| Background:CRC is one of the most common cancer in the wordwild.Chemotherapy is an integral part of the treatment of colorectal cancer.However,chemotherapy not only brings benefits to patients,but also brings a series of hazards to patients,leading to loss of appetite,nutritional disorders,leading to intestinal microecological imbalance,and Chemotherapy was stopped in some patients.In recent years,many scholars have found that some of these hazards can be improved by the use of probiotics or nutritional agents,but there are few studies on whether the combination of probiotics and nutritional agents has a more significant effect on postoperative chemotherapy patients.Based on this,to investigate the efficacy of probiotics and nutritional agents during chemotherapy in patients after surgery is the result we want to get.Objective:To explore the efficacy of probiotics combined with enteral nutrition preparations during postoperative chemotherapy for patients with CRC,so as to provide more effective adjuvant therapy for patients with postoperative chemotherapy of CRC and improve the harm caused by chemotherapy drugs.Methods:65 patients who were hospitalized in Suizhou Central Hospital affiliated to Hubei University of Medicine from December 2019 to December 2020and were willing to receive postoperative chemotherapy were randomly divided into three groups.The postoperative pathological diagnosis was colorectal adenocarcinoma,TNM staging was partial IIA,IIB,IIC and III.The control group(n=24)was treated with Cape OX regimen without probiotics and enteral nutrition preparations.Drug administration:Oxaliplatin(OXA)130 mg/m~2,intravenous drip,D1,capecitabine 1000 mg/m~2,oral,2 times/day,d1-d14;nor-mal diet.Chemotherapy combined with probiotics group(probiotics group,n=23):Cape OX regimen chemotherapy+oral probiotics,chemotherapy drug usage was the same as the control group;probiotics administration regimen:Bifidobacterium triple viable capsules(usage:oral,0.63 g/time,twice/day)were taken from the first day of chemotherapy for 5 consecutive days;common diet.Chemotherapy combined with probiotics and enteral nutrition group(nutrition group,n=18):Cape OX chemotherapy+oral probiotics+oral nutritional supplements(ONS).Usage of ONS:Oral enteral nutrition preparation(Lishikang homogenate diet)was taken from the first day of chemotherapy for 5 days.Before and after chemotherapy,the number of intestinal flora,the proportion of CD4+cells,CD8+cells,Albumin(ALB),Prealbumin(PA)and endotoxin were detected respectively.Results:1.After chemotherapy,PA levels were not significantly different among the three groups.(P>0.05);There was no significant difference in ALB level between before and after chemotherapy in nutritional group(P=0.147>0.05),but there was significant difference in ALB level between nutritional group and control group or probiotics group after chemotherapy(P<0.05);2.After chemotherapy,the levels of I-FABP and endotoxin in nutrition group were lower than those in control group and probiotics group(P<0.05);3.After chemotherapy,the percentage of CD4+cells in the control group and the probiotics group was lower than that in the nutrition group(P<0.05),and the percentage of CD8+cells in the control group was lower than that in the nutrition group(P=0.022<0.05);4.After chemotherapy,the numbers of Bifidobacterium,Lactobacillus,Escherichia coli and Enterococcus had no significant difference between the nutritional group and the probiotics group(P>0.05),but the numbers of Bifidobacterium and Lactobacillus increased in the nutritional group and the probiotics group,and decreased in the control group(P<0.05);After chemotherapy,the number of enterococci in the control group was higher than that in the probiotics group and nutrition group(P<0.05),and the level of Escherichia coli in t-he nutrition group was lower than that in the control group(P<0.05);5.Compared with the control group and the probiotic group,the nutritional group had a shorter hospital stay and a lower incidence of adverse reactions,which was statistically significant(P<0.05,P<0.0167).Conclusion:Chemotherapy plus probiotics combined with oral enteral nutrition is helpful to maintain the homeostasis of intestinal flora,reduce immunosuppression,improve nutritional status,protect intestinal barrier function,reduce the incidence of bone marrow suppression and gastrointestinal reactions caused by chemotherapy,and shorten the hospitalization time of patients. |
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