| 乌梅丸治疗化疗性肠黏膜炎的临床疗效及机制研究 |
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| 作者姓名： | 卢冬雪 严晶 孙志广 李烜 刘峰 王亚军 葛飞 |
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| 作者单位： | 1.南京中医药大学第二附属医院，江苏 南京 210023 |
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| 基金项目： | 国家自然科学基金81603578国家自然科学基金81503536国家自然科学基金81673795国家自然科学基金81903974江苏省自然科学基金BK20181235江苏省中医药局科技项目YB2017066全国中医药创新骨干人才培训项目南通市“226高层次人才培养工程”项目 |
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| 摘 要： | 目的 观察乌梅丸对化疗性肠黏膜炎(CIM)腹泻的影响及其可能的作用机制。方法 选取海安市中医院化疗性肠黏膜炎腹泻门诊患者50例，按照随机数字表法分为治疗组和对照组各25例。对照组予以口服洛哌丁胺治疗，治疗组予以乌梅丸中药汤剂口服，疗程4周，观察患者的腹泻发生率、总有效率，评估中医证候积分，检测血清炎症因子和肠黏膜屏障相关指标，并进行粪便菌群培养。结果 治疗后，2组腹泻发生率、中医证候积分均降低(P < 0.05, P < 0.01)，治疗组优于对照组(P < 0.01)，治疗组临床有效率高于对照组(P < 0.05)；2组血清白介素-1β(IL-1β)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、二胺氧化酶(DAO)、内皮素(ET)及D-乳酸水平均降低(P < 0.05, P < 0.01)，白介素-10(IL-10)水平升高(P < 0.01)，肠道致病菌丰度降低、益生菌丰度增加(P < 0.05, P < 0.01)，治疗组优于对照组(P < 0.01)。结论 乌梅丸可以显著改善化疗性肠黏膜炎腹泻相关症状，其可能机制与中药复方多靶点作用下的抗炎症反应、改善肠黏膜屏障以及调节肠道菌群有关。
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| 关 键 词： | 乌梅丸 化疗性肠黏膜炎 腹泻 炎症反应 肠道菌群 |
| 收稿时间： | 2020-11-22 |
Clinical Efficacy and Mechanism of Wumei Pill in the Treatment of Chemotherapy-induced Intestinal Mucositis |
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| Authors: | LU Dong-xue YAN Jing SUN Zhi-guang LI Xuan LIU Feng WANG Ya-jun GE Fei |
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| Abstract: | OBJECTIVE To observe the effect of Wumei pill on diarrhea in chemotherapy-induced intestinal mucositis (CIM) and its possible mechanism of action.METHODS We selected 50 CIM outpatients with diarrhea in Hai'an TCM Hospital, and divided them into the treatment group with 25 cases and the control group with 25 cases in accordance with the random number table. In the control group, oral loperamide was administered, while as for the treatment group, Chinese herbal decoction Wumei pill was given. The total course of treatment was four weeks. The incidence rate of diarrhea and the total effective rate of the patients were observed, and the scores of traditional Chinese medicine (TCM) syndrome were evaluated. In addition, we measured serum inflammatory factors and After treatment, the incidence rate of diarrhea and the scores of TCM syndrome were decreased in both groups (P < 0.05, P < 0.01), and results in the treatment group were better than those in the control group (P < 0.01). The clinical efficacy rate of the treatment group was higher than that of the control group (P < 0.05). The levels of serum interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), diamine oxidase (DAO), endothelin (ET) and D-lactate were decreased (P < 0.05, P < 0.01), while the levels of interleukin 10 (IL10) were increased (P < 0.01). The abundances of enteropathogenic bacteria were reduced while the abundances of probiotics were increased (P < 0.05, P < 0.01), and the treatment group were better than the control group (P < 0.01).CONCLUSION Wumei pill can significantly improve the symptoms associated with diarrhea of CIM, and the mechanism may be related to the anti-inflammatory response, improvement of intestinal mucosal barrier function and regulation of intestinal flora under the multi-target effect of the Chinese herbal compound. |
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| Keywords: | Wumei pill chemotherapy-induced intestinal mucositis diarrhea inflammatory response intestinal flora |
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