Ginger Xie Xin Tang Prevent Irinotecan Kang Delayed Diarrhea

Objective Irinotecan is a chemotherapy usually used in clinic. But one of it's side effects—delayed-onset diarrhea affects the cancer patient's quality of life and the rate of chemotherapy completion .This clinical study was to observing the ShengJiangXieXinTang on preventing delayed-onset diarrhea caused by Irinotecan, and furthermore study the mechanism by animal study.Methods In clinical study, we used prospective,randomized, non-blind comparative experiment, 46 patients with advanced colorectal cancer were Randomly assigned to two group, 24 in Chinese herb group and 22 in control group. All of the were accept de Gramont (CPT-11/5-FU/CF) chemotherapy. Observing the incidence of diarrhea, the quality of life, Immune Index and the chemotherapy response. In animal study, first select 6 rats from 24 Sprague Dawley male rats, injected with 150mg/kg/day CPT-11 for two consecutive days in the tail vein as Trifan's, to establish a delayed-onset diarrhea model. Other 18 rats were randomly assigned to three groups: (1)herb group (using ShengJiangXieXinTang for oral administration once a day from day 1 to day 9, injected with 150mg/kg/day CPT-11 on day 4,5 in the tail vein); (2) diarrhea control group: using distilled water instead of ShengJiangXieXinTang, the same treatment as herb group;(3)normal control group: using physiologic saline instead of CPT-11, distilled water instead of ShengJiangXieXinTang ,the same treatment as herb group. Scoring of delayed-onset diarrhea, conducting body weight and food-intake. Rats were killed on day 10, removed ileum,cecum and colon. Mesured the PH of cecal contents. Using light microscope to grade intestinal mucosa damage depend on chiu's score..CD4+,CD8+ T-lymphocytes and SIgA were labeled by immunohistochemical staining and there number was calculated by imaging analyzer.Results The clinical study has revealed that incidence rate of delayed-onset diarrhea in Chinese herb group was 12.5%(3/24), all are 1 degree. no case upwards of second-degree was found. while in control group, the rate of delayed-onset diarrhea was 40.9%(9/22), evidently higher than those of herb intervening group (P<0.05). Expression of T cell subsets in the peripheral blood in herb group was higher than that in control group. There was no difference between two groups in tumor effective rate (P>0.05). The animal study has delayed that Compared with diarrhea control group, The incidence of diarrhea and the damage of intestinal mucosa in herb group was milder (P<0.05); numbers of CD4+ and CD8+T lymphocytes and SIgA in rats'intestinal tissue increased significantly (P<0.05).Conclusion ShengJiangXieXinTang can prevent delayed diarrhea caused by CPT-11, improve the advanced colorectal cancer patient's quality of life, enhance the immune function, and have no influence on curative effect of chemotherapy. The animal study identified ShengJiangXieXinTang could alter the PH value of bowel, improve the expression of T-lymphocytes and SIgA in rats'intestinal tissue. So it could prevent the delayed-onset diarrhea caused by CPT-11.