中链甘油三酯的生酮饮食在化疗3个月以上乳腺癌患者中的随机对照研究  

Randomized controlled trial of MCT ketogenic diet in patients with breast cancer over 3 months of chemotherapy

作　　者：刘柳 张园园 何珍 吴贝 徐洋[1] 曹蔚 Liu Liu;Zhang Yuanyuan;He Zhen;Wu Bei;Xu Yang;Cao Wei(Department of Oncology,the Third Hospital of Wuhan/Tongren Hospital Affiliated to Wuhan University,Wuhan 430061,Hubei,China)

机构地区：[1]武汉市第三医院/武汉大学附属同仁医院肿瘤科,湖北武汉430061

出　　处：《肿瘤代谢与营养电子杂志》2024年第2期195-200,共6页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：湖北省卫生健康委员会科研项目(WJ2020H191)。

摘　　要：目的分析基于中链甘油三酯(MCT)的生酮饮食在接受化疗3个月以上的乳腺癌患者中的应用价值。方法选取武汉市第三医院2021年3月至2023年3月期间入院的乳腺癌患者(接受化疗干预3个月以上)120例,简单随机将其分为对照组(60例)、干预组(60例)。其中,对照组接受传统化疗饮食干预,干预组接受基于MCT的生酮饮食干预,两组患者均实施为期5周的临床观察。比较两组患者干预前、干预1周、2周、3周、5周血酮、血糖及体重情况。同时,比较两组患者炎症指标[C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α、白介素-1β(IL-1β)]、免疫指标(CD3^(+)、CD4^(+)、CD8^(+)T细胞)、肠道门水平优势菌群(厚壁菌门、拟杆菌门、变型菌门)、不良反应(恶心、呕吐、腹泻、便秘)、低血糖发生率差异。结果干预1周至5周,干预组血酮水平较干预前升高,且干预组血酮水平高于对照组[(1.84±0.12)mmol/L比(0.41±0.10)mmol/L]、[(2.10±0.11)mmol/L比(0.42±0.09)mmol/L]、[(2.01±0.15)mmol/L比(0.44±0.10)mmol/L]、[(2.00±0.19)mmol/L比(0.43±0.08)mmol/L](P<0.05)。干预1周至5周,干预组血糖水平较干预前升高,且干预组血糖水平低于对照组(P<0.05)。干预5周,与干预前相比,两组患者体重均下降(P<0.05)。干预后,干预组CD3^(+)、CD4^(+)T细胞占比高于对照组[(70.15±6.07)%比(57.62±5.09)%]、[(54.02±5.62)%比(43.06±4.98)%],CD8^(+)T细胞占比[(30.62±3.45)%比(35.62±3.11)%]、炎症指标低于对照组(P<0.05)。干预后,两组患者厚壁菌门、变型菌门丰度均较干预前下降,拟杆菌门较干预前上升,且干预组拟杆菌门丰度高于对照组,厚壁菌门、变型菌门丰度低于对照组(P<0.05)。干预组不良反应总发生率(13.33%,8/60)显著低于对照组(31.67%,19/60)(P<0.05)。结论对接受化疗3个月以上的乳腺癌患者而言,基于MCT的生酮饮食干预可改善患者的整体健康状况、减少化疗的不良反应等,生酮饮食治疗乳腺癌�Objective To analyze the application value of medium-chain triglyceride(MCT)based ketogenic diet in breast cancer patients receiving chemotherapy for more than 3 months.Method A total of 120 patients with breast cancer(receiving chemotherapy intervention for more than 3 months)were enrolled in the Oncology Department of Wuhan Third Hospital from March 2021 to March 2023,and were simply randomly divided into control group(n=60)and intervention group(n=60).Among them,the control group received traditional chemotherapy diet intervention,and the intervention group received MCT-based ketogenic diet intervention.Both groups were subjected to clinical observation for 5 weeks.Blood ketone,blood glucose and body weight of the two groups were compared before intervention,after 1,2,3 and 5 weeks of intervention.Meanwhile,the inflammatory indexes(CRP,TNF-α,interleukin-1β),immune indexes(CD3^(+),CD4^(+),CD8^(+)),and the dominant bacteria group of intestinal hilum(Firmicutes,Bacteroidetes,and Morphomycetes)were compared between the two groups.The incidence of variant bacteria,adverse reactions(nausea,vomiting,diarrhea,constipation)and hypoglycemia were different.Result After 1 to 5 weeks of intervention,blood ketone levels in the intervention group were higher than before intervention.Moreover,the blood ketone in the intervention group was higher than that in the control group[(1.84±0.12)mmol/L vs(0.41±0.10)mmol/L],[(2.10±0.11)mmol/L vs(0.42±0.09)mmol/L],[(2.01±0.15)mmol/L vs(0.44±0.10)mmol/L],[(2.00±0.19)mmol/L vs(0.43±0.08)mmol/L](P<0.05).After 1 to 5 weeks of intervention,the blood glucose level in the intervention group was higher than before intervention,and the blood glucose level in the intervention group was lower than that in the control group(P<0.05).After 5 weeks of intervention,body weight decreased in both groups compared with before intervention(P<0.05).After intervention,CD3^(+)and CD4^(+)in the intervention group were higher than those in the control group[(70.15±6.07)mmol/L vs(57.62±5.09)%]and[(54.

关 键 词：乳腺癌 化疗 饮食 中链甘油三酯 生酮饮食 

分 类 号：R737.9[医药卫生—肿瘤] R459.3[医药卫生—临床医学]