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抑郁焦虑情绪的调节作用

Regulatory effect of Shugan Yunpi Decoction on depressive and anxiety symptoms in colorectal cancer patients with depressive disorder 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 disorder  Shugan Yunpi Decoction  PI3K-AKT signaling pathway

中文摘要:

      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。现有治疗方法存在局限，尤其在肿瘤治疗与抑郁治疗的协同干预方面缺乏系统性和针对性。目的 基于PI3K-AKT信号通路，探索疏肝运脾汤改善结直肠癌伴抑郁障碍患者抑郁焦虑情绪的有效性和安全性。方法 本研究为随机对照试验。纳入2023年11月—2025年7月保定市第一中医院收治的结直肠癌伴抑郁障碍患者106例，随机分为研究组和对照组各53例。对照组接受常规化疗联合中医五行音乐治疗，研究组接受常规化疗联合疏肝运脾汤治疗，两组均治疗8周。采用HAMD-17、HAMA分别评定抑郁和焦虑情绪；采用Western blot检测PI3K、AKT、pAKT；采用qRT-PCR检测PI3K mRNA、AKT mRNA表达。结果 重复测量方差分析显示，两组HAMD-17和HAMA评分的时间效应、组别效应及交互效应均有统计学意义(P均<0.01)。治疗4周和8周后，研究组HAMD-17和HAMA评分均低于对照组(P均<0.01)。两组PI3K、AKT、pAKT蛋白及PI3K mRNA、AKT mRNA表达的时间效应、组别效应及交互效应均有统计学意义(P<0.05或0.01)。治疗8周后，研究组PI3K、pAKT蛋白及PI3K mRNA、AKT mRNA表达均低于对照组，AKT蛋白表达高于对照组(P均<0.01)。研究组不良反应发生率低于对照组(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，改善结直肠癌伴抑郁障碍患者的抑郁焦虑情绪，降低PI3K、pAKT、PI3K mRNA、AKT mRNA水平，且安全性较好。

英文摘要:

      Background Colorectal cancer is frequently complicated with depression, which severely affects the quality of life, treatment compliance, tumor treatment effect and prognosis of patients. Current therapeutic strategies still have notable limitations. Objective To explore the effectiveness and safety of Shugan Yunpi Decoction in alleviating depressive and anxiety symptoms in colorectal cancer patients with depressive disorder through the PI3K-AKT signaling pathway. Methods This study was a randomized controlled trial. A total of 106 patients were enrolled and divided into a study group and a control group with 53 cases in each group. The control group received conventional treatment combined with traditional Chinese medicine five element music therapy, while the study group received conventional treatment combined with Shugan Yunpi Decoction therapy. Both groups were treated for 8 weeks. HAMD-17 and HAMA were used to assess depressive and anxiety symptoms. Western blot was used to detect PI3K, AKT, and pAKT. qRT-PCR was used to detect PI3K mRNA and AKT mRNA. Results Repeated measures ANOVA showed that the time effects, group effects, and time-group interaction effects for HAMD-17 and HAMA scores in both groups were statistically significant (P<0.01). After 4 and 8 weeks of treatment, HAMD-17 and HAMA scores in the study group were lower than those in the control group (P<0.01). The time effects, group effects, and interaction effects for PI3K, AKT, pAKT protein and PI3K mRNA, AKT mRNA expression were all statistically significant (P<0.05 or 0.01). After 8 weeks, PI3K, pAKT protein and PI3K mRNA, AKT mRNA expression in the study group were lower than those in the control group, while AKT protein expression was higher (P<0.01). The incidence of adverse reactions in the study group was lower than that in the control group (χ²=4.810, P<0.05). Conclusion Shugan Yunpi Decoction may help to ameliorate depressive and anxiety symptoms in colorectal cancer patients with depressive disorder by regulating the PI3K-AKT signaling pathway, with a favorable safety profile.