灌肠方抑制晚期肠癌生长及对血清VEGF和miR-NA-31表达的临床研究

Clinical Research on Guanchang Fang's Inhibit Function on the Growth of Advanced intestinal Cancer and the Expression of Serum VEGF and miRNA31

目的观察灌肠方联合化疗和单用化疗治疗肠癌病人外周血miRNA-31和血管内皮生长因子(VEGF)表达的变化。方法将符合纳入标准的患者随机分为20例实验组和20例对照组,实验组采用仙鹤草、败酱草、龙葵组成的灌肠方联合化疗治疗,对照组单用FOLFOX方案化疗,观察灌肠方联合化疗对晚期肠癌患者治疗后临床疗效评价、中医证侯疗效判定、生活质量评分标准及毒性反映等影响,采用荧光定量PCR法检测灌肠方干预后患者血清miRNA-31表达水平的变化,采用ELISA检测其对人VEGF表达水平的影响,探索灌肠方的作用机理。结果联合治疗组缓解率明显大于单用化疗组(P<0.05);2组临床证候疗效比较,P>0.05;经卡氏评分,联合治疗组生活状况优于单用化疗组(P<0.05);联合治疗组VEGF、miRNA-31均低于单用化疗组(P<0.01)。结论灌肠方联合化疗治疗晚期大肠癌能提高临床客观疗效及疾病控制率,降低晚期大肠癌患者血清VEGF水平,其作用机制可能与miRNA-31水平下调有关。

OBJECTIVE To observe intestinal cancer patients＇ peripheral blood miRNA31 and VEGF expression changes when treated with the Guanchang Fang combined chemotherapy and chemotherapy alone. METHODS A prospective controlled clinical research methods were used and the intestinal cancer patients were randomly divided into 20 cases of experimental group and 20 cases of the control group. The experimental group using Guanchang Fang （made by Herba Agrimoniae, Herba Patriniae, and Herba Solani Nigri） combined with chemotherapy, and the control group treated with chemotherapy （FOLTOX scheme） alone. Guanchang Fang combined chemotherapy＇s effect on advanced intestinal cancer patients, the efficacy of traditional Chinese medicine syndrome curative effect, clinical curative effect, standards of life quality score, toxicity reflection were observed. Quantitative PCR assay was used to test the post Guanchang Fang intervention serum miRNA31 level changes; analysis of clinical efficacy and miRNA31 correlation was detected by ELISA in human vascular endothelial growth factor （VEGF） expression level changes, the mechanism of Guanchang Fang was explored. RESULTS Guanchang Fang combination chemotherapy＇s effect on treating advanced intestinal cancer is better than the chemotherapy alone （P〈0.05） ; Comparison of the two groups shows that（P〈0.05）; The KPS shows combined group＇s patients life quality are better （P〈0.05）; the VEGF and miRNA31 of combined group are lower than the chemotherapy group （P〈0.01）. CONCLUSION Guanchang Fang combined with chemotherapy can control and reduce advanced intestinal cancer serum VEGF levels, and its mechanism may be associated with miRNA31 level down regulation.