Abstract:

Mucositis is the most common side effect of radiotherapy and chemotherapy. It is an inflammatory disease with an unclear pathogenesis, diverse clinical manifestations and no effective treatment. It often manifests as local mucosal burning and stinging pain in the oral cavity and nausea, vomiting and diarrhea in the gastrointestinal tract. At present, it has been found that local microflora imbalance promotes the occurrence and development of chemoradiotherapy mucositis, and probiotics can be used as an emerging approach to prevent and treat mucositis. This paper reviews the research progress of probiotics in the prevention and treatment of oral and gastrointestinal chemoradiotherapy mucositis, focusing on the influence of microorganisms on the pathogenesis and treatment of gastrointestinal mucositis. Literature review results showed that the occurrence and development of mucositis may be related to changes in the composition and function of local microflora, and probiotics can play a preventive role by regulating local microecology and host immunity. At present, the main probiotics used in the prevention and treatment of mucositis are Lactobacillus and Bifidobacterium. Most clinical trials have confirmed that probiotics have a positive effect in the prevention and treatment of mucositis. However, due to the variety of probiotics and different tumor treatment regimens, prevention and treatment effects may not be observed in some studies. Therefore, the selection of probiotics with high efficacy and safety and the design of the best combination of probiotics and intervention programs are current research hotspots.

Key words: probiotics, Lactobacillus, Bifidobacterium, oral mucositis, gastrointestinal mucositis, tumor, chemotherapy, radiotherapy, local microecology, host immunity

摘要：

黏膜炎是放疗、化疗最为常见的副反应,是一种发病机制不明、临床表现多样、尚无有效治疗方法的炎症性疾病,在口腔常表现为局部黏膜烧灼样刺痛,在胃肠道多表现为恶心、呕吐、腹泻等。目前发现局部菌群失调可促进放化疗黏膜炎发生发展,益生菌可作为防治黏膜炎的新兴路径。本文就益生菌防治口腔和胃肠道放化疗黏膜炎的研究进展予以综述,重点关注微生物对黏膜炎的发病机理和治疗的影响。文献复习结果显示,黏膜炎的发生发展与局部菌群组成和功能改变有关,益生菌可通过调节局部微生态及宿主免疫等机制发挥防治作用。目前用于防治黏膜炎的益生菌多为乳杆菌、双歧杆菌等,多数临床试验证实益生菌防治黏膜炎有积极作用。但由于益生菌品种繁多、肿瘤治疗方案不同,可能造成部分研究未观察到防治作用,选择有效性及安全性高的益生菌、设计最佳菌种组合及干预方案是当前领域的研究热点。

关键词: 益生菌, 乳杆菌, 双歧杆菌, 口腔黏膜炎, 胃肠道黏膜炎, 肿瘤, 化疗, 放疗, 局部微生态, 宿主免疫