基于肠道菌群平衡分析微生态制剂联合浙贝黄芩汤对急性淋巴细胞白血病大剂量化疗后患者的临床影响  

Clinical effects of microecological preparations combined with Zhebei Huangqin Decoction on acute lym-phoblastic leukemia after high-dose chemotherapy based on the analysis of intestinal flora balance

作　　者：张雯[1] 宋超 钟镇阳 呼婷 汪梅花 拓进宝 曹慧琴[1] Zhang Wen;Song Chao;Zhong Zhenyang;Hu Ting;Wang Meihua;Tuo Jinbao;Cao Huiqin(Department of Hematology and Immunology,Affiliated Hospital of Yan′an University,Yan′an,Shannxi 716000,China)

机构地区：[1]延安大学附属医院血液免疫科,陕西延安716000

出　　处：《中国药物与临床》2024年第18期1157-1162,共6页Chinese Remedies & Clinics

基　　金：陕西省教育厅青年创新团队建设科研计划项目(21JP033)。

摘　　要：目的探讨微生态制剂联合浙贝黄芩汤对急性淋巴细胞白血病(ALL)大剂量化疗后患者粒细胞集落刺激因子受体(G-CSFR)、粒单系集落形成单位(CFU-GM)、肠道菌群及红系爆式集落形成单位(BFU-E)的影响。方法选取延安大学附属医院2019年6月至2022年12月收治的ALL患者130例作为研究对象,根据治疗方法将患者分为A组、B组、C组,3组患者均接受大剂量化疗,化疗结束48 h后A组患者实施常规治疗,B组患者单纯浙贝黄芩汤治疗,C组给予微生态制剂联合浙贝黄芩汤治疗,治疗12 d后,对3组患者G-CSFR、CFU-GM、BFU-E表达情况及血细胞数量进行检测。结果治疗后,C组血红蛋白、白细胞、血小板[(79±6)g/L、(3.8±0.4)×10^(9)/L、(66.4±3.6)×10^(9)/L]与A组[(59±7)g/L、(3.2±0.4)×10^(9)/L、(52.6±2.8)×10^(9)/L]、B组[(61±7)g/L、(3.1±0.3)×10^(9)/L、(52.8±2.6)×10^(9)/L]对比,差异有统计学意义(P<0.05)。C组G-CSFR(5.35±0.16)pg/ml和白细胞介素-11受体(IL-11R)(6.38±0.54)μg/kg水平均高于A组[(2.23±0.13)pg/ml和(1.49±0.24)μg/kg]和B组[(2.31±0.16)pg/ml和(2.31±0.49)μg/kg]差异有统计学意义(P<0.05)。治疗后,C组患者7 d CFU-GM(18.5±6.0)个和14 d BFU-E(83.5±7.5)个高于A组[7 d CFU-GM(9.5±2.0)个和14 d BFU-E(59.5±6.5)个]和B组[7 d CFU-GM(12.0±6.5)个和14 d BFU-E(63.5±5.0)个],差异有统计学意义(P<0.05)。7 d后,C组双歧杆菌(12.56±3.25)lgCFU/g、乳酸杆菌(13.56±2.58)lgCFU/g、肠杆菌(5.12±1.45)lgCFU/g、肠球菌(5.14±0.58)lgCFU/g高于A组[(9.26±1.03)lg CFU/g、(8.65±0.84)lg CFU/g、(8.08±0.64)lgCFU/g、(8.15±0.46)lgCFU/g]和B组[(11.35±1.36)lg CFU/g、(12.43±1.14)lgCFU/g、(6.49±0.55)lgCFU/g、(6.66±0.43)lgCFU/g],差异有统计学意义(P<0.05)。结论微生态制剂联合浙贝黄芩汤治疗可以有效提高ALL大剂量化疗后患者的G-CSFR、CFU-GM、BFU-E水平,可能更好地改善化疗引起的患者骨髓抑制情况,改善肠道菌群,具有临床研究价值。Objective To explore the effects of microecology+Zhebei Huangqin Decoction on granulocyte colony-stimulating factor receptor(G-CSFR),granuliophytic colony formation unit(CFU-GM),intestinal flora and erythroid explosive colony formation unit(BFU-E)in patients after high-dose chemotherapy for acute lym-phoblas-tic leukemia.Methods A total of 130 patients with acute lymphoblastic leukemia admitted to Affiliated Hospital of Yan′an University from June 2019 to December 2022 were selected as the study objects,and the patients were divided into group A,group B,and group C according to the method of therapeutic efficacy,and the patients of all 3 groups received high-dose chemotherapy,and the conventional treatment was implemented in the patients of group A after 48 h of the end of chemotherapy,the patients of group B were treated with Zhebei Huangqin Decoc-tion alone,and the patients of group C were treated with microecological preparation+Zhebei Huangqin decoction.In group C,microecological preparation+Zhebei Huangqin Decoction was given,and after 12 d of treatment,the expression of human G-CSFR,CFU-GM,BFU-E and blood cell counts of patients in the three groups were detected.Results After treatment,hemoglobin,leukocytes,and platelets in group C[(79±6)g/L,(3.8±0.4)×10^(9)/L,(66.4±3.6)×10^(9)/L]were similar to those in group A[(59±7)g/L,(3.2±0.4)×10^(9)/L,(52.6±2.8)×10^(9)/L],and group B[(61±7)g/L,(3.1±0.3)×10^(9)/L,(52.8±2.6)×10^(9)/L]were compared,and the difference was statistically significant(P<0.05).After treatment,the levels of G-CSFR(5.35±0.16)pg/ml and IL-11R(6.38±0.54)μg/kg were higher in group C than in group A[(2.23±0.13)pg/ml,(1.49±0.24)μg/kg],and group B[(2.31±0.16)pg/ml,(2.31±0.49)μg/kg]comparisons,and the differences were statistically significant(P<0.05).After treatment,the number of 7 d CFU-GM(18.5±6.0)and 14 d BFU-E(83.5±7.5)was higher in patients in group C than in group A[7 d CFU-GM(9.5±2.0)and 14 d BFU-E(59.5±6.5)],group B[7 d CFU-GM(12.0±6.5)and 14 d BFU-E(63.5±5.0)on

关 键 词：白血病 淋巴样 受体 粒细胞集落刺激因子 干细胞 粒单系集落形成单位 红系爆式集落形成单位 

分 类 号：R273[医药卫生—中西医结合]