補充麩醯胺對於術前化學及放射線治療之直腸癌病人腹瀉的影響

Effects of Oral Glutamine on Diarrhea in Rectal Cancer Patients Undergoing Preoperative Chemotherapy and Radiotherapy

郭素娥(Su-E Kuo) ； 陳秋盈(Chiu-Ying Chen)

《臺灣營養學會雜誌》 38卷3期 (2013/09) Pp. 71-78

https://doi.org/10.6691/NSJ.201309_38(3).0001

摘要

大腸直腸癌是國人癌症發生率最高的癌症，因治療引起的體重減輕與腹瀉是病人常見的問題，也因而影響營養狀況及生活品質。研究顯示麩醯胺可以改善腸道之黏膜修復及減緩腹瀉情形，本研究欲了解麩醯胺對於術前進行化學治療及放射線治療之直腸癌病人腹瀉症狀之影響。完成試驗者31位病人，隨機分配至實驗組及控制組，實驗為期五週於治療前、中、後三個時間點，二組均接受飲食指導、體位測量、血液檢查及問卷評估，實驗組介入麩醯胺每日30克，而控制組則無。結果二組受試者於實驗前、後體重均無明顯改變，二組之間亦無差異；二組間血液檢查的治療前後差異值亦無統計上意義。受試者的排便次數於治療期間均顯著增加，但是治療後實驗組的腹瀉症狀減緩，而控制組直到治療後的排便次數未見減緩趨勢。在治療後，嚴重腹瀉（7次／天）發生率於實驗組為18.8%，顯著低於控制組的46.7%。本研究顯示每日補充30克麩醯胺對於術前進行化學治療及放射線治療之直腸癌病人可以改善其腹瀉症狀。

關鍵字

麩醯胺 ； 直腸癌 ； 腹瀉 ； 化學治療 ； 放射線治療

並列摘要

Colorectal cancer (CRC) is the most prevalent cancer in Taiwan. Treatment-related weight loss and diarrhea are very common, and may impact a patient's nutritional status and quality of life. Previous studies showed the effects of glutamine in repairing the gut mucosa and relieving diarrhea symptoms. In this study, we assessed the effects of glutamine on improving the frequency of bowel movements during cancer therapy. Thirty-one CRC patients scheduled for preoperative chemotherapy and radiotherapy were recruited, and after informed consent was received, patients were randomly divided into a glutamine supplementation group that received 30 g/day and a control group. During the 5-week treatment period, all patients received nutrition counseling, anthropometric measurements, and blood sampling to check weight changes and the nutritional status pre-, during, and post-treatment. There was no significant weight loss after treatment in either group, and changes in body weight and blood laboratory tests also showed no differences between the groups. The frequency of bowel movements significantly increased during treatment in both groups, but had decreased in the supplementation group by the end of cancer therapy, whereas diarrhea did not subside in the control group. After treatment, the incidence of severe diarrhea (7 times/day) was 18.8%, significantly lower than the 46.7% rate of the control group. Daily supplementation with 30 g glutamine can relieve symptoms of diarrhea, which would thus improve the quality of life of cancer patients.

並列關鍵字

rectal cancer ； glutamine ； diarrhea ； chemotherapy ； radiotherapy