OEM Kev Cai Pob Khoom Ntuj Macrocephalae Rhizoma roj

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Ua ib yam tshuaj kho mob zoo, 5-fluorouracil (5-FU) siv dav rau kev kho cov qog nqaij hlav hauv txoj hnyuv, lub taub hau, caj dab, hauv siab, thiab zes qe menyuam. Thiab 5-FU yog thawj kab tshuaj rau mob qog nqaij hlav hauv tsev kho mob. Lub tshuab ua haujlwm ntawm 5-FU yog thaiv kev hloov pauv ntawm uracil nucleic acid mus rau hauv thymine nucleic acid hauv cov hlwb qog, tom qab ntawd cuam tshuam rau kev tsim thiab kho DNA thiab RNA kom ua tiav nws cov nyhuv cytotoxic (Afzal et al., 2009; Ducreux et al., 2015; Longley et al., 2003). Txawm li cas los xij, 5-FU kuj tsim cov tshuaj kho mob raws plab (CID), ib qho ntawm cov kev tsis zoo uas feem ntau ua rau ntau tus neeg mob (Filho et al., 2016). Qhov tshwm sim ntawm kev raws plab hauv cov neeg mob uas tau kho nrog 5-FU yog txog li 50% -80%, uas cuam tshuam loj heev rau kev nce qib thiab kev ua haujlwm ntawm kev kho mob chemotherapy (Iacovelli et al., 2014; Rosenoff et al., 2006). Yog li ntawd, nws yog qhov tseem ceeb heev uas yuav tsum nrhiav kev kho mob zoo rau 5-FU induced CID.

Tam sim no, kev kho mob uas tsis siv tshuaj thiab kev kho mob uas siv tshuaj tau raug coj los siv rau hauv kev kho mob CID. Kev kho mob uas tsis siv tshuaj suav nrog kev noj zaub mov kom zoo, thiab kev ntxiv ntsev, qab zib thiab lwm yam khoom noj muaj txiaj ntsig. Cov tshuaj xws li loperamide thiab octreotide feem ntau siv rau kev kho mob raws plab ntawm CID (Benson et al., 2004). Tsis tas li ntawd, cov tshuaj ethnomedicines kuj tau txais yuav los kho CID nrog lawv tus kheej txoj kev kho mob tshwj xeeb hauv ntau lub tebchaws. Tshuaj suav tshuaj suav (TCM) yog ib qho tshuaj ethnomedicine uas tau siv ntau tshaj 2000 xyoo hauv cov tebchaws East Asian suav nrog Tuam Tshoj, Nyiv Pooj thiab Kauslim Teb (Qi et al., 2010). TCM tuav tias cov tshuaj chemotherapy yuav ua rau siv Qi, tsis txaus spleen, tsis sib haum xeeb hauv plab thiab tsis noo noo endophytic, ua rau muaj kev ua haujlwm tsis zoo ntawm txoj hnyuv. Hauv kev xav ntawm TCM, txoj kev kho mob ntawm CID yuav tsum tau vam khom rau kev ntxiv Qi thiab txhawb nqa spleen (Wang et al., 1994).

Cov cag qhuav ntawmAtractylodes macrocephalaKoidz. (AM) thiabPanax ginsengCA Mey. (PG) yog cov tshuaj ntsuab ib txwm muaj hauv TCM nrog cov txiaj ntsig zoo ib yam ntawm kev ntxiv Qi thiab txhawb nqa lub qhov ntswg (Li et al., 2014). AM thiab PG feem ntau yog siv ua khub tshuaj ntsuab (hom yooj yim tshaj plaws ntawm kev sib raug zoo ntawm cov tshuaj ntsuab Suav) nrog cov txiaj ntsig ntawm kev ntxiv Qi thiab txhawb nqa lub qhov ntswg los kho mob raws plab. Piv txwv li, AM thiab PG tau sau tseg hauv cov qauv tshuaj tiv thaiv kev raws plab xws li Shen Ling Bai Zhu San, Si Jun Zi Tang los ntawmTaiping Huimin Heji Ju Fang(Song dynasty, Tuam Tshoj) thiab Bu Zhong Yi Qi Tang los ntawmPi Wei Lun(Yuan dynasty, Tuam Tshoj) (Daim Duab 1). Ntau txoj kev tshawb fawb yav dhau los tau tshaj tawm tias tag nrho peb cov mis muaj peev xwm ua kom CID zoo dua (Bai et al., 2017; Chen et al., 2019; Gou et al., 2016). Tsis tas li ntawd, peb txoj kev tshawb fawb yav dhau los tau qhia tias Shenzhu Capsule uas tsuas muaj AM thiab PG muaj cov teebmeem rau kev kho mob raws plab, colitis (xiexie syndrome), thiab lwm yam kab mob plab (Feng et al., 2018). Txawm li cas los xij, tsis muaj kev tshawb fawb tau tham txog cov teebmeem thiab cov txheej txheem ntawm AM thiab PG hauv kev kho CID, txawm tias ua ke lossis ib leeg.

Tam sim no cov kab mob hauv plab hnyuv suav tias yog ib qho tseem ceeb hauv kev nkag siab txog cov txheej txheem kho mob ntawm TCM (Feng et al., 2019). Cov kev tshawb fawb niaj hnub qhia tau hais tias cov kab mob hauv plab hnyuv ua lub luag haujlwm tseem ceeb hauv kev tswj hwm lub plab hnyuv homeostasis. Cov kab mob hauv plab hnyuv noj qab haus huv pab txhawb rau kev tiv thaiv cov hnyuv mucosal, kev ua haujlwm ntawm lub cev, kev tiv thaiv kab mob homeostasis thiab kev teb, thiab kev tiv thaiv kab mob (Thursby thiab Juge, 2017; Pickard et al., 2017). Cov kab mob hauv plab hnyuv uas tsis zoo ua rau lub cev tsis ua haujlwm ntawm lub cev thiab lub cev tiv thaiv kab mob ncaj qha lossis tsis ncaj qha, ua rau muaj kev tsis haum tshuaj xws li raws plab (Patel et al., 2016; Zhao thiab Shen, 2010). Cov kev tshawb fawb tau qhia tias 5-FU hloov pauv qhov qauv ntawm cov kab mob hauv plab hnyuv hauv cov nas uas raws plab (Li et al., 2017). Yog li ntawd, cov teebmeem ntawm AM thiab PM ntawm 5-FU ua rau raws plab tej zaum yuav yog los ntawm cov kab mob hauv plab hnyuv. Txawm li cas los xij, seb AM thiab PG ib leeg thiab ua ke puas tuaj yeem tiv thaiv 5-FU ua rau raws plab los ntawm kev hloov pauv cov kab mob hauv plab tseem tsis tau paub meej.

Yuav kom tshawb nrhiav cov teebmeem tiv thaiv kev raws plab thiab cov txheej txheem hauv qab ntawm AM thiab PG, peb siv 5-FU los ua qauv raws plab hauv nas. Ntawm no, peb tsom mus rau cov teebmeem ntawm kev siv ib zaug thiab ua ke (AP) ntawmAtractylodes macrocephalaroj tseem ceeb (AMO) thiabPanax ginsengtag nrho cov saponins (PGS), cov khoom xyaw nquag uas tau rho tawm los ntawm AM thiab PG, ntawm kev raws plab, kab mob plab hnyuv thiab cov qauv microbial tom qab 5-FU chemotherapy.

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Qhov cuam tshuam ntawm Ethnopharmacological

Tshuaj suav ib txwm muaj(TCM) tuav hais tias qhov tsis txaus ntawm spleen-Qi yog qhov tseem ceeb pathogenesis ntawm chemotherapy-induced raws plab (CID). Cov tshuaj ntsuab khub ntawmCov tshuaj AtractylodesmacrocephalaKoidz. (AM) thiabPanax ginsengCA Mey. (PG) muaj cov txiaj ntsig zoo ntawm kev ntxiv Qi thiab txhawb nqa lub spleen.

Lub hom phiaj ntawm txoj kev tshawb fawb

Txhawm rau tshawb nrhiav cov txiaj ntsig kho mob thiab cov txheej txheem ntawmAtractylodes macrocephalaroj tseem ceeb (AMO) thiabPanax ginsengtag nrhosaponins(PGS) ib leeg thiab ua ke (AP) ntawm 5-fluorouracil (5-FU) chemotherapy ua rau raws plab hauv nas.

Cov ntaub ntawv thiab cov txheej txheem

Cov nas tau muab AMO, PGS thiab AP rau 11 hnub, thiab txhaj tshuaj 5-FU rau hauv plab rau 6 hnub txij li hnub thib 3 ntawm kev sim. Thaum lub sijhawm sim, qhov hnyav ntawm lub cev thiab cov qhab nia raws plab ntawm cov nas tau raug kaw txhua hnub. Cov ntsuas thymus thiab spleen tau suav tom qab tua cov nas. Kev hloov pauv pathological hauv cov ntaub so ntswg ileum thiab colonic tau kuaj xyuas los ntawm hematoxylin-eosin (HE) staining. Thiab cov ntsiab lus ntawm cov cytokines inflammatory hauv plab hnyuv tau ntsuas los ntawm enzyme-linked immmunosorbent assays (ELISA).16S rDNAAmplicon Sequencing tau siv los tshuaj xyuas thiab txhais cov ntaub ntawvcov kab mob hauv plabntawm cov qauv quav.

Cov txiaj ntsig

AP tau tiv thaiv qhov hnyav ntawm lub cev, raws plab, txo cov thymus thiab spleen indexes, thiab kev hloov pauv ntawm ileums thiab colons uas tshwm sim los ntawm 5-FU. Tsis yog AMO lossis PGS ib leeg xwb tau txhim kho qhov tsis zoo uas tau hais los saum toj no. Dhau li ntawm qhov ntawd, AP tuaj yeem tiv thaiv qhov nce ntawm 5-FU-mediated ntawm cov cytokines inflammatory hauv plab hnyuv (TNF-α, IFN-γ, IL-6, IL-1βthiab IL-17), thaum AMO lossis PGS tsuas yog txwv qee qhov ntawm lawv tom qab 5-FU chemotherapy. Kev tshuaj xyuas kab mob hauv plab qhia tau tias 5-FU ua rau muaj kev hloov pauv ntawm cov qauv ntawmcov kab mob hauv plabtau thim rov qab tom qab kev kho mob AP. Tsis tas li ntawd, AP tau hloov kho qhov ntau ntawm cov phyla sib txawv zoo ib yam li cov nqi ib txwm muaj, thiab rov qab kho cov piv ntawmCov Firmicutes/Cov kab mob Bacteroidetes(F/B). Ntawm theem genus, kev kho mob AP txo qis cov kab mob xws liCov kab mob Bacteroides,Ruminococcus,AnaerotruncusthiabDesulfovibrioAP kuj tawm tsam cov teebmeem tsis zoo ntawm AMO thiab PGS ib leeg rau qee hom tsiaj xws liBlautia,ParabacteroidesthiabCov kab mob LactobacillusTsis yog AMO lossis PGS ib leeg xwb tsis tau txwv tsis pub muaj kev hloov pauv ntawm cov qauv ntawm cov kab mob hauv plab uas tshwm sim los ntawm 5-FU.