基于PI3K-AKT信号通路探讨疏肝运脾汤对结直肠癌伴抑郁障碍患者情绪的调节作用

Exploring the regulatory effect of Shugan Yunpi Tang on the emotions of patients with colorectal cancer and depression based on the PI3K-AKT signaling pathway

中文关键词:  结直肠癌  抑郁障碍  疏肝运脾汤  PI3K-AKT信号通路

英文关键词:Colorectal cancer  Depressive disorders  Shugan Yunpi Tang  PI3K-AKT signaling pathway

中文摘要:

      【摘要】背景 结直肠癌常并发抑郁障碍，严重影响患者生活质量、治疗依从性及肿瘤治疗效果与预后，现有治疗方法有局限且相关生物学机制研究不深入，探寻更有效综合干预方法及明确机制意义重大。目的 探究基于PI3K-AKT信号通路，疏肝运脾汤对结直肠癌伴抑郁障碍患者情绪的调节作用。方法 本研究采用随机对照试验设计，运用随机数字表法，将2023年11月至2025年7月中国中医科学院广安门医院保定医院收治的106例结直肠癌合并抑郁障碍患者分为两组，每组各53例。对照组给予常规治疗联合中医五行音乐治疗，研究组给予常规治疗联合疏肝运脾汤治疗，两组疗程均为8周。观察并比较两组患者基本资料、治疗前后汉密尔顿抑郁量表17项版（HAMD-17）、汉密尔顿焦虑量表（HAMA）评分、PI3K、AKT、pAKT、PI3K mRNA、AKT mRNA表达及不良反应。采用t检验、F检验等方法进行数据分析，以P<0.05为差异有统计学意义。结果 治疗4周、8周后，两组HAMD-17、HAMA评分较治疗前均降低（P<0.05），研究组HAMD - 17（24.11±3.46 vs 26.64±3.52；18.85±3.02 vs 23.38±2.86）、HAMA评分（12.64±2.26 vs 15.38±2.35；7.06±2.02 vs 13.57±2.21）均低于对照组（t=-3.728、-7.919；t=-6.110、-16.112；均P<0.001）。治疗8周后，研究组PI3K（3.79±0.88 vs 4.80±1.02）、pAKT（25.65±4.15 vs 41.45±8.59）、PI3K mRNA（2.24±0.52 vs 3.15±1.13）、AKT mRNA（3.07±0.72 vs 4.11±0.94）均低于对照组，AKT（43.32±8.24 vs 30.88±7.03）水平高于对照组（t=-5.459、-12.061、-5.326、-6.406、8.353；均P<0.001）。研究组不良反应发生率（11.32% vs 28.30%）低于对照组（χ2=4.810，P<0.05）。结论 疏肝运脾汤可能通过调控PI3K-AKT信号通路，可能有助于改善结直肠癌伴抑郁障碍患者的情绪症状，降低生物学标志物水平，减少治疗相关不良反应，为肿瘤合并情绪障碍综合干预提供基于信号通路调控的新依据。

英文摘要:

      Background Colorectal cancer is often complicated with depression, which seriously affects the quality of life, treatment compliance, tumor treatment effect and prognosis of patients. The existing treatment methods are limited and the related biological mechanism research is not in-depth. It is of great significance to explore more effective comprehensive intervention methods and clarify the mechanism. Objective To explore the regulating effect of Shugan Yunpi Decoction on the emotion of colorectal cancer patients with depression based on PI3K-Akt signaling pathway. Methods In this study, 106 patients with colorectal cancer complicated with depression admitted to Baoding hospital, Guang''anmen Hospital, Chinese Academy of traditional Chinese medicine from November 2023 to July 2025 were randomly divided into two groups, 53 cases in each group. The[基金项目：保定市科技计划项目；项目名称（运脾化浊法治疗恶性肿瘤相关性抑郁(轻中度)肝郁脾虚证的临床疗效观察）；项目编号：2341ZF291 请完善基金项目信息各要素：基金名称、项目名称、项目编号。如下图 基金项目：基金名称......（项目名称： ....需与本研究主题一致 ，项目编号：....） [Funded by Baoding City Science and Technology Project; (number, 2341ZF291 )]] control group was given conventional treatment combined with traditional Chinese medicine five element music therapy, and the observation group was given conventional treatment combined with Shugan Yunpi decoction. The course of treatment of both groups was 8 weeks. The basic data, Hamilton Depression Scale 17 (HAMD-17), Hamilton Anxiety Scale (HAMA) score, PI3K, Akt, pAkt, PI3K mRNA, Akt mRNA expression and adverse reactions were observed and compared between the two groups. The data were analyzed by t-test and F-test, and the difference was statistically significant (P<0.05). Results After 4 and 8 weeks of treatment, the scores of Hamilton Depression Scale (HAMD-17) and Hamilton Anxiety Scale (HAMA) in the two groups were lower than those before treatment (P<0.05), HAMD-17 (24.11±3.46 vs 26.64±3.52; 18.85±3.02 vs 23.38±2.86) and HAMA scores (12.64±2.26 vs 15.38±2.35; 7.06±2.02 vs 13.57±2.21) in the research group were lower than those in the control group (t=-3.728, -7.919; t=-6.110, -16.112;all P<0.001). After 8 weeks of treatment, the PI3K (3.79±0.88 vs 4.80±1.02) , pAKT (25.65±4.15 vs 41.45±8.59), PI3K mRNA (2.24±0.52 vs 3.15±1.13), and AKT mRNA (3.07±0.72 vs 4.11±0.94) in the research group were all lower than those in the control group, while AKT (43.32±8.24 vs 30.88±7.03) was higher than that in the control group (t=-5.459, -12.061, -5.326, -6.406, 8.353; all P<0.001). The incidence of adverse reactions (11.32% vs 28.30%) in the research group was lower than that in the control group (χ2=4.810, P<0.05). Conclusion Shugan Yunpi decoction may help to improve the emotional symptoms of colorectal cancer patients with depressive, reduce the level of biomarkers, and reduce treatment-related adverse reactions by regulating PI3K-Akt signaling pathway, which provides a new basis for comprehensive intervention of tumor patients with emotional disorder based on signaling pathway regulation.