Research On The Effect And Mechanism Of Peifeikang And Kangfuxin Liquid In Preventing Acute Radiation Enteritis

ObjectiveThis study is to probe the influence and mechanism of bifidobacterium triple living bacterium preparation(Peifeikang)and Kangfuxin Liquid in preventing acute radioactive enteritis,and the effect on serum cytokines,peripheral blood lymphocyte subsets and fecal flora.Methods50 patients who were treated in Qingdao Central Hospital from August 2020 to February2022 and pathologically diagnosed as pelvic malignant tumors(rectal cancer or cervical cancer)and required pelvic radiotherapy,were randomly divided into experimental group and control group,with 25 patients in each group.From the first day of radiotherapy to the seventh day after radiotherapy,patients in the experimental group toke Peifeikang 420 mg bid(half an hour after a meal),Kangfuxin Liquid 10 ml tid(dinner),and patients without specific cure in the control group.Patients with grade 2 or above acute radiation enteritis were treated with intestinal mucosal protectant or rehydration.Within 1 week before the radiation,3 weeks and 5 weeks during radiation therapy,all patients were tested 12 cytokines,lymphocyte subgroup analysis by flow cytometry,and fecal flora was analyzed by Gram’s stain.The incidence time of first appearance and duration of acute radioactive enteritis were contrasted of the two groups.Serum cytokines,peripheral blood lymphocyte subsets and fecal bacteria were contrasted of the two groups began of radiotherapy started and the finished of radiation respectively.Statistics work was done with SPSS22.0 statistical software.According to data types,t test,rank sum test or Chi-square test was used to compare groups.Results(1)The fundamental clinical distinctions of the two groups included gender,age,disease classification,pathological type,clinical stage(UICC/AJCC stage and FIGO stage),whether they had received surgical treatment,whether they had received synchronous chemotherapy,synchronous chemotherapy regimen,radiotherapy dose and intestinal irradiation dose volume.That did not differ significantly between the two groups(P>0.05).(2)The incidence of acute radioactive enteritis in the experimental group was(33.3%,8/24),which was lower than that in the control group(72.0%,18/25),the difference was significant(P=0.043).The first occurrence time of symptoms in the experimental group(15.0±2.13d)was later than that in the control group(13.1±4.12d)did differ significantly in the two groups(P=0.012).The duration of time in the experimental group(7.2±2.12d)was shorter than in the control group(10.3±3.54d),but the difference was nonsignificant(P>0.05).(3)In the experimental group,the expression level of IL-5,IL-6,IL-8 and TNF-α after radiotherapy were higher than before radiotherapy,the difference was statistically significant(P<0.05).The expression level of IL–1β,IL-17,IFN-γ and INF-α with radiotherapy were higher than before,but the changes of the group were nonsignificant(P>0.05).The expression level of IL-2,IL-4,IL-10 and IL-12p70 had no dramatically changed compared with those before radiotherapy,(P>0.05).In the control group,the expression level of IL-6,IL-8,and TNF-α after radiotherapy were higher than before radiotherapy,but the changes of the group were nonsignificant(P<0.05).There was no differ in the levels of IL-1β,IL-5,IL-10,IL-12p70,IL-17,INF-γ,IL-2,IL-4 and INF-α after radiotherapy contrasted of no radiotherapy,but the changes of the group were nonsignificant(P>0.05).In the experimental group,the level of expressed about IL-6,IL-8 and TNF-α were little lower than that in the control group,the changes of two groups were significant(P<0.05).(4)In the experimental group,it did no differ significantly in the numbers of peripheral blood lymphocytes,T cells,and NK cells between after radiotherapy and before radiotherapy(P>0.05).The counts of CD4+T and CD8+T cells after radiotherapy was fewer than before radiotherapy,the change was significantly(P<0.05).The rate of CD4+/CD8+ after radiotherapy were fewer than before radiotherapy in the experimental group,the difference did not reach statistical significance(P>0.05).In the control group,the figures of peripheral blood lymphocytes,T cells,NK cells,CD4+T cells and CD8+T cells after radiotherapy were fewer than before radiotherapy,the difference was statistically significant(P<0.05).Compared with before radiotherapy,no difference in the ratio of CD4+/CD8+ was found in the after radiotherapy(P>0.05).In the experimental group,the counts of CD4+T cells and CD8+T cells were all higher than that in the control group,the changes were statistically significantly(P<0.05).(5)The percentage of G-bacilli after radiotherapy was lower than before radiotherapy in the experimental group,and the percentage of G+bacilli after radiotherapy was higher than before radiotherapy,the change was significantly(P<0.05).In the another group,the change that about the percentage of G-bacilli after radiotherapy was higher than before radiotherapy did reach statistical significance(P<0.05),the percentage of G+bacilli after radiotherapy was lower than before radiotherapy,the difference was no statistically significant(P>0.05).Conclusion(1)Peifeikang and Kangfuxin Liquid can reduce the occurrence rate of acute radioactive enteritis in pelvic malignant tumor patients and delay the occurrence time.These were worthy of clinical promotion.(2)Peifeikang and Kangfuxin Liquid can increase the percentage of G+bacilli after radiotherapy,and thus improve the intestinal micro ecology.(3)Peifeikang and Kangfuxin Liquid can reduce the expression levels of IL-6,IL-8,TNF-α after radiotherapy.It may be the mechanism of prevention of acute radioactive enteritis.(3)Peifeikang and Kangfuxin Liquid can reduce he numbers of CD4+T cells,CD8+T cells after radiotherapy.It alleviate the suppression of immune function by pelvic radiotherapy.It may be one of the mechanism of prevention of acute radioactive enteritis.