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摘要： 化疗相关性腹泻(chemotherapy-induced diarrhea,CID)是肿瘤患者化疗中常见的并发症,不仅会降低患者的体质和生活质量,严重者导致化疗被迫中断,从而影响疗效。许多化疗药物都可以引起腹泻,其中以氟尿嘧啶类(fluorouracil)和伊立替康(irinotecan,CPT-11)的腹泻发生率最高。本文通过对相关化疗药物(主要是5-FU和CPT-11)引起CID的发生机制和治疗策略进行综述,探讨临床有效防治CID的措施。
关键词: 化疗相关性腹泻 ；伊立替康 ；5-FU ；机制 ；治疗策略
被引量
57
【期刊论文】 • PAN Xin 1,2XU Kang 3,4XIONG Rui 1
+3位作者
• 《Chinese Journal of Integrative Medicine》 CSCD
• 2019年第7期 536 -
542， 共7页
摘要： Objective:To investigate whether Ershen Pill(ESP,二神丸)could alleviate the symptom of Pi(Spleen)-Shen(Kidney)yang deficiency(PSYD)-induced diarrhea in rat model and explore its anti-diarrhea mechanism.Methods:Seventy-five Sprague-Dawley rats were divided into 5 groups by a random number table,including control,positive,model,low-dose(LD)and high-dose(HD)ESP groups,15 rats in each group.All the rats,except those in the control group,were developed PSYD induced-diarrhea based on its pathology and etiology.The rats in positive,LD and HD ESP groups were treated with Shenling Baizhu Pill(参苓白术丸),LD(1.05 g/kg)or HD(3.50 g/kg)ESP petroleum ether extract once a day for 2 weeks,respectively.Body weight change and diarrhea index were measured.The histology scores of the kidney were evaluated via hematoxylin and eosin(HE)staining.Aquaporin-3(AQP3)expression in the colon was analyzed by immunofluorescence,quantitative reverse transcription-polymerase chain reaction(qRT-PCR)and Western blot,respectively.Results:Compared with the model group,oral administration of LD and HD ESP prevented body weight loss and inhibited diarrhea after 2-week treatment(P<0.05).Kidney deterioration was impeded,and the histology score in LD and HD ESP groups were 8.2 and 10.5,respectively,which were both higher than those in the model group(P<0.05).In addition,ESP treatment alleviated rat colitis,and HD ESP significantly improved the AQP3 positive staining intensity in the colon tissue compared with the model group.The result from Western blot revealed that AQP3 protein synthesis in colon tissue of LD and HD ESP groups increased by 2.1-and 5.9-fold compared with the model group(P<0.05).qR T-PCR result showed that AQP3 gene expression in the HD ESP group was also up-regulated by 2.5-fold normalized to the model group(P<0.05).Conclusion:ESP extract effectively alleviates the symptoms of PSYD and relieves PSYD-induced diarrhea by improving AQP3 synthesis in the colon.
关键词: Ershen Pill ；Chinese medicine ；petroleum ether extract ；anti-diarrhea ；AQP3 ；colon
被引量
10
摘要： 目的探讨抗菌药物相关性腹泻(antibiotic-associated diarrhea,AAD)的治疗策略和临床药师的工作意义。方法对临床药师参与的1例AAD患者的药物治疗全过程以及其他用药进行药学监护,提出合理的用药建议。结果AAD患者对万古霉素不敏感,在抗菌药物暂无法停用的情况下,临床药师建议加用曲美布汀片和双歧杆菌三联活菌胶囊,联合蒙脱石散和地衣芽孢杆菌活菌胶囊处理,患者腹泻症状好转;应用头孢哌酮/舒巴坦抗感染治疗期间,临床药师建议可预防使用维生素K,避免发生出血事件;并且患者长期服用的美托洛尔缓释片可经胃管给药。结论非艰难梭菌感染或非感染性AAD对万古霉素的反应性不明确,但抗蠕动剂可能有效。目前仍需更多的研究证实头孢哌酮用药期间维生素K作为预防措施的价值。临床药师须密切关注用药细节,发挥专业优势,为患者提供优质和个体化的药学服务。
关键词: 抗菌药物相关性腹泻 ；万古霉素 ；曲美布汀 ；药学监护
被引量
1
摘要： 目的观察黄连碱对化疗相关性腹泻(CID)裸鼠的保护作用,并探讨其作用机制。方法 32只裸鼠随机分为正常组、模型组、洛哌丁胺组、黄连碱组,每组8只;正常组腹腔注射1 m L生理盐水,模型组、洛哌丁胺组、黄连碱组均腹腔注射伊立替康溶液(剂量为350 mg/kg)进行造模。正常组、模型组均灌胃1 m L0.5%CMC-Na溶液,洛哌丁胺组灌胃洛哌丁胺混悬液(0.3 mg/kg),黄连碱组灌胃黄连碱混悬液(30 mg/kg),2次/天,共4天。观察裸鼠腹泻情况、小肠病理改变,ELISA法检测回肠组织中肿瘤坏死因子α(TNF-α)、白介素-6(IL-6)含量,Western blot法检测核因子κB(NF-κB)抑制蛋白α(IκBα)、NF-κB p65蛋白表达。结果正常组均未发生腹泻,模型组、洛哌丁胺组及黄连碱组均出现腹泻;与模型组比较,洛哌丁胺组、黄连碱组2~3分腹泻发生率及腹泻评分均明显下降(P<0.05,P<0.01)。洛哌丁胺组回肠破坏程度较模型组稍减轻,差异无统计学意义(P>0.05),黄连碱组裸鼠回肠黏膜损伤程度较模型组及洛哌丁胺组均明显减轻(P<0.01)。与正常组比较,模型组回肠组织中TNF-α、IL-6及NF-κB p65表达均升高(P<0.01),IκBα表达明显降低(P<0.01);与模型组和洛哌丁胺组比较,黄连碱组TNF-α、IL-6及NF-κB p65表达均明显降低(P<0.05,P<0.01),IκBα表达均明显升高(P<0.05,P<0.01)。结论黄连碱可降低伊立替康引起的CID发生率,减轻腹泻程度及回肠黏膜损伤,其机制可能与其上调IκBα表达,抑制NF-κB通路活化,减轻肠道炎症反应有关。
关键词: 黄连碱 ；化疗相关性腹泻 ；炎症细胞因子 ；核因子κB抑制蛋白α ；核因子κB
被引量
17
摘要： Cancer is recognized as a leading cause of deaths nowadays,accounting for 10 million annual deaths worldwide and resulting in heavy health and economic burdens[1].Reducing cancer incidence through precision prevention is thus of great scientific and clinical value.Gastric cancer(GC)is one of the most common cancers in China.Pathologically,the onset of GC,especially the intestinal-type ones,would usually suffer a series of premalignant lesions,including atrophic gastritis,intestinal metaplasia,and low-grade dysplasia(LGD),which is known as the process of gastritis-induced tumorigenesis(GIGT)[2].Epidemiological studies have shown that GIGT has exhibited the characteristics of longterm and low-probability,that is,only a small number of gastritis patients would develop into GC after a long period.Therefore,it has become the key challenge for GC precision prevention that how to uncover the biological mechanism underlying GIGT,followed by accurately identifying the critical time point at which effective diagnosis and treatment strategies could be developed to prevent GC.Of note,this is also a common challenge for the precision prevention of other cancer types,such as liver and colon cancers.
关键词: prevention ；gastritis ；diagnosis
被引量
29
【期刊论文】 • HU Hongyi 1
摘要： OBJECTIVE: To evaluate the clinical efficacy and safety of Buzhongyiqi pills(BZYQP, 补中益气丸) in improving the appetite of patients with colorectal cancer(CRC) receiving chemotherapy. TRIAL DESIGN: A pilot, randomized, single-blind crossover clinical trial was conducted on diagnosed stage II-IV CRC patients receiving chemotherapy. METHODS: Patients were randomly assigned to either the BZYQP-placebo or placebo-BZYQP groups. The BZYQP-placebo group received BZYQP for 1-2 d before the first cycle of chemotherapy and continued until the end of the third cycle. A 7-day washout followed, after which they received a placebo until the end of the sixth cycle. The placebo-BZYQP group followed the opposite treatment order. The oral dose of BZYQP and placebo was ten pills three times daily. A total of 12 visit points were scheduled in this study, with each visit point carried out before and after each of the six cycles of chemotherapy. The Simplified Nutrition Appetite Questionnaire(SNAQ), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30, version 3.0), and the National Cancer Institute Common Terminology Criteria for Adverse Events(CTCAE, V5.0) were used to evaluate patient appetite, quality of life, and drug safety. RESULTS: Totally 62 patients completed the study, and baseline characteristics were balanced between the BZYQP-placebo and placebo-BZYQP groups. The primary outcome, as assessed by SNAQ scores, demonstrates a statistically significant difference between the two groups during the first three cycles of chemotherapy, with the mean SNAQ score of the BZYQP-placebo group consistently higher than that of the placebo-BZYQP group from V1(P < 0.001). After the washout period, the SNAQ score of the BZYQP-placebo group decreased from V7, and the difference in SNAQ scores between the two groups gradually became more significant after the intersection at V9. Secondary outcomes showed that during the first three cycles of chemotherapy, the BZYQP-placebo group had significantly lower scores in physical, role, emotional, cognitive, and social functioning domains, as well as in fatigue, loss of appetite, and diarrhea symptoms, compared to the placebo-BZYQP group(P < 0.001). Scores for physical, role, emotional, cognitive, and social functioning in the BZYQP-placebo group remained lower(P < 0.05) at V11. The chemotherapy-induced adverse events(AEs) in the BZYQP-placebo group were significantly lower than those in the placebo-BZYQP group at V5, mainly in nausea and vomiting(9.1% vs 62.1%, P < 0.001), diarrhea(12.1% vs 44.8%, P = 0.004), and anemia(15.2% vs 41.4%, P = 0.021). No drugrelated events were reported in this study. CONCLUSION: BZYQP is feasible and safe to effectively improve the appetite of patients with CRC receiving chemotherapy and help them with better quality of life.
关键词: colorectal neoplasms ；appetite ；quality of life ；adverse events ；pilots ；cross-over studies ；randomized controlled trials ；Buzhongyiqi pills
被引量
2
摘要： 目的:探讨伊立替康化疗相关性腹泻发生的特点与危险因素,提高伊立替康临床应用安全性。方法:收集2014年1月至2016年6月以伊立替康为基础的化疗方案治疗的肿瘤患者信息,分析患者性别、年龄、烟酒史、原发灶部位、伊立替康剂量、UGT1A1基因多态性等临床特征与腹泻发生率、腹泻严重程度的关系,总结伊立替康致化疗相关性腹泻的危险因素。结果:共175例使用含伊立替康方案化疗的患者纳入分析,男性105例,女性70例,腹泻发生率为25.7%(45/175),其中早发性腹泻7例(4.0%),迟发性腹泻38例(21.7%);轻中度腹泻(I～II级) 36例(20.6%),严重腹泻(III～IV级) 9例(5.1%)。严重腹泻均为迟发性腹泻,发生于给药后5～14 d。高龄(≥65岁)是腹泻发生的危险因素(P=0.02);伊立替康联合铂类化疗时严重腹泻发生率为17.0%(8/47),高于FOLFIRI方案(P=0.003);联合奥沙利铂化疗的严重腹泻率为40%(4/10),高于联合其他铂类,但无统计学差异(P=0.22);患者性别、烟酒史、原发灶部位、伊立替康剂量、UGT1A1基因多态性对腹泻发生率和发生的严重程度无影响。结论:高龄(≥65岁)患者使用伊立替康为主的化疗方案治疗时发生腹泻的风险较高,伊立替康联合铂类化疗时需警惕严重腹泻的发生。
关键词: 伊立替康 ；化疗相关性腹泻 ；迟发性腹泻 ；危险因素 ；UGT1A1基因多态性
被引量
21
【期刊论文】 • GAO Lei 1HAO Cai-xia 1ZHANG Gan-lin 1CAO Ke-xin 1
+5位作者
• 《Chinese Journal of Integrative Medicine》 CSCD
• 2021年第7期 514 -
519， 共6页
摘要： Objective:To study the effect and mechanism of Huayu Wan(化瘀丸,HYW)in combination of chemotherapy of tumor treatment.Methods:HYW serum was added in Lewis cells to assess its impact on fluorescent doxorubicin delivery in vitro.Then,Lewis tumor cells was implanted in C57BL/6 mice via xenograft transplantation.Tumor growth was measured and signal intensity corresponding to blood flow was assessed by laser doppler perfusion imaging(LDPI).Finally,the effect of HYW on the effificacy of doxorubicin was studied.Results:HYW can improve the transfer of fluorescent doxorubicin into cells.The blood flow signal in the tumor tissues of the HYW group was higher than that of the control group(P<0.01).Furthermore,HYW improved drug delivery of doxorubicin to tumor tissues,and this activity was associated with HYW-induced microvascular proliferation(P<0.01).Conclusions:HYW can promote microangiogenesis and increase blood supply in tumor tissues,which in turn may increase the risk of metastasis.At the same time,HYW increases drug delivery and improves the effificacy of chemotherapy drugs through vascular proliferation.Therefore,rational judgment must be exercised when considering applying HYW to an antitumor regimen.
关键词: Huayu Wan ；Chinese medicine ；fluorescent doxorubicin ；drug delivery
被引量
5
【期刊论文】 • YANG Ruocong LI Xiangyu
+2位作者
• 《Journal of Traditional Chinese Medicine》 CSCD
• 2021年第5期 695 -
705， 共11页
摘要： OBJECTIVE:To investigate the underlying mechanism of the effect of Fengreqing oral liquid(风热清口服液,FOL)on wind-heat pattern(WHP).METHODS:In this study,we predicted the potential targets of FOL via the approach of network pharmacology and verified it by in vitro inflammation model.In the network pharmacology part,two strategies,namely the direct target search and the indirect one,were used to collect the target sets of FOL in WHP treatment.The enrichment analysis was carried out by David database and Clue Go plug-in in Cytoscape.Furthermore,the potential targets were mapped in the candidate pathways.In the verification experiment section,in vitro model of lipopolysaccharide(LPS)induced RAW 264.7 was used to confirm the predictive results in the network pharmacology part.RESULTS:Through the two screening strategies,a total of 141 non-repetitive intervention targets of FOL on WHP were obtained.Gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis showed that the intervention effect was mainly focused on the anti-inflammatory effect,and the Toll-like receptor signaling pathway was one of the most critical regulatory pathways.Further mapping analysis showed that phosphatidylinositol 3-kinase(PI3 K)-protein kinase B(AKT)signaling transfer might be the key part of regulating the concentration of inflammation mediators of FOL in the Toll-like receptor signaling pathway.In vitro experiment showed that FOL significantly reduced the levels of NO,IL-1,IL-6,and TNF-αproduced by RAW264.7 induced by LPS.Further immunofluorescence found that this effect is related to the regulation of PI3 K-AKT pathway activity by FOL.CONCLUSION:FOL can intervene in WHP by regulating the content of inflammatory mediators via the PI3 K-AKT pathway.
关键词: inflammation ；wind-heat ；network pharmacology ；Fengreqing oral liquid
被引量
10
【期刊论文】 • Shari Garrett 1,2Yongguo Zhang 1Yinglin Xia 1Jun Sun 1,2,3,4
摘要： Intestinal homeostasis is maintained by specialized host cells and the gut microbiota.Wnt/β-catenin signaling is essential for gastrointestinal development and homeostasis,and its dysregulation has been implicated in inflammation and colorectal cancer.Axin1 negatively regulates activated Wnt/β-catenin signaling,but little is known regarding its role in regulating host–microbial interactions in health and disease.Here,we aim to demonstrate that intestinal Axin1 determines gut homeostasis and host response to inflammation.Axin1 expression was analyzed in human inflammatory bowel disease datasets.To explore the effects and mechanism of intestinal Axin1 in regulating intestinal homeostasis and colitis,we generated new mouse models with Axin1 conditional knockout in intestinal epithelial cell(IEC;Axin1^(ΔIEC))and Paneth cell(PC;Axin1^(ΔPC))to compare with control(Axin1^(LoxP);LoxP:locus of X-over,P1)mice.We found increased Axin1 expression in the colonic epithelium of human inflammatory bowel disease(IBD).Axin1^(ΔIEC) mice exhibited altered goblet cell spatial distribution,PC morphology,reduced lysozyme expression,and enriched Akkermansia muciniphila(A.muciniphila).The absence of intestinal epithelial and PC Axin1 decreased susceptibility to dextran sulfate sodium(DSS)-induced colitis in vivo.Axin1^(ΔIEC) and Axin1^(ΔPC)mice became more susceptible to DSS-colitis after cohousing with control mice.Treatment with A.muciniphila reduced DSS-colitis severity.Antibiotic treatment did not change the IEC proliferation in the Axin1Loxp mice.However,the intestinal proliferative cells in Axin1^(ΔIEC)mice with antibiotic treatment were reduced compared with those in Axin1^(ΔIEC) mice without treatment.These data suggest non-colitogenic effects driven by the gut microbiome.In conclusion,we found that the loss of intestinal Axin1 protects against colitis,likely driven by epithelial Axin1 and Axin1-associated A.muciniphila.Our study demonstrates a novel role of Axin1 in mediating intestinal homeostasis and the microbiota.Further mechanistic studies using specific Axin1 mutations elucidating how Axin1 modulates the microbiome and host inflammatory response will provide new therapeutic strategies for human IBD.
关键词: Axin1 ；Bacteria ；Microbiome inflammation ；Inflammatory bowel disease ；Immunity ；Microbiome ；Paneth cells ；Akkermansia muciniphila ；Wnt
被引量
2
【期刊论文】 • ZHENG Wei 1
摘要： OBJECTIVE: To study the molecular mechanism of Buyang Huanwu Tang( 补阳还五汤)(BHT) protecting retinal ganglion cells(RGCs) from oxygen induced oxidative stress and apoptosis after anterior ischemia. METHODS: In this study, the Chinese herbs of BHT were extracted by first boiling in water, then were filtered, concentrated, and freeze-dried. The chemical profile of BHT extract was determined by liquid chromatography mass spectrometry(LC-MS). H2O2-induced RGC-5 cells were used as a cell model to investigate the protective effect and mechanism of BHT on RGCs. RESULTS: The survival rate of damaged RGC-5 by BHT was significantly increased by the 3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazolium-romid method. Fluorescence activating cell sorter(FACS analysis) showed that BHT could significantly reduce apoptosis induced by oxidative stress via the reactive oxygen species(ROS)-mitogen-activated protein kinase(MAPK)-Caspase-3 signal pathway. CONCLUSION: BHT possesses a high antioxidant capacity and could significantly reduce ROS levels of RGC-5 cells damaged by H2O2.Therefore, the present study has provided possible alternative strategies for the prevention and treatment of ischemic optic disease by using traditional Chinese herbal formulas.
关键词: optic neuropathy ；ischemic ；oxidative stress ；apoptosis ；reactive oxygen species ；mitogen-activated protein kinase ；caspase 3 ；Buyang Huanwu Tang
被引量
9
摘要： 化疗相关性腹泻(CRD)可导致治疗效果和患者依从性降低,影响肿瘤患者的长期治疗结局,甚至危及生命。除传统化疗药物外,许多分子靶向药物也可导致CRD,包括小分子表皮生长因子受体(EGFR)抑制剂、抗EGFR单克隆抗体、磷酸肌醇3-激酶抑制剂、血管内皮细胞生长因子受体小分子抑制剂、BCR-ABL1和KIT抑制剂、人表皮生长因子受体2靶点抑制剂、周期蛋白依赖性激酶抑制剂、抗体-药物偶联物等多种分子靶向药物。其发生机制可能与分子靶向治疗药物引起肠黏膜损伤或肠炎等有关,临床表现为大便频率增加和/或松散不成形,患者常伴有产气过多和/或肠绞痛。不同药物引起的CRD发生率不同,临床应重视病史采集和鉴别诊断,积极干预并进行动态评估,加强患者教育,以及时发现和预防肠毒性的发生。
关键词: 化疗相关性腹泻 ；肿瘤 ；靶向治疗 ；肠毒性 ；不良反应
被引量
12
摘要： 化疗相关性腹泻（chemotherapy-induced diarrhea,CID）是肿瘤患者最常见的化疗副反应之一,尤其以氟尿嘧啶类和伊立替康发生率最高。CID不但可引起机体的血容量减少,导致缺水和电解质平衡紊乱,诱发急性肾功能不全,增加感染的发生率,影响患者的体质和生活质量,甚至危及生命;并且增加住院费用,加重患者心理负担,降低肿瘤的治疗效果。
关键词: 化疗相关性腹泻 ；不换金正气散 ；临床观察 ；diarrhea ；电解质平衡紊乱 ；急性肾功能不全 ；肿瘤患者 ；防治
被引量
7
摘要： 目的探讨穴位贴敷对肺癌化疗相关性腹泻患者肠黏膜屏障的作用。方法选取2018年1月~2019年1月我院门诊或住院治疗肺癌化疗相关性腹泻患者72例,随机分为观察组和对照组。对照组患者均予以口服或静脉补液、纠正水电解质酸碱平衡紊乱等西医常规治疗。观察组患者加用穴位贴敷治疗。两组均连用1周。分别与治疗前后比较两组患者血清肠黏膜屏障功能指标[内毒素、降钙素原(PCT)和D-乳酸]及体力状态的变化,并比较临床效果。结果治疗1周后,两组患者血清内毒素、PCT和D-乳酸指标显著下降(P<0.05或P<0.01),且观察组患者下降程度更显著(P<0.05);同时两组患者KPS评分明显上升(P<0.05或P<0.01),且观察组患者上升程度更显著(P<0.05);观察组患者的临床总有效率为94.44%,显著高于对照组的75.00%,差异有统计学意义(χ2=5.260,P<0.05)。结论穴位贴敷用于肺癌化疗相关性腹泻患者的效果较确切,能有效缓解其腹泻症状,增强其体力状态,其作用机制可能是其能降低血清内毒素、PCT和D-乳酸指标,保护肠黏膜屏障功能密切相关。
关键词: 肺癌 ；化疗相关性腹泻 ；穴位贴敷 ；肠黏膜屏障
被引量
11
摘要： 目的将化疗相关性腹泻(chemotherapy induced diarrhea,CID)循证证据应用于直肠癌化疗患者的临床护理中,开展循证护理实践,促进临床护理质量持续改进。方法检索数据库获取CID的最新、最佳证据,组建证据应用团队,制订审查指标及审查方法。开展基线审查,分析障碍因素,制订证据应用策略,并将其应用于临床。在证据应用后再次进行审查,主要评价各审查指标的执行率、护士与患者对CID相关知识的掌握情况及患者CID的发生情况。结果在系统层面,构建了多学科合作方式,完善了CID的管理流程,促进了最新、最佳证据的临床应用,编制了基于证据的健康教育手册,对科室内相关人员进行了培训。在护士层面,护士CID相关知识问卷的回答正确率由53.64%提升到92.70%,6条审查指标的执行率分别提升至87.88%、89.65%、64.28%、78.57%、100.00%、100.00%。在患者层面,患者CID相关知识问卷的回答正确率由53.06%提升至81.28%,腹泻发生率由43.90%下降至42.42%。结论 CID循证实践提升了护士和患者CID的相关知识,规范了临床护理人员处理CID的流程,完善了医院相关管理制度,对提升护士的循证实践意识、护理质量等有较好的意义。
关键词: 化疗相关性腹泻 ；证据应用 ；质量改进 ；循证实践 ；直肠癌
被引量
8
摘要： 目的探究对5-氟尿嘧啶致中性粒细胞减少伴发热及化疗相关性腹泻进行药学监护的意义。方法选择郑州大学第二附属医院2022年8月至2024年1月收治的86例5-氟尿嘧啶致中性粒细胞减少伴发热及化疗相关性腹泻患者作为本次研究对象,根据随机数字表法将其分为两组,各组均43例,对照组接受常规用药管理,研究组接受药学监护,对比分析两组监护效果。结果研究组治疗依从性良好率为93.02%,高于对照组76.74%,差异具有统计学意义(P<0.05)。研究组中腹泻、中性粒细胞减少、发热、骨髓抑制等症状均消失,而对照组中仍有4例患者有上述症状(0 VS 9.30%),研究组低于对照组,差异具有统计学意义(χ2=4.195,P=0.041)。研究组中仅有1例患者出现治疗疗程不合适情况,发生率为2.32%,对照组中适应症不合适情况、重复用药、药物剂量不合适与药物剂型不合适各有2例,预防用药过度与治疗疗程过短各1例,发生率为23.26%,研究组低于对照组,差异具有统计学意义(P<0.05)。结论对5-氟尿嘧啶致中性粒细胞减少伴发热及化疗相关性腹泻患者进行药学监护可有效提高患者治疗依从性,降低不良反应发生率,减少药物相关问题发生率,具有参考意义。
关键词: 5-氟尿嘧啶 ；中性粒细胞减少 ；化疗 ；腹泻 ；药学监护
摘要： [目的]化疗相关性腹泻(CID)是5-氟尿嘧啶(5-Fu)治疗最常见的不良反应。本研究旨在研究托里消毒散对CID的潜在保护作用,并探讨其可能的机制。[方法]将5-Fu致CID模型小鼠随机分为对照组、空白组、CID模型组、阳性药物(洛哌丁胺)组、托里消毒散-散低剂量组、托里消毒散-中剂量组和托里消毒散-高剂量组。评估各组小鼠腹泻程度、肿瘤生长、肠屏障损伤、肠道炎症和Toll样受体4(TLR4)/骨髓分化主要反应蛋白88(Myd88)/核因子κB(NF-κB)通路活性和NOD样受体热蛋白结构域相关蛋白3(NLRP3)炎性小体活化水平。[结果]研究表明,托里消毒散能明显抑制5-Fu诱导的CID小鼠腹泻和肿瘤生长。苏木精-伊红(HE)染色结果显示,与CID模型组相比,托里消毒散能改善5-Fu诱导的CID小鼠肠黏膜损伤。此外,与CID模型组相比,托里消毒散导致CID小鼠肠道内炎症因子白细胞介素(IL)-1β、IL-8、IL-6以及肿瘤坏死因子(TNF)-α的表达降低,NLRP3水平也明显下降。[结论]托里消毒散通过抑制CID小鼠肠道TLR4/Myd88/NF-κB通路活性和NLRP3炎性小体活化水平减轻5-Fu所致CID小鼠的肠道损伤,为CID治疗提供了一种新的方法。
关键词: 托里消毒散 ；TLR4/Myd88/NF-κB通路 ；NLRP3炎性小体 ；化疗相关性腹泻
摘要： 目的探讨益生菌对非小细胞肺癌患者化疗后腹泻的效果观察。方法选取2017年5月至2019年5月在我院肿瘤科接受GP方案化疗后发生化疗相关性腹泻(CID)的非小细胞肺癌患者97例为研究对象,随机将其分为观察组48例和对照组49例,两组患者均给予补液、营养支持以及维持水电解质平衡等对症支持治疗,观察组采用双歧杆菌乳杆菌三联活菌片治疗,对照组采用盐酸洛哌丁胺治疗。治疗后观察两组患者治疗效果。结果观察组患者治疗效果优于对照组(P<0.05)。结论与盐酸洛哌丁胺相比,对CID患者采用益生菌治疗效果更明显。
关键词: 非小细胞肺癌 ；化疗 ；化疗相关性腹泻 ；盐酸洛哌丁胺 ；益生菌
被引量
11
摘要： 目的探讨谷氨酰胺对肺癌化疗患者营养状况、化疗不良反应及治疗延迟的影响。方法选取2015年7月至2016年8月就诊于河北省唐山市人民医院存在营养不良的肺癌化疗患者104例,采用随机数字表法分为对照组和试验组各52例,对照组给予紫杉醇联合顺铂化疗及常规营养支持,试验组在此基础上给予谷氨酰胺口服,3次/d,10g/次,共干预28d。比较两组患者干预前及干预28d后的营养指标、化疗不良反应发生率及治疗延迟率。结果干预后,两组患者的总蛋白、血红蛋白、白蛋白、前白蛋白比较,试验组均优于对照组,差异有显著性(P<0.05)。化疗相关性腹泻发生率试验组为17.3%,低于对照组40.4%,周围神经毒性发生率试验组为38.5%,低于对照组59.6%,差异有显著性(P<0.05)。试验组肺癌患者化疗治疗延迟率为1.9%,低于对照组的15.4%,差异有显著性(χ^2=4.379,P=0.036)。结论谷氨酰胺能够改善肺癌化疗患者的营养状况,减轻化疗相关性腹泻、周围神经毒性反应,降低化疗治疗延迟率。
关键词: 谷氨酰胺 ；肺癌 ；化疗 ；营养状况 ；治疗延迟
被引量
19
摘要： 目的:系统评价益生菌辅助防治化疗相关性腹泻(CID)的有效性,为临床提供循证参考。方法:计算机检索EMBase、Cochrane图书馆、Pub Med、中国期刊全文数据库、中文科技期刊数据库、万方数据库和中国生物医学文献数据库,收集益生菌辅助防治CID的随机对照试验(RCT),提取资料并根据Cochrane Hand book 5.0推荐的"风险偏倚评估"工具评价质量,采用Rev Man5.2统计软件进行Meta分析。结果:最终纳入10项RCT,共871例患者。Meta分析结果显示,在常规对症治疗的基础上加用益生菌可以显著降低肿瘤患者总腹泻率[OR=0.31,95%CI(0.20,0.49),P<0.001]和Ⅲ~Ⅳ级腹泻率[OR=0.09,95%CI(0.03,0.24),P<0.001],提高总有效率[OR=4.16,95%CI(2.40,7.23),P<0.001]和完全缓解率[OR=2.55,95%CI(1.66,3.90),P<0.001],差异均有统计学意义;但对患者Ⅰ~Ⅱ级腹泻率[OR=0.86,95%CI(0.48,1.56),P=0.62]和部分缓解率[OR=1.00,95%CI(0.67,1.50),P=1.00]影响不大,差异均无统计学意义。结论:化疗前使用益生菌可有效预防肿瘤患者严重CID的发生;在治疗CID中,联用益生菌亦可以提高常规对症治疗的疗效。
关键词: 化疗相关性腹泻 ；益生菌 ；系统评价 ；Meta分析 ；随机对照试验
被引量
11
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