目的 探讨微生态制剂联合浙贝黄芩汤对急性淋巴细胞白血病(ALL)大剂量化疗后患者粒细胞集落刺激因子受体(G-CSFR)、粒单系集落形成单位(CFU-GM)、肠道菌群及红系爆式集落形成单位(BFU-E)的影响。方法 选取延安大学附属医院2019年6月至2022年12月收治的ALL患者130例作为研究对象，根据治疗方法将患者分为A组、B组、C组，3组患者均接受大剂量化疗，化疗结束48 h后A组患者实施常规治疗，B组患者单纯浙贝黄芩汤治疗，C组给予微生态制剂联合浙贝黄芩汤治疗，治疗12 d后，对3组患者G-CSFR、CFU-GM、BFU-E表达情况及血细胞数量进行检测。结果 治疗后，C组血红蛋白、白细胞、血小板[(79±6)g/L、(3。8±0。4)×109/L、(66。4±3。6)×109/L]与 A 组[(59±7)g/L、(3。2±0。4)×109/L、(52。6±2。8)× 109/L]、B 组[(61±7)g/L、(3。1±0。3)×109/L、(52。8±2。6)×109/L]对比，差异有统计学意义(P＜0。05)。C组G-CSFR(5。35±0。16)pg/ml 和白细胞介素-11 受体(IL-11R)(6。38±0。54)μg/kg 水平均高于 A 组[(2。23±0。13)pg/ml 和(1。49±0。24)μg/kg]和 B 组[(2。31±0。16)pg/ml 和(2。31±0。49)μg/kg]差异有统计学意义(P＜0。05)。治疗后，C 组患者 7 d CFU-GM(18。5±6。0)个和 14 d BFU-E(83。5±7。5)个高于 A 组[7 d CFU-GM(9。5±2。0)个和 14 d BFU-E(59。5±6。5)个]和 B 组[7 d CFU-GM(12。0±6。5)个和 14 d BFU-E(63。5±5。0)个]，差异有统计学意义(P＜0。05)。7 d 后，C 组双歧杆菌(12。56±3。25)lgCFU/g、乳酸杆菌(13。56±2。58)lgCFU/g、肠杆菌(5。12±1。45)lgCFU/g、肠球菌(5。14±0。58)lgCFU/g 高于 A 组[(9。26±1。03)lgCFU/g、(8。65±0。84)lgCFU/g、(8。08±0。64)lgCFU/g、(8。15±0。46)lgCFU/g]和B 组[(11。35±1。36)lgCFU/g、(12。43±1。14)lgCFU/g、(6。49±0。55)lgCFU/g、(6。66±0。43)lgCFU/g]，差异有统计学意义(P＜0。05)。结论 微生态制剂联合浙贝黄芩汤治疗可以有效提高ALL大剂量化疗后患者的G-CSFR、CFU-GM、BFU-E水平，可能更好地改善化疗引起的患者骨髓抑制情况，改善肠道菌群，具有临床研究价值。
Clinical effects of microecological preparations combined with Zhebei Huangqin Decoction on acute lym-phoblastic leukemia after high-dose chemotherapy based on the analysis of intestinal flora balance
Objective To explore the effects of microecology+Zhebei Huangqin Decoction on granulocyte colony-stimulating factor receptor(G-CSFR),granuliophytic colony formation unit(CFU-GM),intestinal flora and erythroid explosive colony formation unit(BFU-E)in patients after high-dose chemotherapy for acute lym-phoblas-tic leukemia.Methods A total of 130 patients with acute lymphoblastic leukemia admitted to Affiliated Hospital of Yan'an University from June 2019 to December 2022 were selected as the study objects,and the patients were divided into group A,group B,and group C according to the method of therapeutic efficacy,and the patients of all 3 groups received high-dose chemotherapy,and the conventional treatment was implemented in the patients of group A after 48 h of the end of chemotherapy,the patients of group B were treated with Zhebei Huangqin Decoc-tion alone,and the patients of group C were treated with microecological preparation+Zhebei Huangqin decoction.In group C,microecological preparation+Zhebei Huangqin Decoction was given,and after 12 d of treatment,the expression of human G-CSFR,CFU-GM,BFU-E and blood cell counts of patients in the three groups were detected.Results After treatment,hemoglobin,leukocytes,and platelets in group C[(79±6)g/L,(3.8±0.4)×109/L,(66.4±3.6)×109/L]were similar to those in group A[(59±7)g/L,(3.2±0.4)×109/L,(52.6±2.8)×109/L],and group B[(61±7)g/L,(3.1±0.3)×109/L,(52.8±2.6)×109/L]were compared,and the difference was statistically significant(P＜0.05).After treatment,the levels of G-CSFR(5.35±0.16)pg/ml and IL-11R(6.38±0.54)μg/kg were higher in group C than in group A[(2.23±0.13)pg/ml,(1.49±0.24)μg/kg],and group B[(2.31±0.16)pg/ml,(2.31±0.49)μg/kg]comparisons,and the differences were statistically significant(P＜0.05).After treatment,the number of 7 d CFU-GM(18.5±6.0)and 14 d BFU-E(83.5±7.5)was higher in patients in group C than in group A[7 d CFU-GM(9.5±2.0)and 14 d BFU-E(59.5±6.5)],group B[7 d CFU-GM(12.0±6.5)and 14 d BFU-E(63.5±5.0)ones],the difference was statistically significant(P＜0.05).After 7 d,group C bifidobacteria(12.56±3.25)lgCFU/g,lactobacillus(13.56±2.58)lgCFU/g,enterobacteria(5.12±1.45)lgCFU/g,enterococci(5.14±0.58)lgCFU/g were better than the A group[(9.26±1.03)lgCFU/g,(8.65±0.84)lgCFU/g,(8.08±0.64)lgCFU/g,(8.15±0.46)lgCFU/g],and B group[(11.35±1.36)lgCFU/g,(12.43±1.14)lgCFU/g,(6.49±0.55)lgCFU/g,(6.66±0.43)lgCFU/g]were compared with each other,and the difference was statistically significant(P＜0.05).Conclusion Treatment with microecological agents+Zhebei Huangqin Decoction can effectively increase the levels of G-CSFR,CFU-GM,and BFU-E in patients after high-dose chemotherapy for ALL,and may better improve chemotherapy-induced myelosuppression in patients and improve the intestinal flora,which is of clinical research value.
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