The Study Of Jianpi Huayu Decotion To Patients With Advanced Colorectal Cancer About The Metabonomics Changes

Objective:To observe the toxicity and effect of Jianpi Huayu Decoction combined with chemotherapy in the treatment of patients with advanced colorectal cancer.In order to reveal the possible mechanism of treatment of advanced colorectal cancer by Jianpi Huayu Decoction,the changes of small metabolic molecule between the two groups patients was detected by HPLC-MS.Through the study of metabolites of patients with excess syndrome and deficiency syndrome,it reveals the metabolic differences between the two groups and provides evidence for syndrome differentiation in TCM.Methods:The basic information of 40 cases of patients with advanced colorectal cancer in our hospital was collected.The gender and age of patients were analyzed.Through the combination of the four diagnostic methods of TCM,the syndrome was classified according to the principles of TCM differentiation.The serum samples of patients with advanced colorectal cancer were analyzed by HPLC-MS technique and the ion peak spectrum was obtained.To explore the changes of serum metabonomics between the control group(chemotherapy group)and the experimental group(TCM + chemotherapy group)and excess syndrome and deficiency syndrome in patients with advanced colorectal cancer.The model of orthogonal partial least-squares method(OPLS-DA)and principal components analysis(PCA)was constructed by using the software SIMCA-14.After the PC A and OPLS-DA model were constructed,the corresponding map of distribution points(s-plot)was obtained.The most important metabolic compounds were found between the control group and the experimental group,as well as between the empirical and deficiency syndrome.The quality of the compounds and the retention time were imported into the database to identify the compounds with statistical differences.Results:(1)There are 40 patients with advanced colorectal cancer,20 cases were in the control group(chemotherapy group)and 20 cases in the experimental group(TCM + chemotherapy group).Due to the side effects and personal subjective reasons,6 cases were not adhered to the end of treatment.At last,15 cases in control group and 19 cases in experimental groups.Chemotherapy-induced neurotoxicity and platelet decline did not differ between the two groups.There was no significant difference in clinical efficacy,but leukopenia,gastrointestinal reactions,and KPS score after chemotherapy were significantly different between the experimental group and the control group.(2)The serum of 34 patients with colorectal cancer were analyzed by HPLC-MS metabonomics.Multivariate analysis was performed according to the control group and the experimental group.The model was constructed using OPLS-DA and the corresponding scatter plots were obtained.We found that the distributions between the control and experimental groups were aggregated,and 16 metabolites were analyzed by metabolites.Eight metabolites were identified in the HMDB database.Lysine,tryptophan,and stearic acid increased in the test group,and glutamine,pyruvic acid,lactic acid,citric acid,and guanosine decreased in the experimental group.(3)The metabonomic analysis was performed on the serum samples of positive and deficiency syndromes,and it was found that there was a certain trend of separation between the empirical and deficiency syndrome scores.There are 10 different metabolites,of which 7 are highly related and 5 can identify metabolite structures.Conclusion:(1)Chemotherapy combined with Jianpi Huayu Decoction can relieve the gastrointestinal reaction caused by chemotherapy,improve KPS score,and reduce the incidence of leukopenia.(2)Based on HPLC-MS technology in the serum metabonomics study of patients with advanced colorectal cancer,compared with the chemotherapy alone group,the serum metabolites of patients with advanced colorectal cancer in the combination of chemotherapy and Jianpi Huayu Decoction were changed,which explained that the Traditional Chinese Medicine played an anti-tumor effect Possible mechanisms.(3)Through modeling,we found that the distribution of patients with advanced and incompetent cancers has their own clustering,which provides a direction for TCM syndrome differentiation research.