参苓白术散治疗宫颈癌放疗后急性放射性直肠炎的效果及对核因子κB信号通路的影响

Effect of Shenling Baizhu powder in the treatment of acute radiation proctitis after radiation therapy for cervical cancer and its effect on nuclear factor κB signaling pathway

目的观察参苓白术散防治宫颈癌放疗所致急性放射性肠炎(ARP)的临床疗效及对核因子κB(nuclearfactor-κB,NF-κB)信号通路的影响.方法选择2018年1~12月在我院就诊的初治宫颈癌患者60例,随机分为观察组和对照组,各30例.对照组采用放射治疗和对症治疗,观察组在对照组的基础上加用参苓白术散6.0 g tid至放疗结束.采用酶联免疫吸附试验(ELISA)检测血清瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-1β(interleukin-1β,IL-1β)的表达水平;采用Western blot法检测直肠组织NF-κB抑制蛋白激酶β(inhibitor ofNF-κβ kinaseβ,IKKβ)、NF-κB p65的表达水平.结果治疗结束后,观察组ARP的发生率(26.67%)明显低于对照组(50.00%),有统计学差异(P<0.05).观察组血清TNF-α、IL-1β的表达水平明显低于对照组,有统计学差异(P<0.05).观察组直肠黏膜组织IKKβ、NF-κB p65蛋白的相对表达水平明显低于对照组,有统计学差异(P<0.05).结论参苓白术散可有效防治ARP,其作用机制可能与抑制NF-κB信号通路有关.

Objective To observe the clinical efficacy of Shenling Baizhu powder in the prevention and treatment of acute radiation proctitis (ARP) caused by radiotherapy of cervical cancer and its effect on nuclear factor-κB (NF-κB) signaling pathway. Methods A total of 60 patients with cervical cancer who were initially treated in our hospital from January to December 2018 were selected. They were randomly divided into observation group and control group, with 30 cases in each group. The control group was given radiation therapy and symptomatic treatment. On the basis of the control group, the observation group was further given Shenling Baizhu power 6.0 g tid to the end of radiotherapy. The expression levels of serum necrosis factor-α(TNF-α) and interleukin-1β(IL-1β) were detected by enzyme-linked immunosorbent assay (ELISA);the expression levels of inhibitor of NF-κB kinaseβ(IKKβ) and NF-κBp65 in rectal tissues were detected by Western blot. Results After treatment, the incidence rate of ARP in the observation group (26.67%) was significantly lower than that in the control group (50.00%), and the difference was statistically significant (P<0.05). The expression levels of serum TNF-α and IL-1β in the observation group were significantly lower than those in the control group, and the difference was statistically significant (P<0.05). The relative expression levels of IKKβ and NF-κB p65 protein in the rectal mucosa in the observation group were significantly lower than those in the control group, and the differences were statistically significant(P<0.05). Conclusion Shenling Baizhu powder can effectively prevent and treat ARP, and its mechanism may be related to the inhibition of NF-κB signaling pathway.