健脾解毒方加减对脾气亏虚证晚期结直肠癌化疗患者肠道菌群及免疫功能的影响

Effects of Modified Jianpi Jiedu Formula (健脾解毒方) on Intestinal Flora and Immune Function in Advanced Colorectal CancerChemotherapy with Spleen Qi Deficiency Syndrome

目的观察健脾解毒方加减对脾气亏虚证晚期结直肠癌化疗患者肠道菌群和免疫功能的影响。方法将56例晚期结直肠癌脾气亏虚证患者随机分为对照组和观察组各28例。对照组采用XELOX、FOLFOX4方案进行化疗。观察组在对照组化疗的基础上,同时给予健脾解毒方加减口服,每日1剂。8周后比较两组患者治疗后生存质量卡氏量表(KPS)评分、中医证候积分、免疫指标、肠道菌群及粪便分泌型免疫球蛋白A(sIgA)水平,并判定临床疗效。结果观察组临床疗效总有效率为60.71%,对照组为21.43%,观察组临床疗效优于对照组(P<0.01)。治疗后观察组KPS评分、CD3^+、CD4^+、CD4^+/CD8^+、自然杀伤细胞、sIgA水平及乳酸杆菌、双歧杆菌数量显著升高,且高于对照组(P<0.05或P<0.01)。观察组中医证候积分、CD8^+水平、肠道大肠杆菌及肠球菌数量较治疗前下降,且低于对照组(P<0.05或P<0.01)。结论健脾解毒方加减具有调节肠道菌群失调,保护肠道屏障的作用,这可能是健脾解毒方改善结直肠癌化疗患者脾虚症状、减轻化疗不良反应、提高生活质量、增强非特异性免疫功能的重要原因。

Objective To observe the effects of Modified Jianpi Jiedu Formula(健脾解毒方)on intestinal flora and immune function in advanced colorectal cancer patients with spleen qi deficiency syndrome treated with chemotherapy.Methods A total of 56 advanced colorectal cancer patients with spleen qi deficiency syndrome were randomly divided into a control group and a observation group with 28 patients in each group.The control group received XELOX and FOLFOX4 chemotherapy.On the basis of the control group,the observation group was given Modified Jianpi Jiedu Formula(健脾解毒方)orally,1 dose daily.After 8 weeks,the Karnorfsky scores(KPS),syndrome scores in traditional Chinese medicine,immune indicators,intestinal flora,and fecal secretory immunoglobulin A(sIgA)levels of both groups of patients were compared after treatment,and the clinical efficacy was determined.Results The total effective rate of clinical effects in the observation group was 60.71%,and that in the control group was 21.43%.The clinical effects in the observation group was superior to that in the control group(P<0.01).After treatment,the KPS,CD3^+,CD4^+,CD4^+/CD8^+,natural killer cells,sIgA levels,and the number of lactobacillus and bifidobacteria were significantly increased in the observation group,and were higher than those in the control group(P<0.05 or P<0.01).The syndrome scores,CD8^+level,the number of intestinal E.coli and enterococci of the observation group were also lower than those before treatment,and were lower than those of the control group(P<0.05 or P<0.01).Conclusion Modified Jianpi Jiedu Formula(健脾解毒方)has the effects of regulating intestinal flora imbalance and protecting the intestinal barrier.This may be the important causes of Modified Jianpi Jiedu Formula(健脾解毒方)improving the symptoms of spleen deficiency in patients with colorectal cancer chemotherapy,reducing adverse reactions to chemotherapy,improving quality of life,and enhancing nonspecific immune function.