Clinical Study Of The Effects Of Glutamine And Probiotics On Intestinal Barrier Function In Postoperative Adjuvant Chemotherapy For Colorectal Cancer

Objective:To investigate the damage of postoperative chemotherapy for colorectal cancer on patients’ intestinal barrier function and the impact of the alanyl-glutamine and the bifid-triple viable capsule on the intestinal barrier function during the chemotherapy.Methods:A total of 120 patients with colorectal cancer from January 2018 to March2019 were collected and were randomly assigned into three groups.Namely,the control group(n=40): Patients accepted the chemotherapy regimen of oxaliplatin + capecitabine(Cape OX)with different alanyl-glutamine and bifid-triple viable capsule;The glutamine(Gln)group(n=40): Patients accepted the same chemotherapy regimen as above,but one day before the chemotherapy,they were intravenously injected with alanyl-glutamine(Method: 20 g alanyl Glutamine Injection(Shandong Lukang Pharmaceutical Group)+ 500 m L compound amino acid injection(18AA),intravenous injection,1/day)for five consecutive days.The probiotics group(n=40): Patients accepted the same chemotherapy regimen as above,but one day before the chemotherapy,they took bifid-triple viable capsule through oral administration(Method:0.42 g bifid-triple viable capsule through oral administration,2/day)for five consecutive days.Indicators of intestinal barrier function such as levels of diamine oxidase(DAO),D-lactic acid(D-LAC),bacterial endotoxin(BT)in blood,and nutritional indexes,including albumin(Alb),hemoglobin(Hb),lymphocyte count as well as body mass index(BMI),were detected and recorded before and after thechemotherapy.Adverse reactions of chemotherapy,containing nausea,emesis,diarrhea,abdominal distension,reduction of borborygmus,anorexia,declines of white blood cell count,neutrophil count,and blood platelet count,were recorded and scored.Results:1.Before the chemotherapy,the clinical data of these three groups were comparatively meaningful without significant differences(P > 0.05);2.After the chemotherapy,indicators of intestinal barrier function such as DAO,D-LC,BT in the Gln and probiotics groups were lower than that in the control group,which appeared a significant difference(P < 0.05);3.Indicators of intestinal barrier function such as DAO,D-LC,BT in the control group after the chemotherapy enhanced compared with those before the chemotherapy(P < 0.05);4.The scores of diarrhea in the Gln and probiotics groups after the chemotherapy were lower than those in the control group,which showed a significant difference(P<0.05);5.The scores of abdominal distension in the Gln and probiotics groups after the chemotherapy were lower than those in the control group with a significant difference(P<0.05);6.For these three groups,differences of adverse reaction scores after the chemotherapy,including nausea,emesis,reduction of borborygmus,anorexia,declines of white blood cell count,neutrophil count,and blood platelet count,demonstrated no significant difference(P > 0.05).7.In terms of these three groups,the nutritional indexes,including Alb,Hb,lymphocyte count,and BMI,before and after the chemotherapy displayed no significant difference(P>0.05).Conclusion:(1)The Cape OX chemotherapy regimen have a damaging effect on indicators of intestinal barrier function such as DAO,D-LAC,and BT;(2)Alanyl-glutamine and bifid-triple viable capsule play a certain protective role in the intestinal barrier function of patients with colorectal cancer after accepting the Cape OX chemotherapy regimen;(3)Alanyl-glutamine and bifid-triple viable capsule could improve the symptoms of diarrhea and abdominal distension caused by the Cape OXchemotherapy regimen.