丙氨酰谷氨酰胺及双歧杆菌三联活菌胶囊在结直肠癌术后辅助化疗中对肠道屏障功能的影响

Effect of alanyl glutamine and bifidobacterium triple viable capsule on intestinal barrier function in postoperative adjuvant chemotherapy for colorectal cancer

目的 探讨结直肠癌术后化疗对患者肠道屏障功能的损害及丙氨酰谷氨酰胺、双歧杆菌三联活菌胶囊对肠道屏障功能的影响。方法 将安徽医科大学附属六安医院接受术后辅助化疗的结直肠癌患者120例,随机分为3组,每组40例。对照组:使用奥沙利铂+卡培他滨(CapeOX)化疗。谷氨酰胺组:化疗方案与对照组相同,在化疗开始前1天静脉滴注丙氨酰谷氨酰胺注射液,连续用5?d。益生菌组:化疗方案与对照组相同,在化疗前1天口服双歧杆菌三联活菌胶囊,口服5d。3组患者在化疗前后分别检测血液中二胺氧化酶、D-乳酸、细菌内毒素等肠道屏障功能指标,并评价3组患者化疗后恶心、呕吐、腹泻、腹胀、肠鸣音减弱、食欲不振等化疗不良反应。结果 谷氨酰胺组及益生菌组化疗后二胺氧化酶、D-乳酸、细菌内毒素等指标水平较对照组低(P<0.05);对照组化疗前后二胺氧化酶、D-乳酸及细菌内毒指标水平比较,差异有统计学意义(P<0.05),化疗后较化疗前升高;化疗后谷氨酰胺组腹泻及腹胀症状评分较对照组低(P<0.05)。结论 CapeOX方案化疗对肠道屏障功能具有损伤作用;丙氨酰谷氨酰胺及双歧杆菌三联活菌胶囊对结直肠癌患者CapeOX方案化疗后肠道屏障功能具有一定改善作用;丙氨酰谷氨酰胺对CapeOX方案化疗所致腹泻及腹胀症状具有改善作用。

Objective To explore the impairment of colorectal cancer post-operative chemotherapy on intestinal barrier function of patients and the effects of alanyl glutamine and bifidobacterium triple viable capsule on intestinal barrier function.Methods Totally 120 patients with colorectal cancer who received post-operative adjuvant chemotherapy were randomly divided into three groups:The control group (n=40):only oxaliplatin plus capecitabine (CapeOX) chemotherapy was applied;glutamine group (n=40):with the same chemotherapy regimen as that of the control group,alanyl glutamine injection was used one day before the chemotherapy for 5 consecutive days;probiotic group (n=40):with the same chemotherapy regimen as that of the control group.bifidobacterium triple viable capsules were taken orally one day before the chemotherapy for 5 consecutive days.The intestinal barrier function indexes such as diamine oxidase,D-lactic acid and bacterial endotoxin were detected before and after chemotherapy in the three groups,and the adverse reactions such as nausea,vomiting,diarrhea,abdominal distention,weakened bowel sounds and anorexia were evaluated during post-operative adjuvant chemotherapy in the three groups.Results The levels of diamine oxidase,D-lactic acid and bacterial endotoxin in glutamine and probiotic groups after chemotherapy were lower than those in control group,difference of which was statistically significant (P<0.05).The levels of diamine oxidase,D-lactic acid and bacterial endotoxin in the control group were higher than those before chemotherapy,which showed a statistically significant difference (P<0.05).The scores of diarrhea and abdominal distension after chemotherapy in glutamine was lower than those in control group,and the difference was statistically significant (P<0.05).Conclusion CapeOX chemotherapy regimen would damage intestinal barrier function.Alanyl glutamine and bifidobacterium triple viable capsule could improve the intestinal barrier function indexes of patients with colorectal cancer treated with post-operative CapeOX regimen chemotherapy.Alanyl glutamine capsule could improve diarrhea and abdominal distension caused by CapeOX regimen chemotherapy.