The Study Of Jianpi Yangzheng Xiaozheng Decoction To Patients With Advanced Gastric Cancer About The Metabonomics Changes

Objective:In this study,we investigated the clinical efficacy,safety indicators and symptom improvement indexes of patients with advanced gastric cancer by observing the therapeutic effect of Jianpi Yangzheng Xiezheng decoction combined with chemotherapy.The serum of the two groups of patients was detected by HPLC-TOFMS.Compared the difference of serum metabolites between the two groups of serum metabolites,In order to explore the possible mechanism of the treatment of advanced gastric cancer by the combination of Jianpi Yangzheng Xiezheng decoction and chemotherapy.providing a clinical basis for the treatment of advanced gastric cancer patients by Traditional Chinese Medicine.Methods:A total of 36 patients with advanced gastric cancer who were hospitalized in Yangzhou Hospital of TCM from April 2016 to December 2016 were randomly divided into treatment group(19 cases)which are given Jianpi Yangzhengxie decoction combined with chemotherapy and control group(17 cases)which are treated with chemotherapy only.The safety indexes(blood routine,liver and kidney function,neurotoxicity,gastrointestinal reaction),clinical efficacy index(imaging,TCM syndrome score,KPS score)were recorded before and after treatment.and two cycles as a course of treatment.Serum samples of two groups are accqu before and after the treatment for detecting different metabolite.Results:1.The cases of patients who have leukopenia.thrombocytopenia or Gastrointestinal reactions in treatment group are less than patients in control group,the difference has statistical sense with P<0.05.The TCM symptom score and KPS score of the treatment group were significative higher than those of the control group and P<0.05.2.There are no significant differences in the number of cases who has liver and kidney function damage or neurotoxicity,and clinical efficacy between the two groups with P<0.05.3.Analysis the serum of the control group and the treatment group by HPLC-TOFMS.Compared with the control group,there were 49 different metabolites in the treatment group and 11 could identify the structural information in the HMDB.Among them,the content of di-Hydroxymelatonin,DG(22:2n6/0:0/18:4n3),Diosmetin 7-O-beta-D-glucuronopyranoside,1-Phosphatidyl-D-myo-inositol,LysoPE(20:1(11Z)/0:0),Indoleacrylic acid、Pyruvic acid in treatment group were higher compared with the control group,and 18-Carboxy-dinor-LTE4,Glucosylsphingosine’s content were less than control group.Conclusion:1.Compared with chemotherapy alone,the clinical curative effect of the patients which were given Jianpi Yangzheng Xiezheng decoction combined with chemotherapy have not improved,but it can improve the patients’ bone marrow suppression,nausea and vomiting and other side effects caused by chemotherapy,increase the patient’s Chinese medicine syndrome points and KPS score,better their life.2.Jianpi Xiaozheng Xiezheng decoction can influence the Metabolic process of melatonin,Lipid,Cysteinyl leukotrienes,in hunan body.