双歧杆菌三联活菌胶囊对进展期胃癌术后化疗患者化疗副作用及肠道菌群的影响

Effect of Bifid Triple Viable capsules on side effects of chemotherapy and intestinal flora in patients with advanced gastric cancer after postoperative chemotherapy

目的探讨口服双歧杆菌三联活菌胶囊(BTVC)对进展期胃癌术后化疗患者的化疗副作用及肠道菌群影响。方法选取铜陵市人民医院2016年2月至2017年1月收治的根治性胃癌术后首次化疗患者为研究对象,随机分成奥沙利铂+替吉奥联合化疗方案组32例(对照组),奥沙利铂+卡培他滨+BTVC联合治疗组26例(观察组)。检测两组患者肠道菌群变化及记录患者不良反应情况。结果治疗后对照组中白细胞<3×109/L、粒细胞<2×109/L、血红蛋白<110g/L、血小板<100×109/L、肝功能损害、周围神经炎、恶心/呕吐、腹泻及Ⅲ/Ⅳ级不良反应发生例数均多于观察组(P<0.05)。治疗前两组患者肠道各菌群数量差异无统计学意义(P>0.05);治疗后对照组患者乳杆菌、双歧杆菌数量及杆/球比明显少于观察组(P<0.01),而肠球菌、大肠埃希菌数量明显多于观察组(P<0.01)。治疗后对照组患者乳杆菌、双歧杆菌数量及杆/球比明显少于治疗前(P<0.01),而肠球菌、大肠埃希菌数量多于治疗前(P<0.05)。治疗后观察组患者乳杆菌、双歧杆菌数量及杆/球比多于治疗前(P<0.05);而肠球菌、大肠埃希菌数量与治疗前差异无统计学意义(P>0.05)。结论 BTVC对胃癌术后化疗副作用有预防作用,并可调节患者肠道菌群。

Objective To explore the effect of oral Bifid Triple Viable capsules（BTVC）on the side effects of chemotherapy and intestinal flora in patients with advanced gastric cancer after postoperative chemotherapy.Methods Patients with gastric cancer who were admitted in our hospital from February 2016 to January2017 and underwent first chemotherapy after radical gastrectomy were randomly divided into the control group（32 cases,accepting Oxaliplatin ＋ S-1 chemotherapy）or the observation group（26 cases,accepting Oxaliplatin ＋ Capecitabine＋ BTVC treatment）.The changes of intestinal flora and side effects in the two groups were observed.Results After treatment,the counts of WBC（ 3×109/L）,granulocytes（ 2×109/L）,hemoglobin（ 110 g/L）and platelet（ 100×109/L）,the incidences of liver function damage,peripheral neuritis,nausea,vomiting and diarrhea as well as grade Ⅲ/Ⅳ adverse reactions in the control group were more than in the observation group（P〈0.05）.Before treatment,there was no significant difference in the numbers of intestinal bacteria between the two groups（P〉0.05）.After treatment,the numbers of Lactobacilli and Bifidobacteria and the ratio of bacilli/enterococci（B/E）in the control group were significantly less（P〈0.01）,while those of Enterococci and Escherichia coli were significantly more than in the observation group（P〈0.01）.After treatment,the numbers of Lactobacilli and Bifidobacteria and the B/E ratio significantly reduced（P〈0.01）,while the numbers of Escherichia coli and Enterococci increased（P〈0.05）.After treatment,the numbers of Lactobacilli and Bifidobacteriaand the B/E ratio in the observation group increased（P〈0.05）,but the numbers of Escherichia coli and Enterococci did not change significantly（P〉0.05）.Conclusion BTVC can prevent the side effects of chemotherapy after gastric cancer operation and regulate the intestinal flora.