【摘要】 目的通过对胃癌患者在化疗前后肠道中菌群的变化进行定量分析,探讨胃癌患者肠道菌群的变化情况及微生态调节剂对胃癌患者肠道菌群的干预作用。方法选取商丘市第一人民医院及郑州大学第一附属医院80例符合标准的中晚期胃癌作为治疗组。另选取商丘市第一人民医院体检中心20例健康人作为健康对照组。80例胃癌患者被随机分成观察组(40例)和干预组(40例)。观察组采用奥沙利铂+卡培他滨联合化疗方案,干预组采用奥沙利铂+卡培他滨+金双歧联合治疗方案。使用粪便细菌及真菌培养法培养粪便中的大肠杆菌、双歧杆菌、肠球菌、乳酸杆菌、类杆菌、酵母菌、葡萄球菌、消化链球菌。结果治疗组胃癌患者肠道双歧杆菌、乳酸杆菌数量及杆/球比均低于健康对照组(P<0.01);治疗后观察组患者肠道双歧杆菌、乳酸杆菌数量及杆/球比,均低于治疗前观察组(P<0.01);治疗后干预组患者肠道双歧杆菌、乳酸杆菌数量及杆/球比均高于治疗前干预组(P<0.01);治疗后干预组患者肠道双歧杆菌、乳酸杆菌数量及杆/球比例均高于治疗后观察组(P<0.01);干预组患者腹泻、恶心呕吐、食欲下降、白细胞减少、血红蛋白减少和血小板减少、肝功能损害均低于观察组(P<0.01)。结论胃癌患者肠道菌群处于一种失平衡状态;化疗药物可抑制肠道正常菌群生长,可导致肠道菌群失调进一步加重;双歧杆菌乳杆菌三联活菌片可扶植正常菌群生长,调整肠道菌群失调,对胃癌患者化疗导致的肠道菌群失调有预防作用,可明显降低化疗的不良反应,提高患者对化疗的耐受性。更多还原

【Abstract】 Objective To explore the changes of intestinal flora and intervention of microbioecologics by quantitative analysis of intestinal flora in patients with gastric carcinoma before and after chemotherapy. Methods Eighty standard middle and advanced stage patients with gastric carcinoma were randomly divided into observation group( 40) and intervention group( 40). Another 20 healthy volunteers were selected as healthy control group. Patients in observation group were treated with oxaliplatin and capecitabine,and patients in intervention group were treated with oxaliplatin,capecitabine and golden bifid.The Escherichia coli,Bifidobacteria,Enterococcus,Lactobacillus,Bacteroides,Yeast,Staphylococcus and Peptostreptococcus were quantitatively detected by fecal bacteria and fungus culture method in the fecal samples from patients with gastric carcinoma in pre and post chemotherapy. Results In the treatment group,Bifidobacteria,Lactobacillus and proportion of bacillus and coccus of patients with gastric carcinoma were significantly lower than those in the healthy control group( P < 0. 01). In the observation group after treatment,Bifidobacteria,Lactobacillus and proportion of bacillus and coccus of patients with gastric carcinoma were significantly lower than those in the observation group before treatment( P < 0. 01). In the intervention group after treatment,Bifidobacteria,Lactobacillus and proportion of bacillus and coccus of patients with gastric carcinoma were higher significantly than those in the intervention group before treatment( P < 0. 01). In the intervention group after treatment,Bifidobacteria,Actobacillus and proportion of bacillus and coccus of patients with gastric carcinoma were higher significantly than those in the observation group after treatment( P < 0. 01). In the intervention group,diarrhea,nausea and vomiting,loss of appetite,leukopenia,hemoglobin reduction,thrombocytopenia and liver function damage of patients with gastric carcinoma were lower significantly than those in the observation group( P < 0. 01). Conclusions There is a certain imbalance of intestinal flora in patients with gastric carcinoma. Chemotherapy drugs can inhibit the growth of normal intestinal flora and increase the imbalance of intestinal flora. Microbioecologics can effectively prevent intestinal flora imbalance caused by chemotherapy in patients with gastric carcinoma,and can obviously reduce the adverse reaction of chemotherapy drug,increase patients’ tolerance to chemotherapy drug.更多还原