| Objective: Large samples with advanced NSCLC at stageⅢb/Ⅳhad been studied in this study, to systematically analyze the rules of the syndrome distribution and combination of theMethods: To collect 120 eligible patients, and to assess the single syndrome and find out the related zang-fu organs for each case. Then, to analyze the state of excess and deficiency, the combined types of syndrome, the distribution of combination and the location of zang-fu organs. Besides, to analyze the effect of different factors on the common syndrome and the state of excess and deficiency, such as sex, age, TNM stage, KPS scale (Karnofsky Performance Status Scale) and so on.Results: In the 120 advanced NSCLC patients, 84 of them were belong to excess and deficiency mingled syndrome (70.00%), 25 of them were simple deficiency syndrome (20.83%), 11 of them were simple excess syndrome (9.17%). These three groups had significant differences (p＜0.01). Also, the group with simple deficiency syndrome and the group with simple excess syndrome had significant differences (p＜0.05). The sequence of the occurrence frequency of the complex types of syndromes was that the type with three syndromes (44 cases, existed in 36.67%), the type with four syndromes (35 cases, existed in 29.17%), the type with two syndromes(27 cases, existed in 22.50%), the type with five syndromes(8 cases, existed in 6.67%), the type with six syndromes(4 cases, existed in 3.33%), the type with single syndrome(2 cases, existed in 1.67%). The occurrence frequency of the types with three, four and two syndromes was statistically higher than that of the types with single, five and six syndromes(p＜0.01). To analyze the occurrence frequency of the single syndrome, it was found that the most common syndrome was spleen deficiency syndrome and 75 patients showed themselves with it(62.50%); Secondly, there were 73 patients with phlegm syndrome(including phlegm-heat syndrome and phlegm-damp syndrome) (60.83%), 37 of them with phlegm-heat syndrome (30.83%) and 36 of them with phlegm-damp syndrome (30.00%); thirdly, there were 72 patients with blood stasis syndrome (60.00%); besides, there were 49 patients with qi deficiency syndrome (40.83%) and 42 patients with excess-heat syndrome (including phlegm-heat syndrome, damp-heat syndrome and heat-toxin syndrome)(35.00%). Through analyzing statistically, the occurrence frequency of spleen deficiency syndrome, phlegm syndrome and blood stasis syndrome had significant differences with that of other twelve syndromes (p＜0.01). The occurrence frequency of the syndromes of lung and spleen was the highest in the location of the zang-fu organs, 97 cases with the syndromes of lung (80.83%) and 86 cases with the syndromes of spleen (71.67%). The occurrence frequency of the syndromes of lung and spleen was statistically higher than that of the syndromes of other zang-fu organs (p＜0.05). Besides, the occurrence frequency of the syndromes of kidney was high, including 66 cases (55.00%). The distribution of the deficiency/excess syndrome and the common single syndrome had not significant difference between the male and female patients (p＞0.05). The distribution of the common single syndrome had not significant difference between the patients under 60 years old and those above 60 years old (p＞0.05). But there were 5 patients under 60 years old (9.62%) and 20 patients above 60 years old (29.41%) with deficiency syndrome (p＜0.01), while there were 9 patients under 60 years old (17.31%) and 2 patients above 60 years old (2.94%) with excess syndrome (p＜0.05). Patients under 60 years old and those above 60 years old with excess and deficiency mingled syndrome had not significant differences (p＞0.05). There were 64 cases(67.37%) with spleen deficiency syndrome in the group of stageⅣwhile there were 11 cases(44.00%) in the group of stageⅢb, there was significant difference between the two groups (p＜0.05). But in the distribution of another single syndrome and deficiency/excess syndrome, these two groups had not significant difference (p＞0.05). In the group of KPS＜60, there were 32 cases (88.89%) with spleen deficiency syndrome and 27 cases (75.00%) with qi deficiency syndrome, while in the group of KPS≥60, there were 43 cases (51.19%) with spleen deficiency syndrome and 27 cases (26.19%) with qi deficiency syndrome. There was significant difference between the two groups (p＜0.05). But there was no significant difference between the two group in other single syndromes (p＞0.05). There were 13 cases (36.11%) with single deficiency syndrome in the group of KPS＜60, while 12 cases (14.29%) in the group of KPS≥60, There was significant difference between the two groups (p＜0.01). There was no significant difference between the two group in the single excess syndrome and the excess and deficiency mingled syndrome (p＞0.05).Conclusion: The excess and deficiency mingled syndrome is the most common clinical manifestations in the advanced NSCLC. It indicates that supporting healthy and eliminating evil should be the principle of treating advanced NSCLC. The sequence of the occurrence frequency of the single syndrome is spleen deficiency syndrome, phlegm syndrome, blood stasis syndrome, qi deficiency syndrome and heat syndrome. It indicates that invigorating the spleen, benefiting vital energy, eliminating phlegm, removing blood stasis, clearing away heat should be the main methods of treating advanced NSCLC. The clinical manifestations mainly show themselves complex types of syndromes, especially the types with three, four and two syndromes. The advanced NSCLC has the closest relationship with lung and spleen, besides kidney. Sex has not an obvious effect on the TCM syndromes. Deficiency syndrome mainly occurs in the patients above 60 years old, while excess syndrome mainly occurs in the patients under 60 years old, but excess and deficiency mingled syndrome may occurs in both group. The occurrence frequency of the spleen deficiency syndrome of the patients at stage IV is higher than that at stageⅢb, while the TNM stage does not effect other syndromes obviously. The patients whose KPS＜60 are more likely to be with deficiency syndrome (including spleen deficiency syndrome and qi deficiency syndrome) than the patients whose KPS≥60.Objective: By the animal experiment, to observe the effect of Xianyu decoction, which could strengthen spleen, clear lung, eliminate phlegm and remove blood stasis, on inhibiting the Lewis lung carcinoma in mice, the carcinoma cell cycle, the cell apoptotic rate and the expression of genes p53 and bc1-2 in the tumor tissue. So as to discuss the mechanism of the method of strengthening spleen, clearing lung, eliminating phlegm and removing blood stasis in treating lung cancer.Methods: The Lewis lung cancer cells were frozen by fluid nitrogen and conventionally thawed, then inoculated to C57BL/6J mice. Sixty mice were divided into six groups equally, including high dose of Xianyu decoction group, middle dose of Xianyu decoction group, low dose of Xianyu decoction group, CTX group, model group and control group. In the Chinese Medicine groups, the mice were given 0.4ml juice of Chinese Medicine (4.368g/ml, 2.184g/ml, 1.092g/ml for each group) through stomach feeding. In the CTX group, the mice were given 0.2ml cyclophosphamide (2mg/ml)through intraperitoneal injection. In the model group, the mice were given 0.4ml normal saline through stomach feeding. Each group was given medicine once a day, 14 days in all. After 24 hours since the last time, the mice were put to death by cervical vertebra dislocation. The tumor were separated, weighed and then calculated the average weight and the inhibition rate of the tumors for each group. Then, to prepare single cell suspension and to check the cell cycle and apoptotic rate by flow cytometry(FCM). At last, to check the expression of genes p53 and bc1-2 by immunohistochemical method.Results: Being statistically analyzed, it was found that the tumor's weight of each of the therapeutic groups was lighter than that of the model group (p＜0.05 or p＜0.01). In the Chinese Medicine groups, the more the dosage grew, the lighter the tumor's weight became and the higher the inhibition rate of the tumor was. The cell apoptotic rate of each of the therapeutic groups was statistically higher than that of the model group (p＜0.05 or p＜0.01). In the Chinese Medicine groups, the more the dosage grew, the higher the cell apoptotic rate was. The percentage of the cells in G0/G1 phase in high dose of Xianyu decoction group and CTX group was statistically higher than that in the model group (p＜0.05 or p＜0.01). The percentage of the cells in S phase in each of the therapeutic groups was statistically lower than that in the model group(p＜0.05 or p＜0.01), which showed obviously G0/G1 cell cycle arrest. The SⅡof gene bc1-2 in the Chinese Medicine groups is statistically lower than that in the model group (P＜0.01). The SⅡof gene p53 in the Chinese Medicine groups is statistically higher than that in the model group (P＜0.01).Conclusion: The Xianyu decoction can inhibit the growth of the Lewis lung cancer in mice. It could induce the apoptosis of the Lewis lung cancer cells, increase the expression of gene p53 and decrease expression of gene bc1-2. Its effect would become stronger if the dosage grows more. Its mechanism may be related with increasing the expression of gene p53 and decreasing the expression of gene bc1-2 which could induce the apoptosis of the tumor cells, then inhibit the tumor. |
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