本文關(guān)鍵詞： 健脾化疲方 晚期大腸癌 微小RNA 細胞因子　出處：《南京中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:通過觀察健脾化瘀方聯(lián)合化療以及單用化療治療晚期大腸癌患者的臨床客觀療效,以及對血清miRNAs、細胞因子等指標的影響,客觀評價健脾化瘀方治療晚期大腸癌的綜合療效,分析健脾化瘀方與miRNA、細胞因子之間的相關(guān)性,探索健脾化瘀方在治療晚期大腸癌中可能存在的作用機制。方法:隨機將晚期大腸癌患者分為22例試驗組及21例對照組,試驗組采用健脾化瘀方聯(lián)合XELOX化療方案治療,對照組單用XELOX方案化療,治療2周期后,觀察兩組治療前后患者瘤體大小、腫瘤指標、體力狀況、血清細胞因子SIL-2R、IL-6、IL-8水平變化以及采用RT-PCR檢測血清中miR-21、miR-155、miR-146a、miR-145表達量的改變。結(jié)果:(1)近期客觀療效的比較:治療后試驗組與對照組比較差異無統(tǒng)計學意義(P0.05)。(2)KPS評分的比較:治療后試驗組KPS評分明顯提高,優(yōu)于對照組,差異有統(tǒng)計學意義(P0.05)。(3)腫瘤標志物的比較:治療后兩組CEA、CA199較治療前降低,組間比較,試驗組CEA低于對照組,差異有統(tǒng)計學意義(P0.05);CA199差異無統(tǒng)計學意義(P0.05)。(4)血清miRNAs的比較:兩組治療后miRNA-21的表達較治療前下調(diào),試驗組與對照組比較差異無統(tǒng)計學意義(P0.05);兩組治療后miRNA-146a、miRNA-145的表達較治療前均上調(diào),試驗組高于對照組,差異有統(tǒng)計學意義(P0.05);兩組治療后miRNA-155的表達較治療前上調(diào),試驗組低于對照組,差異有統(tǒng)計學意義(P0.05)。(5)血清細胞因子的比較:兩組治療后血清IL-6水平較治療前降低,試驗組低于對照組,差異有統(tǒng)計學意義(P0.05);兩組治療后血清IL-8水平亦較治療前降低,試驗組與對照組比較差異無統(tǒng)計學意義(P0.05);兩組治療后血清SIL-2R水平較治療前上升,試驗組與對照組比較差異無統(tǒng)計學意義(P0.05)。結(jié)論:(1)健脾化瘀方聯(lián)合化療與單獨化療相比,能夠明顯改善晚期大腸癌患者的體力狀況,有降低腫瘤標志物的作用。(2)健脾化瘀方在晚期大腸癌中發(fā)揮作用的機制可能是通過調(diào)節(jié)miRNAs(miR-21、miR-146a、miR-145)以及IL-6等細胞因子的表達水平。
[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.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R735.34

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