓杰 富颖超 韩玫 邓力威 陈娟 ZHANG Jing;GAO Xiaojie;FU Yingchao;HAN Mei;DENG Liwei;CHEN Juan(Hebei General Hospital for Veterans,Xingtai 054000,China;Xingtai Hospital of TCM,Xingtai 054001,China)

机构地区：[1]河北省退役军人总医院,河北邢台054000 [2]邢台市中医院,河北邢台054001

出　　处：《西部中医药》2023年第12期1-6,共6页Western Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局中医药计划项目(2021455)。

摘　　要：目的:通过环芳香烃受体(cyclic aromatic hydrocarbon receptor,AhR)/白细胞介素22(interleukin-22,IL-22)/信号转导和转录激活因子3(signal transducer and activator of transcription3,STAT3)通路探讨董氏奇穴联合丁沉扶正汤对胃癌患者术后肠道菌群紊乱的影响,并探讨其具体作用机制。方法:选择接受腹腔镜下胃癌根治术的患者120例,随机分为对照组和针药联合组,每组60例。对照组接受董氏奇穴针灸治疗,针药联合组在对照组的基础上给予丁沉扶正汤治疗。比较两组术中指标、T淋巴细胞亚群、D-乳酸(D-Lactic acid,D-LA)、炎性因子、肠道细菌以及肠黏膜组织AhR/IL-22/STAT3通路转录和翻译水平。结果:两组干预前指标比较,差异无统计学意义(P>0.05)。干预后两组乳酸杆菌、双歧杆菌含量、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)比值均升高(P<0.05),且上述指标针药联合组均高于对照组(P<0.05)。干预后两组肠道中大肠杆菌、梭菌、拟杆菌、柔嫩梭菌水平及血清中D-乳酸、降钙素原、C反应蛋白(C-reactive protein,CRP)和白细胞介素-6(interleukin-6,IL-6)水平均降低(P<0.05),且以上指标针药联合组均显著低于对照组(P<0.05)。针药联合组住院时间显著短于对照组(P<0.05)。与干预前比较,两组AhR、IL-22和STAT3 mRNA及蛋白水平均升高(P<0.05),针药联合组高于对照组(P<0.05)。结论:董氏奇穴联合丁沉扶正汤可能通过促进AhR/IL-22/STAT3通路保护肠黏膜屏障,进而改善胃癌患者术后的细胞免疫功能、缓解肠道菌群失衡,促进患者恢复。Objective:To explore the effects of Dong′s unique acupoints combined with Dingchen Fuzheng Tang on postoperative intestinal flora disorder in patients with gastric cancer through the cyclic aromatic hydro-carbon receptor(AhR)/interleukin-22(interleukin,IL-22)/STAT3 pathway,and discuss its specific mechanism of action.Methods:All 120 patients who accepted laparoscopic radical resection of gastric cancer were chosen,and randomized into the control group and the needle-medicine combination group,with 60 cases in each group.The control group accepted the acupuncture treatment of Dong′s unique acupoints,and the needle-medicine combina-tion group was treated with Dingchen Fuzheng Tang based on acupuncture.To compare intraoperative indicators,T lymphocyte subsets,D-LA,inflammatory factors,intestinal bacteria and transcription and translation levels of AhR/IL-22/STAT3 pathway in intestinal mucosa tissue between both groups.Results:The difference had no statistical meaning in the indicators between both groups before the intervention(P<0.05).After the intervention,the contents of lactic acid bacillus and bacillus bifidus,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)ratio were increased in the two groups(P<0.05),and the above indicators in the needle-medicine combination group were significantly higher than these of the control group(P<0.05).After the intervention,the levels of Escherichia coli,clostridium,bacteroides and C.tenens in the intestine,the levels of serum D-LA,calcitonin,CRP and IL-6 were decreased in two groups(P<0.05),and the above indicators of the needle-medicine combination group were remarkably lower than these of the control group(P<0.05).The needle-medicine combination group was noticeably lower than the control group in length of stay(P<0.05).Compared with before the intervention,the levels of AhR,IL-22 and STAT3 mRNA and protein were raised in both groups(P<0.05),the needle-medicine combination group was clearly higher than the control group(P<0.05).Conclusion:Dong′s unique acupoints combined with Dingchen Fu

关 键 词：胃癌 董氏奇穴 丁沉扶正汤 肠道菌群 环芳香烃受体/白细胞介素22/信号转导和转录激活因子3通路 作用机制 

分 类 号：R735.2[医药卫生—肿瘤]