[1]季红敏,李秀川,刘春芳,等.乳腺癌病人化疗期间口服益生菌制剂对肠道菌群和认知功能障碍的影响[J].肠外与肠内营养杂志,2024,(02):92-100.[doi:DOI : 10.16151/j.1007-810x.2024.02.005]
　JI Hong-min,LI Xiu-chuan,LIU Chun-fang,et al.Effects of oral probiotics during chemotherapy on gut microbiota and cognitivedysfunction in breast cancer patients[J].PARENTERAL & ENTERAL NUTRITION,2024,(02):92-100.[doi:DOI : 10.16151/j.1007-810x.2024.02.005]
点击复制

乳腺癌病人化疗期间口服益生菌制剂对肠道菌群和认知功能障碍的影响()
分享到：

《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2024年02期
页码:
92-100
栏目:
论著
出版日期:
2024-04-10

文章信息/Info

Title:
Effects of oral probiotics during chemotherapy on gut microbiota and cognitivedysfunction in breast cancer patients
作者:
季红敏 1; 李秀川 2; 刘春芳 1; 张梦媛 3; 郭 琼 11; 李 仪 1; 钱 军 1
蚌埠医科大学第一附属医院，1.肿瘤外科，2.护理部，安徽蚌埠 233003；3.蚌埠医科大学护理学院，安徽蚌埠 233004
Author(s):
JI Hong-min1;  LI Xiu-chuan2;  LIU Chun-fang1;  ZHANG Meng-Yuan3;  GUO Qiong1;  LI Yi1;  QIAN Jun1
1.Department of Oncology；2.Nursing Department, The First Affiliated Hospital of Bengbu MedicalUniversity, Bengbu 233003, Anhui, China；3. School of Nursing, Bengbu Medical University, Bengbu233004, Anhui, China
关键词:
乳腺癌 ; 化疗 ; 益生菌 ; 肠道菌群 ; 认知障碍
Keywords:
Breast cancer;  Chemotherapy;  Probiotics;  Intestinal flora;  Cognitive impairment
分类号:
R459.3
DOI:
DOI : 10.16151/j.1007-810x.2024.02.005
文献标志码:
A
摘要:
目的：探讨口服益生菌制剂对乳腺癌化疗病人肠道菌群及认知功能障碍的影响。 方法：纳入2021年12月至2022年6月安徽省蚌埠医科大学第一附属医院肿瘤外科女性乳腺癌术后接受蒽环类化疗的病人30例，采用随机数字表法将病人随机分为观察组和对照组，每组15例。两组化疗期间均口服肠内营养制剂，观察组于化疗期间口服益生菌制剂。分析对比两组化疗前后粪便菌群差异，以及病人主、客观认知功能水平变化、化疗相关胃肠道不良反应和营养状况。 结果：两组病人化疗前后肠道菌群多样性指数Chao指数、Ace指数，Shannon指数、Simpson指数差异均无统计学意义（均P > 0.05）。相对于对照组，观察组病人化疗后肠道Actinomyces菌丰度显著升高（P < 0.05），而 Acetoanaerobium、Lachnospiracea_incertae_sedis、unclassified_Frankineae 菌丰度显著降低（P <0.05）。两组病人化疗后客观认知功能障碍和主观认知功能障碍的总分及各维度得分均较化疗前显著下降（P <0.05），但观察组化疗后评分显著高于对照组（P < 0.05）。化疗期间，观察组胃肠道不良反应（便秘、恶心呕吐、腹泻、腹胀）发生率均显著低于对照组（P < 0.05）。 结论：口服益生菌制剂可以改善乳腺癌术后化疗病人的胃肠道不良反应和认知功能障碍，可能和调节肠道菌群紊乱有关。
Abstract:
Acetoanaerobium, Lachnospiracea_incertae_sedis, and unclassified_Frankineae bacteria was significantly lower in theobservation group (P < 0.05). The total scores of the objective and subjective cognitive function as well as the scores ofeach dimension in both groups were markedly decreased after chemotherapy (P < 0.05). The scores in the observationgroup were higher than those in the control group after chemotherapy (P < 0.05). During chemotherapy, the presence ofthe gastrointestinal adverse reactions (constipation, nausea and vomiting, diarrhea and abdominal distension) in theobservation group were significantly lower than in control group (P < 0.05). Conclusion: Oral probiotics couldimprove the cognitive impairment and reduce the presence of the gastrointestinal side effects in the breast cancer patientsreceiving chemotherapy, which may be caused by modulating the intestinal microbiota.

参考文献/References:


[1] Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020:GLOBOCAN Estimates of Incidence and Mortality Worldwidefor 36 Cancers in 185 Countries. CA Cancer J Clin, 2021, 71(3):209-249.
[2] Zheng RS, Zhang SW, Zeng HM, et al. Cancer incidence andmortality in China 2016. Journal of the National Cancer Center.
[3] Silberfarb PM. Chemotherapy and cognitive defects in cancerpatients. Annu Rev Med, 1983, 34: 35-46.
[4] Boykoff N, Moieni M, Subramanian SK. Confrontingchemobrain: an in-depth look at survivors’ reports of impact onwork, social networks, and health care response. J Cancer Surviv,2009, 3(4): 223-232.
[5] Jansen CE, Cooper BA, Dodd MJ, et al. A prospectivelongitudinal study of chemotherapy-induced cognitive changes inbreast cancer patients. Support Care Cancer, 2011, 19(10): 1647-1656.
[6] 杜佳家 . 蒽环类化疗药物对乳腺癌患者认知功能的影响及其“脑肠轴”机制研究. 太原：山西医科大学, 2022.
[7] Du J, Zhang A, Li J, et al. Doxorubicin-Induced CognitiveImpairment: The Mechanistic Insights. Front Oncol, 2021, 11:673340.
[8] Loman BR, Jordan KR, Haynes B, et al. Chemotherapy-inducedneuroinflammation is associated with disrupted colonic andbacterial homeostasis in female mice. Sci Rep, 2019, 9(1): 16490.
[9] Henry NL, Somerfield MR, Dayao Z, et al. Biomarkers forSystemic Therapy in Metastatic Breast Cancer: ASCO GuidelineUpdate. J Clin Oncol, 2022, 40(27): 3205-3221.
[10] 陈德利,葛思堂,左芦根等. 胃癌术后早期肠内营养对术后炎症反应及肠屏障功能的影响 . 肠外与肠内营养, 2020, 27 (04):222-225,229.
[11] Chen KL, Xu Y, Chu AQ, et al. Validation of the Chinese Versionof Montreal Cognitive Assessment Basic for Screening MildCognitive Impairment. J Am Geriatr Soc, 2016, 64(12): e285-e290.
[12] 李 洁, 高 蔚, 孙丽美, 等. 中文版癌症治疗功能评估-认知功能量表应用于乳腺癌患者的信效度检验. 中国实用护理杂志,2015, 31(33): 2554-2556.
[13] Wang H, Mao X. Evaluation of the Efficacy of NeoadjuvantChemotherapy for Breast Cancer. Drug Des Devel Ther, 2020,14: 2423-2433.
[14] Pouncey AL, Scott AJ, Alexander JL, et al. Gut microbiota,chemotherapy and the host: the influence of the gut microbiota oncancer treatment. Ecancermedicalscience, 2018, 12: 868-879.
[15] Liu C, Cheng B, Zhao G, et al. Process analysis of anthracyclineadverse reactions in breast cancer patients with postoperativechemotherapy. J Investig Med, 2022, 70(6): 1352-1357.
[16] Mayer EA, Nance K, Chen S. The Gut-Brain Axis. Annu RevMed, 2022, 73: 439-453.
[17] Arab A, Karimi E, Bagherniya M, et al. The Effect of Probioticand Synbiotic Consumption on the Most PrevalentChemotherapy-related Complications: A Systematic Review ofCurrent Literature. Curr Med Chem, 2022, 29(33): 5462-5473.
[18] 梁长林, 杨 磊. 益生菌改善老年人群糖脂代谢紊乱和代谢综合征相关的肠道菌群失调 . 中国老年学杂志, 2022, 42(23):5913-5917.
[19] Deng Y, Jiang YH, Yang Y, et al. Molecular ecological networkanalyses. BMC Bioinformatics, 2012, 13: 113.
[20] Juan Z, Chen J, Ding B, et al. Probiotic supplement attenuateschemotherapy-related cognitive impairment in patients withbreast cancer: a randomised, double-blind, and placebo-controlledtrial. Eur J Cancer, 2022, 161: 10-22.
[21] 陈 鑫. 复合肠道微生态制剂干预乳腺癌和结肠癌化疗患者肠道菌群的临床研究. 长春：吉林大学, 2022.
[22] Goedert JJ, Hua X, Bielecka A, et al. Postmenopausal breastcancer and oestrogen associations with the IgA-coated and IgAnoncoated faecal microbiota. Br J Cancer, 2018, 118(4): 471-479.
[23] 周达成, 王 明, 蒋 辉. 老年阿尔茨海默病患者肠道微生态改变及其与认知功能的关系探讨 . 中国微生态学杂志, 2020, 32(6): 700-704.
[24] Bloemendaal M, Szopinska-Tokov J, Belzer C, et al. Probioticsinduced changes in gut microbial composition and its effects oncognitive performance after stress: exploratory analyses. TranslPsychiatry, 2021, 11(1): 300.
[25] 瞿丛新. 双歧杆菌三联活菌胶囊预防乳腺癌患者化疗后肠道菌群失调症的应用研究 . 中国微生态学杂志, 2016, 28(06):704-706.
[26] Kim HJ, Jung SO, Kim E, et al. Association of chemotherapy andsubjective cognitive impairment in breast cancer patients: Metaanalysis of longitudinal prospective cohort studies. Eur J OncolNurs, 2022, 57: 102099.
[27] Vega JN, Albert KM, Mayer IA, et al. Subjective cognition andmood in persistent chemotherapy-related cognitive impairment. JCancer Surviv, 2022, 16(3): 614-623.
[28] Henneghan AM, Kesler SR. Subjective cancer-related cognitiveimpairments and salience network connectivity in breast cancersurvivors. J Cancer Surviv, 2023, 17(4): 967-973.
[29] Ongnok B, Chattipakorn N, Chattipakorn SC. Doxorubicin andcisplatin induced cognitive impairment: The possible mechanismsand interventions. Exp Neurol, 2020, 324: 113118.
[30] Kesler SR, Blayney DW. Neurotoxic Effects of Anthracycline- vsNonanthracycline-Based Chemotherapy on Cognition in BreastCancer Survivors. JAMA Oncol, 2016, 2(2): 185-192.
[31] Rodríguez Martín B, Fernández Rodríguez EJ, Rihuete Galve MI,et al. Study of Chemotherapy-Induced Cognitive Impairment inWomen with Breast Cancer. Int J Environ Res Public Health,2020, 17(23) : 8896.
[32] Zou B, Li J, Ma RX, et al. Gut Microbiota is an Impact Factorbased on the Brain-Gut Axis to Alzheimer’s Disease: ASystematic Review. Aging Dis, 2023, 14(3): 964-1678.
[33] 王俊杰,谈善军,吴国豪.肠道菌群在癌性恶病质营养代谢及治疗中的作用.肠外与肠内营养,2021,28(01):49-54.
[34] Lu Y, Luo X, Yang D, et al. Effects of probiotic supplementationon related side effects after chemoradiotherapy in cancer patients.Front Oncol, 2022, 12: 1032145.
[35] Zhou J, Li M, Chen Q, et al. Programmable probiotics modulateinflammation and gut microbiota for inflammatory bowel diseasetreatment after effective oral delivery. Nat Commun, 2022, 13(1):3432.

相似文献/References:

[1]徐令婕,毕清泉,郑海燕,等.营养状况对胃癌术后化疗耐受性及负性情绪的影响[J].肠外与肠内营养杂志,2019,(03):166.[doi:DOI : 10.16151/j.1007-810x.2019.03.008]
　XU Ling-jie,BI Qing-quan,ZHENG Hai-yan,et al.Effects of nutritional status on postoperative chemotherapy tolerance and negative emotion in patients with gastric cancer[J].PARENTERAL & ENTERAL NUTRITION,2019,(02):166.[doi:DOI : 10.16151/j.1007-810x.2019.03.008]
[2]辛晓伟,方 玉,龚丽青,等.全程营养管理在晚期胃癌化疗病人中的应用[J].肠外与肠内营养杂志,2019,(04):193.[doi:DOI : 10.16151/j.1007-810x.2019.04.001]
　XIN Xiao-Wei,FANG Yu,GONG Li-Qing,et al.Application of whole-course nutrition management in patients with advanced gastric cancer undergoing chemotherapy[J].PARENTERAL & ENTERAL NUTRITION,2019,(02):193.[doi:DOI : 10.16151/j.1007-810x.2019.04.001]
[3]单宏杰,马 骖,谢 芳,等.营养风险筛查评分在乳腺癌预后中应用研究[J].肠外与肠内营养杂志,2019,(04):203.[doi:DOI : 10.16151/j.1007-810x.2019.04.003]
　SHAN Hong-jie,MA Can,XIE Fang,et al.Application of nutritional risk screening score in predicting of prognosis in patients with breast cancer[J].PARENTERAL & ENTERAL NUTRITION,2019,(02):203.[doi:DOI : 10.16151/j.1007-810x.2019.04.003]
[4]秦 楠,姜桂春.卵巢癌术后化疗病人营养状况的 现状调查与分析[J].肠外与肠内营养杂志,2019,(06):351.[doi:10.16151/j.1007-810x.2019.06.008]
　QIN Nan,JIANG Gui-chun.Survey and analyze the nutritional status of postoperative chemotherapy patients with ovarian cancer[J].PARENTERAL & ENTERAL NUTRITION,2019,(02):351.[doi:10.16151/j.1007-810x.2019.06.008]
[5]李秀川,刘春芳,杨婷婷,等.乳腺癌病人焦虑抑郁情绪与肠道菌群的相关性研究[J].肠外与肠内营养杂志,2021,(05):267.[doi:10.16151/j.1007-810x.2021.05.003]
　LI Xiu-chuan,LIU Chun-fang,YANG Ting-ting,et al.Correlation between anxiety-depression emotion and intestinal flora in patients with breast cancer[J].PARENTERAL & ENTERAL NUTRITION,2021,(02):267.[doi:10.16151/j.1007-810x.2021.05.003]
[6]田小娟,李卫涛,刘鹏举,等.卵巢癌病人化疗期间多学科全程化营养管理方案的构建[J].肠外与肠内营养杂志,2023,(05):298.[doi:10.16151/j.1007-810x.2023.05.008]
　TIAN Xiao-juan,LI Wei-tao,LIU Peng-ju,et al.Construction of a whole-course and multi-disciplinary nutrition management program for ovarian cancer patients during chemotherapy[J].PARENTERAL & ENTERAL NUTRITION,2023,(02):298.[doi:10.16151/j.1007-810x.2023.05.008]
[7]张 峰,于琴琴,冯 帆.脂肪酸转位酶（CD36）在乳腺癌组织中的表达及临床意义[J].肠外与肠内营养杂志,2024,(01):22.[doi:DOI : 10.16151/j.1007-810x.2024.01.005]
　ZHANG Feng,YU Qin-qin,FENG Fan.Expression and clinical significance of CD36 in breast cancer patients[J].PARENTERAL & ENTERAL NUTRITION,2024,(02):22.[doi:DOI : 10.16151/j.1007-810x.2024.01.005]

备注/Memo

备注/Memo:
基金项目：安徽省护理学会护理科研课题青年项目（AHHLa202118）；蚌埠医学院研究生科研创新计划项目（bbycx21022）作者简介：季红敏，主管护师，护理硕士研究生，从事肿瘤营养护理研究。E-mail:2297630542@qq.com通讯作者：李秀川，E-mail:lixiuchuan2005@yeah.net
更新日期/Last Update: 1900-01-01