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目的:观察健脾清肠法对化疗致肠屏障功能障碍的大肠癌患者细胞因子调控的影响,并探讨其可能作用机制。方法:采用随机、同期对照原则,将56例化疗致大肠癌肠屏障功能障碍的患者分成对照组26例(予单纯化疗)、治疗组30例(予健脾清肠法联合化疗),经8周治疗,分别于治疗前后对患者予卡氏评分(KPS)行为状态评分,中医证候总积分,临床疗效评价,并检测血浆内毒素含量和尿乳果糖/甘露醇排泄率、外周血单个核细胞(PMCB)中细胞因子白细胞介素-2(IL-2)、白细胞介素-6(IL-6)含量;结果:1治疗组治疗后KPS评分显著高于对照组(P<0.05);2治疗组改善脾虚湿热证有效率为83.33%,显著高于对照组的38.46%(P<0.05);3治疗组治疗后血浆内毒素含量、尿乳果糖/甘露醇比值均显著低于对照组(P<0.05);4与对照组比较,治疗组外周血PMCB中细胞因子IL-2表达显著升高,IL-6表达显著下降(P<0.05)。结论:具有健脾清肠功效的中药能改善大肠癌患者肠黏膜屏障损伤的临床症状,提高生活质量。其可能机制是通过降低血内毒素含量和尿乳果糖/甘露醇比值,降低肠黏膜屏障通透性;显著促进外周血中IL-2表达、抑制IL-6表达,从调控机体免疫功能角度改善肠屏障功能障碍。
Objective: To observe the effect of Jianpi Qingzheng Decoction on the regulation of cytokines in patients with colorectal cancer caused by chemotherapy-induced intestinal barrier dysfunction and to explore its possible mechanism. Methods: A total of 56 patients with intestinal barrier dysfunction caused by chemotherapy were divided into control group (26 cases) and chemotherapy group (30 cases), treated with spleen and bowel combined with chemotherapy Week treatment, before and after treatment to patients with Karnofsky score (KPS) behavioral status score, TCM syndromes total score, clinical efficacy evaluation, and test the plasma endotoxin content and urine lactulose / mannitol excretion rate, peripheral blood mononuclear (IL-2) and interleukin-6 (IL-6) levels in PMCB were measured. Results: The KPS score of the treatment group after treatment was significantly higher than that of the control group (P <0.05). 2 treatment group was 83.33%, which was significantly higher than that of the control group (38.46%) (P <0.05). The plasma endotoxin level, urine lactulose / mannitol ratio in the treatment group were significantly lower than those in the control group (P <0.05) .4 Compared with the control group, the expression of IL-2 in PMCB of the treated group was significantly increased and the expression of IL-6 was significantly decreased (P <0.05). Conclusion: The traditional Chinese medicine with the effect of strengthening the spleen and intestine can improve the clinical symptoms of intestinal mucosal barrier injury in patients with colorectal cancer and improve the quality of life. The possible mechanism is to reduce the permeability of intestinal mucosal barrier by decreasing the content of blood toxin and the ratio of urine lactulose to mannitol; to promote the expression of IL-2 in peripheral blood and to inhibit the expression of IL-6, and to improve the immune function of the body Gut barrier dysfunction.