| Primary bronchogenic carcinoma known as lung cancer,is a kind of malignant tumors originated from the bronchial mucosa or glands.Morbidity and mortality are very tall.The occurrence of lung cancer is related to smoking,occupational carcinogenic factor,air pollution,ionizing radiation,changing factors such as genetics and gene,etc.According to the histopathological classification,lung cancer is divided into two major categories:non-small cell lung cancer(NSCLC)and small cell lung cancer(SCLC),and NSCLC accounts for most of lung cancer.Irritating cough,hemoptysis,shortness of breath,fever,thin and symptom of pulmonary metastasis are the major clinical manifestations of lung cancer,the main means to the treatment of lung cancer are surgery,radiation and chemotherapy,targeted therapy,immune therapy and treatment of traditional Chinese medicine,etc.However,early symptoms of lung cancer is not obvious,and it has been found to middle-late,missed the best time for surgery.Radiation and chemotherapy method also has entered the platform period,and the adverse reactions after chemotherapy are serious.Targeted therapy is only for a specific genotype and it is expensive.Because of its low toxicity,low cost,significant curative effect factors,more and more people’s attention are taken to traditional Chinese medicine.Lung cancer belongs to category of "cancer" of traditional Chinese medicine,there is no specific name recorded in traditional Chinese medicine.According to the clinical manifestations of lung cancer with corresponding name,referring to "lung volume","cough","hemoptysis","chest pain" and other diseases.The occurrence of cancer is associated with the body weak,the number of pathogens.The body’s vital qi deficiency and exogenous internal injury cause qi stagnation,blood stasis,TanNing,dampness,heat toxin.Lung cancer is divided into lung collaterals syndrome and blood stasis resistance,phlegmy wet aggregates lung card,Yin deficiency of toxic heat,Qi and Yin deficiency syndrome,while most of patients with advanced lung cancer show the qi and Yin deficiency.For this feature,professor Mao Junqing of traditional Chinese medicine in jiangsu province makes the Fuzhengkangai Prescription to treat the advanced lung cancer.This prescription is on the basis of Xiangsha six gentleman’s soup,aimed at replenishing qi spleen and stomach in order to cure the root,with Chinese medicine such as qingrejiedu fights to cure the standard.This study tries to use the Fuzhengkangai Prescription with combination chemotherapy to explore the combination of traditional Chinese medicine and western medicine to treat the advanced NSCLC.The recurrence and metastasis of lung cancer involve multiple links changes such as the abnormal gene expression,the formation of new blood vessels,abnormal signal transduction,etc.A number of experiments show that the Bcl-2 cancer gene and tumor-suppressor gene Bax expression anomaly are closely related to the occurrence of lung cancer.Angiogenic factors(VEGF)and matrix metalloproteinases MMPS in tumor angiogenesis play very important roles.The epidermal growth factor receptor(EGFR)promotes the related signal conduction in cancer.This research tries to detect the expression of Bcl-2,Bax,VEGF,MMP and EGFR in exploring the Fuzhengkangai Prescription’s antitumor mechanism.Part Ⅰ Clinical efficacy of Fuzhengkangai Prescription combined with chemotherapy in the treatment of advanced NSCLCObjective:To observe the clinical curative effect and adverse reactions of Fuzhengkangai Prescription combined with chemotherapy in the treatment of advanced NSCLC.Methods:120 cases of patients with advanced NSCLC were selected from Yangzhou hospital of traditional Chinese medicine and randomly divided into two groups:chemotherapy group and joint group,each group had 60 cases.Chemotherapy group with GP scheme chemotherapy(Gemcitabine plus cisplatin),joint group added in Fuzhengkangai Prescription of traditional Chinese medicine medicinal broth of oral treatment on the basis of the GP scheme chemotherapy,21 days for a cycle,observing four consecutive cycles.Observing the recent curative effect,adverse reactions,completion of chemotherapy and the quality of life of two groups of patients,adverse reactions including gastrointestinal reaction such as nausea and vomiting,bone marrow suppression such as the reduction of white blood cells,hemoglobin and platelet,the damage of Liver and Kidney function.Results:Joint group in the recent curative effect was better than chemotherapy group,the treatment of efficient of two groups were 50%and 28.33%respectively,disease control rates were 96.67%and 85%respectively,comparative differences between the two groups had statistical significance(P<0.05);The occurrence of adverse reactions such as gastrointestinal reaction and bone marrow suppression in joint group was lower than those of chemotherapy group,the difference was statistically significant(P<0.05);Compared with Joint group of liver and kidney impairment,the incidence of chemotherapy group was lower relatively,but the comparison between the two groups,there was no statistically significant difference(P>0.05);the completion of chemotherapy in Joint group was higher than chemotherapy group,two groups of completion of chemotherapy were 88.33%and 56.67%respectively,the difference was statistically significant(P<0.05);The quality of life of Joint group was improved significantly than chemotherapy group,the difference was statistically significant(P<0.05).Conclusions:Fuzhengkangai Prescription can raise the clinical curative effect of GP solution treatment of advanced NSCLC,reduce the occurrence of adverse reactions,improve immunity of patients,assist patients complete chemotherapy regimen smoothly,improve the patients’ quality of life,is worthy of further promotion and research.Part Ⅱ Effect of Fuzhengkangai Prescription on the expression of the Bcl-2 lung cancer gene,tumor-suppressor gene Bax and VEGF,EGFR,MMP in Mice with Lewis lung cancerObjective:To observe Fuzhengkangai Prescription on the antitumor mechanism of Lewis lung cancer in mice.Methods:50 C57BL/6 mice,male and female half and half,each armpit in mice inoculated tumor cells only 0.2 mL model after 24 h,were randomly divided into control group,DDP group,fuzhengkangai Prescription low,medium and high dose group,10 in each group.Respectively drug delivery for 21 days to take out the complete tumor tissue weighing inhibitory rate calculation.The expression of Bcl-2 and Bax mRNA in Lewis lung cancer tissues was assayed by Real-time fluorescent quantitative PCR detection.The expression of MMP-9 protein in Lewis lung cancer tissues was assayed by immunohistochemistry.And the expression of VEGF,EGFR in Lewis lung cancer tissues was detected by method of western blot(WB).Results:Fuzhengkangai Prescription could inhibit the growth of cancer in mice with Lewis lung cancer presenting dose dependent,increase the expression of Bax mRNA in Lewis lung cancer tissues significantly and reduce the expression of Bcl-2 mRNA,MMP-9 protein.Comparing with the model group,Fuzhengkangai Prescription had significant difference(P<0.05).Comparing with cisplatin group,Fuzhengkangai Prescription had significant difference(P<0.05)in increasing the expression of Bax mRNA and reducing the expression of Bcl-2 mRNA.THe expression of VEGF,EGFR in Lewis lung cancer tissues was significantly increased in Model group,Fuzhengkangai Prescription could significantly reduce the expression of VEGF,EGFR in Lewis lung cancer tissues.Comparing with the model group,Fuzhengkangai Prescription had significant difference(P<0.05).Comparing with cisplatin group,no statistical significance(P>0.05).Conclusions:Although Fuzhengkangai Prescription is weaker than cisplatin on the overall effect,it still can effectively inhibit lung cancer cell proliferation,inhibit the expression of Bcl-2 gene in lung cancer cells,activate the high expression of Bax and cut the expression of VEGF,EGFR and MMP in lung cancer cells. |
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