黄芩汤治疗索拉非尼相关性腹泻的临床研究

目的 观察黄芩汤治疗索拉非尼所致腹泻的临床疗效。方法 将30例服用索拉非尼后出现腹泻的原发性肝癌患者随机分为治疗组和对照组，各15例。治疗组给予黄芩汤煎服，对照组给予胃黏膜保护剂蒙脱石散及肠道菌群调节剂地衣芽孢杆菌活菌胶囊口服治疗，两组患者均治疗4周。观察两组患者腹泻持续时间、腹泻程度、肠道菌群变化、不良反应的发生情况及中医证候积分。结果 治疗后治疗组腹泻持续时间明显短于对照组（P<0.05），腹泻程度改善明显优于对照组（P<0.05），不良反应发生率明显低于对照组（P<0.05）；在调节肠道菌群方面，治疗组肠球菌、肠杆菌数较治疗前及对照组均有所下降（P<0.05），对照组无明显变化；证候总积分治疗组下降幅度明显大于对照组（P<0.05），治疗组总有效率93.3%明显优于对照组60.0%（P<0.05）。结论 黄芩汤能明显改善索拉非尼所致腹泻，可调节肠道菌群稳态，维护肠道正常功能。

Clinical Study on Huangqin Decoction in Sorafenib-induced Diarrhea

Objective To observe clinical efficacy of Huangqin Decoction on sorafenib-related diarrhea. Methods A total of 30 patients with primary hepatic carcinoma and diarrhea after taking sorafenib were randomly divided into a treatment group and a control group, with 15 cases in each group. The control group received gastric mucosal protective agent-Montmorillonite Powder and intestinal flora conditioning agent-Live Bacillus Licheniformis Capsules orally, while the treatment group received Huangqin Decoction orally. The intervention lasted for 4 weeks. Duration time of diarrhea, severity of diarrhea, changes of intestinal flora, incidence of adverse reactions and syndrome score of traditional Chinese medicine (TCM) in both groups were observed. Results After the treatment, the duration time of diarrhea in the treatment group was significantly shorter than that in the control group (P< 0.05), the improvement of severity of diarrhea was obviously better than that in the control group (P<0.05), and the incidence of adverse reactions was significantly lower than that in the control group (P<0.05); In the aspect of regulating intestinal flora, the amounts of enterococci and enterobacteria were obviously decreased in the treatment group compared with those before the treatment and those in the control group (P<0.05), while there was no obvious change in the control group; the total syndrome score in the treatment group was more significantly decreased than that in the control group (P<0.05). The total effective rate in the treatment group (93.3%) was obviously better than that in the control group (60.0%) (P<0.05). Conclusion Huangqin Decoction can significantly improve sorafenib-induced diarrhea, regulate intestinal flora homeostasis and maintain normal function of intestinal tract.