摘要
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 clinical effect of strengthening spleen and clearing intestinal therapy on cytokines in colorectal carcinoma patients with intestinal barrier dysfunction after chemotherapy, in order to explore its mechanism. Methods： 56 colorectal carcinoma patients with intestinal barrier dysfunction after chemotherapy were randomly divided into control group （26 cases） and treatment group （30 cases）. Control group were treated with chemotherapy, while the treatment group were treated with combination chemotherapy and strengthening spleen and clearing single intestinal therapy lasted for 8 weeks. KPS scores, traditional Chinese medicine （TCM） symptom score and the curative effect in patients were observed in pretherapy and post-treatment. The levels of endotoxin, the excretion ratio of lactulose/mannitol （L/M） in urine, and the levels of Interleukin-2 （IL-2） and Interleukin-6 （IL-6） in peripheral blood mononuclear cell （PBMC） were also detected. Results： （1） After therapy, KPS score of patients in treatment group was significantly higher than that of control group （P〈0.05）; （2） The effective rate of symptom control of patients in treatment group was 83.33%, which was significantly higher than that of control group; （3） The endotoxin content and excretion ratio of L/M of patients in treatment group was significantly lower than that of control group （P〈0.05）; （4） Compared with control group, IL-2 expression in PMCB of patients in treatment group was increased significantly （P〈0.05）, meanwhile, the IL-6 expression in PMCB was decreased significantly （P〈0.05）. Conclusion： Drugs for strengthening spleen and clearing intestinal therapy could improve the clinical symptoms, life quality and intestinal barrier function of colorectal carcinoma patients with intestinal barrier dysfunction through decreasing endotoxin content, urine L/M ratio and intestinal barrier permeability, improving the IL-2 expression and inhibiting the IL-2 expression in PBMC.
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2015年第6期2171-2175,共5页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
上海市卫生局科研项目(No.20139173)
上海市教委科研项目(No.2013JW045)~~
关键词
健脾清肠法
肠屏障功能障碍
大肠癌
化疗
细胞因子
白细胞介素-2
白细胞介素-6
Strengthening spleen and clearing intestinal therapy
Intestinal barrier dysfunction
Colorectal carcinoma
Chemotherapy
Cytokines
Interleukin-2
Interleukin-6
