枯草杆菌二联活菌颗粒联合斑蝥酸钠维生素B_(6)辅助治疗在慢性阻塞性肺疾病合并非小细胞肺癌中的效果研究  

Efficacy of Live Combined Bacillus Subtilis and Enterococcus Faecium Granules with Multivitamines Combined with Disodium Cantharidinate and Vitamin B_(6) in the Treatment of Chronic Obstructive Pulmonary Disease Complicated with Non-small Cell Lung Cancer

作　　者：陈俊杰 谢利娜 冀丽佳 田秀丽 CHEN Junjie;XIE Lina;JI Lijia;TIAN Xiuli(Department of Respiratory and Critical Care Medicine,the First Hospital of Zhangjiakou City,Zhangjiakou,Hebei 075000,China)

机构地区：[1]张家口市第一医院呼吸与危重症医学三科,河北张家口075000

出　　处：《临床误诊误治》2024年第7期37-42,共6页Clinical Misdiagnosis & Mistherapy

基　　金：张家口市重点研发计划项目(2322165D)。

摘　　要：目的探讨枯草杆菌二联活菌颗粒联合斑蝥酸钠维生素B_(6)辅助治疗在慢性阻塞性肺疾病(COPD)合并非小细胞肺癌(NSCLC)中的效果。方法选取2020年1月—2022年10月收治的COPD合并NSCLC 60例,采用随机数字表法分为观察组和对照组各30例。2组均给予化疗联合免疫治疗,在此基础上对照组给予斑蝥酸钠维生素B_(6)治疗,观察组给予枯草杆菌二联活菌颗粒联合斑蝥酸钠维生素B_(6)治疗,2组均持续治疗4个周期。统计2组治疗4个周期后总缓解率及治疗前、治疗2个周期、治疗4个周期肿瘤因子[癌胚抗原(CEA)、癌抗原125(CA125)、血管内皮生长因子(VEGF)、缺氧诱导因子(HIF-1α)]、免疫功能指标(CD3+、CD4+、CD4+/CD8+)、肠道微生态指标(肠道菌群丰富度、多样性指数)、治疗期间毒副反应、治疗后1年生存率。结果2组总缓解率比较差异无统计学意义(P>0.05)。治疗后2组CEA、CA125、VEGF、HIF-1α呈下降趋势,CD3+、CD4+、CD4+/CD8+呈升高趋势,差异有统计学意义(P<0.05)。治疗后2组肠道菌群丰富度、多样性指数呈升高趋势,且观察组高于对照组(P<0.05)。观察组胃肠道反应发生率为16.67%(5/30)低于对照组的46.67%(14/30)(P<0.05)。2组治疗后1年生存率比较差异无统计学意义(P>0.05)。结论枯草杆菌二联活菌颗粒联合斑蝥酸钠维生素B_(6)辅助治疗能有效纠正COPD合并NSCLC患者化疗及免疫治疗后肠道菌群紊乱,改善机体免疫应答,抑制肿瘤因子表达,减少毒副反应的发生。Objective To investigate the efficacy of Live Combined Bacillus Subtilis and Enterococcus Faecium Granules with Multivitamines combined with Disodium Cantharidinate and Vitamin B_(6) in the treatment of chronic obstructive pulmonary disease(COPD)complicated with non-small cell lung cancer(NSCLC).Methods A total of 60 patients with COPD combined with NSCLC from January 2020 to October 2022 were selected and divided into the observation group(n=30)and the control group(n=30)by random number table method.Both groups were given chemotherapy combined with immunotherapy,on the basis of which the control group was given Disodium Cantharidinate and Vitamin B_(6),and the observation group was given Live Combined Bacillus Subtilis and Enterococcus Faecium Granules with Multivitamines Combined with Disodium Cantharidinate and Vitamin B_(6).Both groups were treated consecutively for 4 cycles.The total response rate after 4 cycles of treatment and the tumor factors[carcinoembryonic antigen(CEA),cancer antigen 125(CA125),vascular endothelial growth factor(VEGF),hypoxia inducible factor-1α(HIF-1α)],immune function indicators(CD3+,CD4+,CD4+/CD8+),and intestinal microecological index(intestinal flora richness and diversity index),toxic and side effects during treatment,and 1-year survival rate after treatment of the two groups before treatment and after 2 and 4 cycles of treatment were analyzed.Results There was no significant difference in the total remission rate between the two groups(P>0.05).After treatment,CEA,CA125,VEGF and HIF-1αin the two groups decreased,while CD3+,CD4+and CD4+/CD8+increased,with statistical significance(P<0.05).After treatment,the intestinal flora richness and diversity index of the two groups showed an increasing trend,which were higher in the observation group than in the control group(P<0.05).The incidence of gastrointestinal reactions in the observation group was 16.67%(5/30),which was lower than that in the control group(46.67%,14/30)(P<0.05).There was no significant difference in 1-year surviva

关 键 词：肺疾病 慢性 阻塞性 肺肿瘤 枯草杆菌二联活菌颗粒 斑蝥酸钠维生素B_(6) 癌胚抗原 CD3+ 毒副反应 生存率 

分 类 号：R563.9[医药卫生—呼吸系统]