世界中医药

作者	单位
闫蕴孜1，2，孙凌云2，徐钰莹1，2，陈冬梅3，闫韶花2，杨宇飞2	1 北京中医药大学研究生院/西苑临床医学院，北京，100029； 2 中国中医科学院西苑医院肿瘤科，北京，100091； 3 中日友好医院，北京，100029

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中文摘要:

目的：分析转移性结直肠癌（mCRC）中医治疗优势人群肠道菌群及TB淋巴细胞亚群分布特征及相关性。方法：选取2018年3月至2019年3月期间中国中医科学院西苑医院肿瘤科门诊或病房收治的mCRC患者40例作为研究对象，采用随机双盲、安慰剂对照临床研究方法，随机分为观察组与安慰剂组，治疗给予常规中医治疗加用祛邪胶囊，对照组在与观察组相同治疗基础上服用安慰剂胶囊。收集基线时患者的粪便样本及外周血样本并进行检测。根据入组患者3年随访的生存结局以及mCRC中医治疗优势人群判定标准，将患者分为中医治疗优势人群及非优势人群，分析2组间肠道菌群及TB淋巴细胞亚群的差异性及相关性。结果：肠道菌群Alpha多样性分析显示，中医治疗非优势人群相比优势人群具有更高的sobs指数且差异有统计学意义（115.17±19.25 vs.81.96±36.79，P=0.005），中医治疗优势人群具有更高比例的拟杆菌属（30.6% vs.23.9%，P=0.33）和普雷沃氏菌属（5.7% vs.3.9%，P=0.69）；TB淋巴细胞亚群分析结果发现，中医治疗优势人群组较非优势人群组具有更高的双阴T细胞绝对值(89.6±82.0 vs.37.1±16.5，P=0.01)以及非HLA依赖细胞毒性T细胞（83.0±43.6 vs.28.4±18.3，P=0.01）；HLA依赖细胞毒性T细胞绝对值与粪厌氧棒状菌（Anaerostipes）呈显著负相关（P=0.04）。结论：mCRC中医治疗优势人群与非优势人群在肠道菌群分布以及TB淋巴细胞亚群特征方面存在显著差异且具有一定相关性，为进一步阐释中医优势人群特征及疗效机制提供了必要的科学依据。

English Summary:

To analyze the distribution characteristics and correlation of intestinal flora and TB lymphocyte subpopulations in Chinese medicine beneficiaries of metastatic colorectal cancer(mCRC). Methods:From March 2018 to March 2019, a total of 40 patients with mCRC admitted to the Oncology Department or Ward of Xiyuan Hospital of the Chinese Academy of Chinese Medical Sciences were selected as the research objects. A randomized double-blind, placebo-controlled clinical research method was used and the patients were randomly divided into a treatment groups and a placebo group. The treatment group was given conventional Chinese medicine treatment plus Quxie Capsules, and the control group was given placebo capsules on the basis of the same treatment as the treatment group. Stool samples and peripheral blood samples of patients at baseline were collected and tested. According to the survival outcome of the three-year follow-up of the enrolled patients and the criteria for determining the dominant group of Chinese medicine treatment of mCRC, the patients were divided into a dominant group and a non-dominant group of traditional Chinese medicine treatment. The difference and correlation of intestinal flora and TB lymphocyte subgroups between the 2 groups were analyzed.Results:The Alpha diversity analysis of the intestinal flora showed that the Chinese medicine in the treatment of non-beneficiaries populations had a higher SOBS index than the Chinese medicine beneficiaries populations group and there was a significant statistical difference (115.17±19.25 vs. 81.96±36.79, P=0.005). Chinese medicine beneficiaries populations group had a higher proportion of Bacteroides (30.6% vs. 23.9%, P=0.33) and Prevotella (5.7% vs.3.9%, P=0.69); the analysis of TB lymphocyte subsets found that the Chinese medicine beneficiaries populations group had a higher absolute value of double-negative T cells (89.6±82.0 vs. 37.1±16.5, P=0.01) and non-HLA dependent group than the other group (83.0±43.6 vs.28.4±18.3)，P=0.01); the absolute value of HLA-dependent cytotoxic T cells was significantly negatively correlated with Anaerostipes (P=0.04). Conclusion:there are significant differences in the distribution of intestinal flora and the characteristics of TB lymphocyte subgroups between the dominant and non-advantaged groups of Chinese medicine treatment of mCRC, which provide a necessary scientific basis for further explaining the characteristics of the dominant group of traditional Chinese medicine and the mechanism of efficacy.

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