肠道菌群干预晚期乳腺癌靶向药物所致腹泻的临床效果

Clinical Effect of Intestinal Flora Intervention on Diarrhea Caused by Targeted Drugs for Advanced Breast Cancer

目的探究肠道菌群干预晚期乳腺癌靶向药物所致腹泻的临床效果。方法选取2019年1月至2021年5月我院肿瘤科收治的曲妥珠单抗联合拉帕替尼治疗的HER-2阳性晚期乳腺癌所致腹泻患者100例,采用随机数字表法分为对照组和研究组各50例。对照组采用洛哌丁胺和饮食调整治疗,研究组在对照组基础上加用双歧四联活菌片治疗。对比两组治疗3个月后因严重腹泻放弃靶向药物治疗例数和临床疗效;对比两组治疗前后联免疫吸附法(ELISA)检测:血清C反应蛋白(CPR)、白介素-6(IL-6)、血清神经肽Y(NPY)、P物质(SP)和5-羟色胺(5-HT)水平。结果研究组患者ORR为92.00%,显著高于对照组的70.00%(P<0.05)。治疗后,研究组患者血清CRP、IL-6、NPY、SP、5-HT水平均低于对照组(P<0.05)。3个月及6个月内,研究组因严重腹泻放弃靶向药物治疗的例数显著少于对照组(P<0.05)。治疗后,研究组患者粪便中双歧杆菌、嗜酸乳杆菌数量均高于治疗前(P<0.05),且研究组显著高于对照组(P<0.05)。结论肠道菌群干预晚期乳腺癌靶向药物所致腹泻,效果显著,可能作用机制在于控制炎性因子及血清NPY、SP和5-HT表达水平。

Objectives To exp lore the clinical effect of intestinal flora intervention on diarrhea caused by targeted drugs in advanced breast cancer.Methods A total of 100 patients with diarrhea caused by trastuzumab combined with lapatinib treatment for HER-2 positive advanced breast cancer admitted to the Department of Oncology of our hospital from January 2019 to May 2021 were selected and randomly divided into control group and treatment group,with 50 cases in each group.The control group was treated with loperamide and diet adjustment,on which basis the treatment group was treated with Bifidobacterium tetravaccine Tablets(live).The number of patients who gave up targeted drug therapy due to severe diarrhea after 3 months and the clinical efficacy were compared between the two groups,enzyme-linked immunosorbent assay(ELISA)before and after treatment was compared between the two groups:Serum C-reactive protein(CPR),interleukin-6(IL-6),serum neuropeptide Y(NPY),substance P(SP)and 5-hydroxytryptamine(5-HT)levels were compared between the two groups.Results The ORR of the treatment group was 92.00%,which was significantly higher than the 70.00%in the control group(P<0.05).After treatment,the levels of serum CRP,IL-6,NPY,SP and 5-HT in the treatment group were significantly lower than those in the control group(P<0.05).Within 3 months and 6 months,the number of patients who gave up targeted drug therapy due to severe diarrhea in the treatment group was significantly less than that in the control group(P<0.05).After treatment,the number of bifidobacteria and lactobacillus acidophilus in the feces of treatment group increased significantly after treatment(P<0.05),and the number was significantly higher than that in the control group(P<0.05).Conclusions Intestinal flora has a significant effect on diarrhea caused by targeted drugs in advanced breast cancer,and the possible mechanism is that it control the expression levels of inflammatory factors and serum NPY,SP and 5-HT levels.