枯草杆菌二联活菌颗粒联合斑蝥酸钠维生素B_(6)辅助治疗在慢性阻塞性肺疾病合并非小细胞肺癌中的效果研究

Efficacy of Live Combined Bacillus Subtilis and Enterococcus Faecium Granules with Multivitamines Combined with Disodium Cantharidinate and Vitamin B_(6) in the Treatment of Chronic Obstructive Pulmonary Disease Complicated with Non-small Cell Lung Cancer

目的探讨枯草杆菌二联活菌颗粒联合斑蝥酸钠维生素B_(6)辅助治疗在慢性阻塞性肺疾病(COPD)合并非小细胞肺癌(NSCLC)中的效果。方法选取2020年1月—2022年10月收治的COPD合并NSCLC 60例,采用随机数字表法分为观察组和对照组各30例。2组均给予化疗联合免疫治疗,在此基础上对照组给予斑蝥酸钠维生素B_(6)治疗,观察组给予枯草杆菌二联活菌颗粒联合斑蝥酸钠维生素B_(6)治疗,2组均持续治疗4个周期。统计2组治疗4个周期后总缓解率及治疗前、治疗2个周期、治疗4个周期肿瘤因子[癌胚抗原(CEA)、癌抗原125(CA125)、血管内皮生长因子(VEGF)、缺氧诱导因子(HIF-1α)]、免疫功能指标(CD3+、CD4+、CD4+/CD8+)、肠道微生态指标(肠道菌群丰富度、多样性指数)、治疗期间毒副反应、治疗后1年生存率。结果2组总缓解率比较差异无统计学意义(P>0.05)。治疗后2组CEA、CA125、VEGF、HIF-1α呈下降趋势,CD3+、CD4+、CD4+/CD8+呈升高趋势,差异有统计学意义(P<0.05)。治疗后2组肠道菌群丰富度、多样性指数呈升高趋势,且观察组高于对照组(P<0.05)。观察组胃肠道反应发生率为16.67%(5/30)低于对照组的46.67%(14/30)(P<0.05)。2组治疗后1年生存率比较差异无统计学意义(P>0.05)。结论枯草杆菌二联活菌颗粒联合斑蝥酸钠维生素B_(6)辅助治疗能有效纠正COPD合并NSCLC患者化疗及免疫治疗后肠道菌群紊乱,改善机体免疫应答,抑制肿瘤因子表达,减少毒副反应的发生。

Objective To investigate the efficacy of Live Combined Bacillus Subtilis and Enterococcus Faecium Granules with Multivitamines combined with Disodium Cantharidinate and Vitamin B_(6) in the treatment of chronic obstructive pulmonary disease(COPD)complicated with non-small cell lung cancer(NSCLC).Methods A total of 60 patients with COPD combined with NSCLC from January 2020 to October 2022 were selected and divided into the observation group(n=30)and the control group(n=30)by random number table method.Both groups were given chemotherapy combined with immunotherapy,on the basis of which the control group was given Disodium Cantharidinate and Vitamin B_(6),and the observation group was given Live Combined Bacillus Subtilis and Enterococcus Faecium Granules with Multivitamines Combined with Disodium Cantharidinate and Vitamin B_(6).Both groups were treated consecutively for 4 cycles.The total response rate after 4 cycles of treatment and the tumor factors[carcinoembryonic antigen(CEA),cancer antigen 125(CA125),vascular endothelial growth factor(VEGF),hypoxia inducible factor-1α(HIF-1α)],immune function indicators(CD3+,CD4+,CD4+/CD8+),and intestinal microecological index(intestinal flora richness and diversity index),toxic and side effects during treatment,and 1-year survival rate after treatment of the two groups before treatment and after 2 and 4 cycles of treatment were analyzed.Results There was no significant difference in the total remission rate between the two groups(P>0.05).After treatment,CEA,CA125,VEGF and HIF-1αin the two groups decreased,while CD3+,CD4+and CD4+/CD8+increased,with statistical significance(P<0.05).After treatment,the intestinal flora richness and diversity index of the two groups showed an increasing trend,which were higher in the observation group than in the control group(P<0.05).The incidence of gastrointestinal reactions in the observation group was 16.67%(5/30),which was lower than that in the control group(46.67%,14/30)(P<0.05).There was no significant difference in 1-year survival rate between the two groups(P>0.05).Conclusion Live Combined Bacillus Subtilis and Enterococcus Faecium Granules with Multivitamines Combined with Disodium Cantharidinate and Vitamin B_(6) can effectively correct the intestinal flora disturbance in COPD patients with NSCLC after chemotherapy and immunotherapy,improve the immune response,inhibit the expression of tumor factors,and reduce the occurrence of toxic and side effects.