双歧杆菌三联活菌胶囊联合FOLFOX方案用于结直肠癌术后对肠道微生态及抗肿瘤免疫应答的影响

Effects of Bifidobacterium triple viable capsule combined with FOLFOX regimen on intestinal micro-ecology and anti-tumor immune response after colorectal cancer surgery

目的:探讨双歧杆菌三联活菌胶囊联合奥沙利铂+5-氟尿嘧啶+亚叶酸钙(mFOLFOX6)方案用于结直肠癌术后对肠道微生态及抗肿瘤免疫应答的影响。方法:选取2018年1月~2021年1月在本院确诊的120例行结直肠癌术患者,采用简单随机分组将患者分为观察组和对照组各60例。对照组患者采用mFOLFOX6方案治疗,观察组加用双歧杆菌三联活菌胶囊治疗,均持续治疗6个月。分别于治疗前后,采用流式细胞检测法检测患者T淋巴细胞亚群水平,酶联免疫吸附法(ELISA)检测Th1和Th2细胞因子,微生物检定系统进行肠道菌群鉴定;记录两组治疗期间的不良反应发生情况。结果:治疗后,观察组患者缓解率为95.00%,高于对照组患者的86.67%;观察组患者双歧杆菌、乳酸杆菌和粪肠球菌水平明显高于对照组,大肠杆菌水平明显低于对照组;观察组CD4^(+)水平和CD4^(+)/CD8^(+)明显高于对照组,CD8^(+)水平明显低于对照组;观察组IL-2和IFN-γ水平明显高于对照组,IL-4和TNF-α水平明显低于对照组;治疗后,两组患者不良反应均集中在Ⅰ~Ⅱ度,观察组患者不良反应率较对照组低,但差异不显著。结论:联合治疗方案用于结直肠癌术后患者的辅助治疗显示出良好的临床疗效,该联合治疗方案能够帮助患者重建肠道微生态平衡,提高抗肿瘤免疫应答能力。

Objective To explore the effects of Bifidobacterium triple viable capsule combined with oxaliplatin + 5-fluorouracil + leucovorin (mFOLFOX6) regimen on intestinal ecology and anti-tumor immune response after colorectal cancer surgery.Methods A total of 120 patients with colorectal cancer confirmed in the hospital were enrolled between January 2018 and January 2021.According to simple random grouping method,they were divided into observation group and control group,60 cases in each group.The control group was treated with mFOLFOX6 regimen,while observation group was additionally treated with Bifidobacterium triple viable capsules.All were continuously treated for 6 months.Before and after treatment,levels of T lymphocyte subsets were detected by flow cytometry.The levels of Th1 and Th2 were detected by enzyme-linked immunosorbent assay (ELISA).The intestinal floras were identified by microbial assay system.The occurrence of adverse reactions during treatment in both groups was recorded.Results After treatment,remission rate in observation group was higher than that in control group (95.00% vs 86.67%).The levels of Bifidobacterium,Lactobacillus and Enterococcus faecalis in observation group were significantly higher than those in control group,while level of Escherichia coli was significantly lower than that in control group.CD4^(+)level and CD4^(+)/CD8^(+)in observation group were significantly higher than those in control group,while CD8;level was significantly lower than that in control group.The levels of IL-2 and IFN-γ in observation group were significantly higher than those in control group,while levels of IL-4 and TNF-α were significantly lower than those in control group.After treatment,the adverse reactions in both groups were at grade Ⅰ-Ⅱ.The incidence of adverse reactions in observation group was lower than that in control group,BUT the difference was not statistically significant.Conclusion The clinical curative effect of combined treatment regimen for adjuvant therapy is significant on patients after colorectal cancer surgery,which can rebuild intestinal micro-ecology balance and improve the ability of anti-tumor immune response.