四川精神卫生2026，Vol.39Issue(4)：324-330,336,8.DOI:10.11886/scjsws20251208003
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症状的调节作用
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
摘要
Abstract
Background Patients with colorectal cancer are frequently comorbid with depression,which severely affects the quality of life and treatment compliance,while compromising the efficacy of anticancer treament and prognosis.Current therapeutic strategies still have notable limitations,particularly the lack of systematic and targeted synergistic regimens that integrate oncological management and anti-depressive intervention.It is of great clinical significance to explore a safe and effective new comprehensive intervention protocol and clarify its underlying mechanism of action.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,in order to provide references for the comprehensive treatment of colorectal cancer and depressive disorder.Methods This study was a randomized controlled trial.A total of 106 patients admitted to the Baoding No.1 Hospital of traditional Chinese medicine from November 2023 to July 2025 were enrolled,who met the diagnostic criteria for the Chinese protocol of diagnosis and treatment of colorectal cancer(2023 edition)and the diagnostic criteria for depressive disorder as specified in the Chinese Classification and Diagnostic Criteria of Mental Disease,third edition(CCMD-3).Patients were divided into the study group and the control group using a random number table,with 53 cases in each group.The control group received conventional chemotherapy combined with traditional Chinese medicine five-element music therapy,while the study group received conventional chemotherapy combined with Shugan Yunpi Decoction therapy.Both groups were treated for 8 weeks.Depressive and anxiety symptoms were assessed using the Hamilton Depression Scale-17 item(HAMD-17)and Hamilton Anxiety Scale(HAMA),respectively.Western blot protein immunoblotting was used to detect the expression levels of PI3K,AKT,and pAKT.Real-time fluorescence quantitative reverse transcription polymerase chain reaction(qRT-PCR)was used to detect the expression levels of PI3K mRNA and AKT mRNA.Adverse reactions were recorded using a self-designed adverse reaction record form.Results Repeated measures analysis of variance showed that the time effects(F=139.336,234.747),group effects(F=43.900,101.266),and time-group interaction effects(F=13.409,43.216)for HAMD-17 and HAMA scores in both groups were statistically significant(P<0.01).After 4 and 8 weeks of treatment,the HAMD-17 and HAMA scores in both groups were lower than those before treatment,with statistically significant differences(P<0.05).HAMD-17 and HAMA scores in the study group were lower than those in the control group(P<0.05).The time effects(F=571.356,309.266,414.492),group effects(F=6.901,26.361,39.362),and time-group interaction effects(F=18.592,19.266,33.484)for the protein expression levels of PI3K,AKT,and pAKT in both groups were all statistically significant(P<0.01).After 8 weeks of treatment,the protein expression levels of PI3K and pAKT in the study group were lower than those in the control group,while the AKT protein expression level was higher than that in the control group(P<0.01).The time effects(F=338.555,225.059),group effects(F=5.429,9.726),and time-group interaction effects(F=12.953,21.214)for PI3K mRNA and AKT mRNA expression levels in two groups were all statistically significant(P<0.01).After 8 weeks of treatment,the expression levels of PI3K mRNA and AKT mRNA in the study group were lower than those in the control group(P<0.05).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,decreasing the levels of PI3K,pAKT,PI3K mRNA,and AKT mRNA,with a favorable safety profile.关键词
结直肠癌/抑郁障碍/疏肝运脾汤/PI3K-AKT信号通路Key words
Colorectal cancer/Depressive disorder/Shugan Yunpi Decoction/PI3K-AKT signaling pathway分类
医药卫生引用本文复制引用
孟静,赵景曼,田芳,魏东,于海如,冯超男,李亚楠,杨颖..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症状的调节作用[J].四川精神卫生,2026,39(4):324-330,336,8.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] [Funded by Baoding City Science and Technology Planning Project(number,2341ZF291)] （轻中度）
