健脾化瘀方联合化疗对晚期大肠癌患者血清miRNAs及细胞因子的影响

发布时间：2018-01-29 11:13

本文关键词： 健脾化疲方晚期大肠癌微小RNA 细胞因子　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过观察健脾化瘀方联合化疗以及单用化疗治疗晚期大肠癌患者的临床客观疗效,以及对血清miRNAs、细胞因子等指标的影响,客观评价健脾化瘀方治疗晚期大肠癌的综合疗效,分析健脾化瘀方与miRNA、细胞因子之间的相关性,探索健脾化瘀方在治疗晚期大肠癌中可能存在的作用机制。方法:随机将晚期大肠癌患者分为22例试验组及21例对照组,试验组采用健脾化瘀方联合XELOX化疗方案治疗,对照组单用XELOX方案化疗,治疗2周期后,观察两组治疗前后患者瘤体大小、肿瘤指标、体力状况、血清细胞因子SIL-2R、IL-6、IL-8水平变化以及采用RT-PCR检测血清中miR-21、miR-155、miR-146a、miR-145表达量的改变。结果:(1)近期客观疗效的比较:治疗后试验组与对照组比较差异无统计学意义(P0.05)。(2)KPS评分的比较:治疗后试验组KPS评分明显提高,优于对照组,差异有统计学意义(P0.05)。(3)肿瘤标志物的比较:治疗后两组CEA、CA199较治疗前降低,组间比较,试验组CEA低于对照组,差异有统计学意义(P0.05);CA199差异无统计学意义(P0.05)。(4)血清miRNAs的比较:两组治疗后miRNA-21的表达较治疗前下调,试验组与对照组比较差异无统计学意义(P0.05);两组治疗后miRNA-146a、miRNA-145的表达较治疗前均上调,试验组高于对照组,差异有统计学意义(P0.05);两组治疗后miRNA-155的表达较治疗前上调,试验组低于对照组,差异有统计学意义(P0.05)。(5)血清细胞因子的比较:两组治疗后血清IL-6水平较治疗前降低,试验组低于对照组,差异有统计学意义(P0.05);两组治疗后血清IL-8水平亦较治疗前降低,试验组与对照组比较差异无统计学意义(P0.05);两组治疗后血清SIL-2R水平较治疗前上升,试验组与对照组比较差异无统计学意义(P0.05)。结论:(1)健脾化瘀方联合化疗与单独化疗相比,能够明显改善晚期大肠癌患者的体力状况,有降低肿瘤标志物的作用。(2)健脾化瘀方在晚期大肠癌中发挥作用的机制可能是通过调节miRNAs(miR-21、miR-146a、miR-145)以及IL-6等细胞因子的表达水平。
[Abstract]:Objective: to observe the clinical objective effect of Jianpi Huayu recipe combined with chemotherapy and chemotherapy alone in the treatment of advanced colorectal cancer patients, and the effect on serum miRNAsand cytokines. Objective to evaluate the comprehensive efficacy of Jianpi Huayu recipe in the treatment of advanced colorectal cancer, and to analyze the correlation between Jianpi Huayu recipe and miRNAs, cytokines. To explore the possible mechanism of Jianpi Huayu recipe in the treatment of advanced colorectal cancer. Methods: 22 patients with advanced colorectal cancer were randomly divided into two groups: the experimental group (n = 22) and the control group (n = 21). The experimental group was treated with Jianpi Huayu recipe combined with XELOX chemotherapy, while the control group was treated with XELOX alone. After 2 cycles of treatment, the tumor size and tumor index were observed before and after treatment. The changes of serum cytokine SIL-2RnIL-6 / IL-8 and the determination of miR-21 miR-155 miR-146a by RT-PCR were used. Changes of miR-145 expression. Results comparison of recent objective effects: there was no significant difference between the experimental group and the control group after treatment. Comparison of KPS score: after treatment, the KPS score of the experimental group was significantly improved. Compared with the control group, the difference was statistically significant (P0.05U. 3) tumor markers: after treatment, the CEA CA199 was lower than that before treatment, and the comparison between the two groups. The CEA of the test group was lower than that of the control group, and the difference was statistically significant (P 0.05). There was no significant difference of CA199 in serum miRNAs: the expression of miRNA-21 in the two groups was down-regulated after treatment. There was no significant difference between the test group and the control group (P 0.05). After treatment, the expression of miRNA-146a miRNA-145 was up-regulated in both groups, and the expression of miRNA-145 in the experimental group was higher than that in the control group (P 0.05). After treatment, the expression of miRNA-155 in both groups was higher than that before treatment, and the expression of miRNA-155 in the experimental group was lower than that in the control group. Comparison of serum cytokines: after treatment, the serum IL-6 level in the two groups was lower than that before treatment, and that in the experimental group was lower than that in the control group. The difference was statistically significant (P 0.05). The level of serum IL-8 in the two groups was also lower than that before treatment, and there was no significant difference between the experimental group and the control group (P 0.05). After treatment, the serum SIL-2R level in the two groups was higher than that before treatment. There was no significant difference between the experimental group and the control group (P 0.05). Conclusion the combination chemotherapy of Jianpi Huayu recipe and chemotherapy alone is not significant. It can obviously improve the physical condition of patients with advanced colorectal cancer. The mechanism of Jianpi Huayu prescription in advanced colorectal cancer may be by regulating miRNAs1 miR-21 miR-146a. The expression level of cytokines such as miR-145) and IL-6.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34

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