参山药膳改善癌因性疲乏的疗效与作用机制初探

A Preliminary Study on the Efficacy and Mechanism of Shenshan Medicated Diet in Improving Cancer-Related Fatigue

目的:探讨参山药膳治疗癌因性疲乏的临床疗效及作用机制。方法:60位癌因性疲乏(CRF)患者,随机分为对照组和治疗组。对照组常规对症治疗。治疗组常规对症治疗及参山药膳。服用4周,观察服药后Piper疲乏修订量评分、多维疲劳量表评分及中医证候量表评分情况。依托TCMSP数据库、GeneCards获取参山药膳与CRF的疾病靶点,构建蛋白互作(PPI)网络,并对靶标进行GO及KEGG分析。结果:治疗后两组的Piper评分、多维疲劳量表评分及中医证候量表评分均较前下降,其中治疗组较对照组更低,其差异有统计学意义(P<0.05)。结果显示,参山药膳治疗癌因性疲乏的核心靶点主要在于包括AKT1、TP53、TNF、EGFR、IL-6等。KEGG分析其主要通路为TNF信号通路、IL-17信号通路。结论:参山药膳可以缓解癌因性疲乏患者的疲乏程度,提高患者生活质量。其改善癌因性疲乏的作用机制可能与抑制炎症细胞因子分泌相关。

Objective To investigate the clinical efficacy and mechanism of Shenshan medicinal diet in the treatment of patients with qi-deficiency cancer-related fatigue(CRF).Methods Sixty patients with CRF were randomly divided into control group and observation group,with 30 cases in each group.The control group was treated symptomatically.Observation group routine symptomatic treatment+Shenshan medicated diet.After taking the medicinal diet for 4 weeks,Piper Fatigue Scale,multidimensional fatigue scale score and TCM syndrome scale score were observed.The active chemical components and targets of Shenshan medicinal diet were retrieved from the TCMSP database,and GeneCards obtained CRF disease targets.Constructing the protein-protein interaction(PPI)network.Gene ontology(GO)function and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis of common targets.Results The scores of Piper Fatigue Scale and multidimensional fatigue scale in the two CRF groups after treatment decreased compared with the previous score,and the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The core targets included serine/threonine-protein kinase(AKT1),tumor protein 53,tumor necrosis factor(TNF),epidermal growth factor receptor(EGFR),Interleukin 6(IL-6).The main pathways of KEGG s analysis are TNF signaling pathway and IL-17 signaling pathway.Conclusion Shenshan medicinal diet can alleviate the fatigue degree of patients with cancer-related fatigue and improve the quality of life of patients.Its mechanism of action in improving cancer-related fatigue may be related to inhibition of inflammatory cytokine secretion.