济生散联合术后辅助化疗对Ⅱ期结直肠癌的疗效及对肠道菌群的影响

Jisheng decoction combined with postoperative adjuvant chemotherapy in treating Patients undergoing chemotherapy post Ⅱ period colorectal cancer operation and its effect on intestinal flora

目的探讨济生散联合术后辅助化疗对Ⅱ期结直肠癌的疗效及对肠道菌群的影响.方法选择南通市中医院2016年9月至2018年9月收治的结直肠癌手术患者60例为研究对象,按随机数字表分为单化疗组和中药加化疗组,每组30例.单化疗组术后第4周开始采用CapeOX化疗方案.中药加化疗组同时给予济生散内服,1剂/d.化疗16周后,比较两组临床疗效、化疗期间毒副反应、胃肠动力、肠道菌群变化.结果化疗16周后,中药加化疗组总有效率(83.33%)高于单化疗组(60.00%),差异有统计学意义(P<0.05).中药加化疗组白细胞减少等毒副反应发生率均低于单化疗组,其中两组患者的白细胞减少、胃肠道反应差异有统计学意义(P<0.05).中药加化疗组患者的排气、排便时间以及肠鸣音恢复时间均少于单化疗组,差异有统计学意义(P<0.01).化疗16周后,中药加化疗组患者的双歧杆菌、乳酸杆菌、粪肠球菌水平高于单化疗组及大肠杆菌低于单化疗组,差异有统计学意义(P<0.01).结论济生散能减轻Ⅱ期结直肠癌患者术后化疗的毒副反应,提高近期疗效,促进胃肠功能和肠道菌群平衡恢复.

Objective To investigate the efficacy of Jisheng decoction combined with postoperative adjuvant chemotherapy in treating patients with Ⅱ period colorectal cancer undergoing chemotherapy post operation and its effect on intestinal flora. Methods Patients with colorectal cancer undergoing chemotherapy post operation were selected and randomly divided into single chemotherapy group and Chinese medicine plus chemotherapy group(30 cases in each group).The single chemotherapy group was given with CapeOX chemotherapy regimens.The Chinese medicine plus chemotherapy group was treated with Jisheng decoction(1 dose/d).After 12 weeks' chemotherapy,the efficacy,toxicity reaction during chemotherapy,gastrointestinal motility,and intestinal flora changes were compared between two groups. Results After 16 weeks' chemotherapy,the total efficacy of the Chinese medicine plus chemotherapy group(83.33%) was higher than the single chemotherapy group(60.00%),the difference was statistically significant(P<0.05).After 16 weeks' chemotherapy,The incidence of toxic and side effects such as leukopenia in the Chinese medicine plus chemotherapy group was lower than that in the single chemotherapy group,and the difference of leukopenia and gastrointestinal reaction between the two groups was statistically significant(P<0.05).The exhaust,defecation,and bowel sounds recovery time of patients in the chemotherapy group were lower than those in the single chemotherapy group,and the difference was statistically significant(P<0.01).After 16 weeks' chemotherapy,the levels of bifidobacteria,lactobacillus,and enterococcus faecalis were higher,while escherichia coli were lower,than those in the single chemotherapy group,and the difference was statistically significant(P<0.01).Conclusions Jisheng decoction can reduce toxic and side-effects caused by chemotherapy in Ⅱperiod colorectal cancer operation cases,increase the recent efficacy,and promote the recovery of gastrointestinal function and intestinal flora balance.