| Objectives To explore the effect of Gegen Qinlian decoction on intestinal barrier function and gut microbiota in patients with colorectal cancer.Methods In this study,a randomized controlled prospective study was designed.A total of 70 patients with colon or rectal cancer diagnosed in the Fourth Hospital of Hebei Medical University from July 1,2018 to December 31,2019 were enrolled.The trial was approved by the Ethics Committee of the Fourth Hospital of Hebei Medical University,and all the patients involved in the study obtained informed consent.Patients who met the inclusion criteria were randomly divided into control group(n = 37)and treatment group(n= 33).The patients in the control group were given routine preparation before operation after admission.On the basis of routine preparation,the patients in the treatment group were given Gegen Qinlian decoction for 7 days before operation.The peripheral blood of the patients in the control group was collected at admission,and the peripheral blood and feces of the patients in the treatment group were collected before and after treatment.Flow cytometry was used to detect the changes of T,NK,NKT and Treg cells of two groups.ELISA was used to detect the levels of serum cytokines TNF-?,IFN-?,IL-2,IL-6,IL-10 and neurotransmitter 5-HT.Immunohistochemical was used to detect the expression of ZO-1,occludin,NF-?B and TNF-? in tumor tissues and normal tissues of two groups.16 S r DNA was used to detect the changes of gut microbiota before and after treatment in the treatment group.Results 1.In the treatment group,14 patients showed diarrhea on admission.After taking Gegen Qinlian decoction,12 patients(about 86%)among these 14 patients complained that their abdominal symptoms were better than those before treatment,such as alleviating diarrhea and reducing the number of defecation,from 5 times per day to 3 times per day.No related adverse events occurred.2.The proportion of CD3+CD4+T cells in peripheral blood in the post-treatment group was significantly higher than those in the pre-treatment and control groups(P<0.05).In addition,the proportion of NKT cells in the post-treatment group was also higher than those in the pre-treatment and control groups(P<0.05).Compared with the pre-treatment and control groups,the proportion of CD3+CD8+T cells,NK cells and Treg had no significant change in the post-treatment(P>0.05).3.The level of TNF-? in the post-treatment group was significantly lower than that in the pre-treatment and control groups(P<0.05).However,there was no significant difference in IFN-?,IL-2,IL-6,IL-10 among the pre-treatment,the post-treatment and the control groups(P>0.05).The content of 5-HT in serum in the post-treatment group was also lower than that in the pre-treatment group(P<0.05),and also lower than that in the control group,but there was no significant difference(P>0.05).4.The expression of ZO-1 and occludin in the tumor tissues of the treatment group was significantly higher than those of the control group(P<0.05).The expression of ZO-1 in the normal tissues of the treatment group was also significantly higher than those of the control group(P=0.010),but there was no significant change in the expression of Occludin between control and treatment groups(P>0.05).Compared with the control group,the expression of NF-?B and TNF-? in the tumor tissues of the treatment group were significantly decreased(P<0.05),while the expression of NF-?B and TNF-? in the normal tissues had no significant change between two groups(P>0.05).5.The ? and ? diversity of gut microbiota in the post-treatment group was lower than that in the pre-treatment group.Compared with the pre-treatment group,the abundance of Bacteroides,Akkermansia and Prevotella increased,while the abundance of Megomonas and Veillonella decreased in the post-treatment group.Compared with the pre-treatment group,the KEGG functional enrichment of gut microbiota showed the significantly different functions were enriched in energy metabolism,immune system disease,immune system,nervous system and cancers(P<0.05).Conclusions Gegen Qinlian decoction improves the intestinal barrier function,reduces the inflammation and enhances the immunity of patients with colorectal cancer.The functions are likely to be achieved by regulating the composition of gut microbiota.Figure [27];Table [4];Reference [72]... |
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