PPI联合FOLFOX方案在结肠癌术后化疗中对肠道黏膜屏障功能及生存质量的影响

Effects of PPI combined with FOLFOX regimen on postoperative intestinal mucosal barrier function and quality of life in patients with colon cancer

目的:探讨质子泵抑制剂(PPI)联合奥沙利铂+亚叶酸钙+氟尿嘧啶(FOLFOX方案)在结肠癌根治术后辅助化疗期间应用的价值。方法:选取我院2015年3月-2017年3月收集的110例结肠癌患者,所有患者均接受结肠癌根治手术,采用随机数字表法分为观察组和对照组各55例;对照组术后接受FOLFOX方案化疗,观察组术后采用奥美拉唑联合FOLFOX方案治疗,对比两组化疗前、化疗结束时的二胺氧化酶(DAO)、血乳酸、尿乳果糖/甘露醇(L/M)、生存质量、各类化疗毒副反应发生率。结果:治疗前,观察组和对照组的血清DAO、血乳酸、L/M水平差异不具有统计学意义(P>0.05);治疗后,观察组患者的血清DAO、血乳酸、L/M水平均低于对照组(P<0.05),两组患者治疗后的血清DAO、血乳酸、L/M水平较治疗前均显著的升高(P<0.05);治疗前,观察组和对照组的各维度生存质量评分差异无统计学意义(P>0.05);治疗后,观察组患者的躯体功能、角色功能、认知功能、社会功能、整体生活质量评分均高于对照组(P<0.05),观察组的疲乏、恶心/呕吐、呼吸困难、失眠、食欲丧失、腹泻评分低于对照组(P<0.05);观察组患者的腹泻、恶心/呕吐发生率显著低于对照组(P<0.05),两组患者的脱发、骨髓抑制、肝肾损害发生率差异无统计学意义(P>0.05)。结论:PPI联合FOLFOX方案在结肠癌根治术后应用较单纯化疗有利于减轻患者的不良反应,保护肠道功能,提高患者的生存质量。

Objective: To investigate the value of proton pump inhibitor(PPI) combined with oxaliplatin ,leucovorin and 5-fluorouracil (FOLFOX) in the treatment of colon cancer. Methods: One hundred and ten patients with colon cancer from March 2015 to March 2017 were enrolled. All patients underwent radical surgery for colon cancer. They were randomly divided into observation group and control group (55 cases). The FOLFOX regimen was treated with omeprazole and FOLFOX in the observation group. The diamine oxidase (DAO), blood lactate, and urinary fructose/mannitol (L/M) were compared before and after chemotherapy. Quality of life, the incidence of various types of chemotherapy toxic side effects were also compared. Results: Before treatment, serum DAO, blood lactate, and L/M levels in the study and control groups were not statistically different (P>0.05);after treatment, serum DAO, blood lactate, and L/M levels were significantly lower in the study group. In the control group, serum DAO, blood lactate, and L/M levels after treatment in both groups were significantly higher than before treatment (P<0.05);before treatment, between the dimensions of the study and control groups, the difference in quality of life scores was not statistically significant (P>0.05). After treatment, the physical function, role function, cognitive function, social function, and overall quality of life scores were higher in the study group than in the control group (P<0.05). Fatigue, nausea, vomiting, dyspnea, insomnia, loss of appetite, and diarrhea were lower in the study group than in the control group (P<0.05). The incidence of diarrhea and nausea and vomiting was significantly lower in the study group than in the control group (P<0.05). There was no significant difference in the incidence of hair loss, myelosuppression, and liver and kidney damage between the two groups (P>0.05). Conclusion: The application of PPI combined with FOLFOX in the treatment of colon cancer after radical resection may contribute more to the reduction of patients' adverse reactions, protection of intestinal function, and improvement of patients’ quality of life.