| BackgroundProstate cancer (Pca) is the most common male genitourinary system malignancies, prostate cancer incidence increasing year by year. With the aging process society intensifies, the incidence of prostate cancer in older men will rise further, increasing the social and economic burden, reducing the quality of life of patients. Clinical manifestations of prostate cancer are:bladder outlet obstruction symptoms, symptoms of local invasion, metastatic symptoms.Diagnosis of prostate cancer depends on early screening, many prostate cancer patients have lost the timing of surgery, part of the prostate cancer is found by biopsy after abnormal physical examination findings. Treatment of prostate cancer are mainly surgery and non-surgical, treatment for Ⅲ, Ⅳ stage prostate cancer primarily non-surgical treatment because the patient has lost the timing of surgery or difficult to tolerate surgery.Now that the incidence of prostate cancer are age, genetics, diet, lifestyle, intake of trace elements, as well as other aspects of androgen levels and other factors. However, there is not enough evidence to substantiate the inevitability of their relations, for which specific pathogenesis are still in the research stage, inconclusive.Chinese medicine believes that the disease belongs to, "Dysuria" "hematuria" "accumulate" "Zhengjia" and other areas. Urology expert Xie jianxing Chen ming through long-term clinical work, stick to the main pathogenesis:Righteousness deficiency, blood stasis falling from Zhengjia, On the basis of support healthy, use the medicine which can promoting blood circulation, detoxify, Xiaoyu Sanjie to form Fu Zheng Xiaoyu Sanjie Recipe to cure PCa. The prescription is lite, supplementation and attack, it works well through years of clinical validation, but lack of the systematic clinical and experimental study.ObjectivesWe studied the efficacy of Fu Zheng Xiaoyu Sanjie Recipe by clinical and experimental aspects, explored the mechanism of Fu Zheng Xiaoyu Sanjie Recipe in inhibiting tumor, promoting prostate cancer cells apoptosis in-depth level of tumor cellsaMethods1. Experimental ResearchThe normal mice were randomly divided into two groups:the experimental group and control group, n= 10, after successful modeling the mice in experimental group were gavaged for 30 days,0.4ml twice a day (0.2ml/10g body weight), the control group received normal saline. After the tumor meets the requirements, measuring tumor volume every six days, calculating the tumor growth inhibition rate, anatomy the tumor and weighed; Detect the cell apoptosis by Annexin V-FITC/PI; detect the expression of Bcl-2 and Bax by immunohistochemistry; Western blot was used to test PTEN protein.2. Clinical ObservationAll the patients observed in this experiment are from the First Affiliated Hospital of Guangzhou university of TCM, October 2013-October 2015.60 patients were randomed divided into treatment group and control group,30 in each group. The treatment group received Fu Zheng Xiaoyu Sanjie Recipe combined with Western medicine, Western medicine control group using standard endocrine therapy alone. Closly observed and evaluated in 1 and 3 months after treatment of two groups of patients, from tPSA,THb, ZYZH, Karnofsky functional status score, FACT-P4.0 and other aspects.Results1. The experimental results:(1) Modeling results:About 7 days after inoculation, miliary pink picchu projections can be seen at the inoculation site. Tumor gradually increased in 7-14 days, Significant tumor mass appeared in the skin, clear boundary, quality and tough at about 2 weeks, and all tumors have been more than 7mm in diameter. All the nude mice after inoculation grew in good condition, no listlessness, weight loss and even death.(2)Changes of tumor:No deaths occurred in nude mice, growth is good, no obvious abdominal distension performance, non-toxic side effects during the gavage. No tumor is ischemia, necrosis, knot in the growth. After treatment, the treatment group tumor mass and tumor volume was significantly lower than the control group the inhibition rate was 21.1%.(3) By observing FITC and PI diagram we can draw, PC3 cells were mainly distributed in the LL region, the number of cell death caused by mechanical operation was very little. Apoptosis rate was higher in the experimental group in LR area.(4) Bax, Bcl-2 localized in the cytoplasm of tumor cells, showed brown particles in the immunohistochemistry. Bax OD value of experimental group was higher, OD value of the Bcl-2 was lower than the control group. Fu Zheng Xiaoyu Sanjie Recipe can promote the express of Bax protein and inhibit the express of Bcl-2 protein.(5) In this study, the expression of PTEN protein detected by WB showed that PTEN/0-actin value was higher in the experimental group, Fu Zheng Xiaoyu Sanjie Recipe can elevate PTEN/f3-actin ratio, increase the expression of PTEN protein.2. Clinical Results:Compared with before the treatment, PSA levels in the treatment group is lower than that in the control group. The drugs in treatment group can more effectively reduce testosterone levels, but did not get better therapeutic effect with time. Hemoglobin levels were significantly increased in the treatment group and decreased in the control group, but either got better effct with time.Looking at the results from the TCM symptom score:The symptom score of TCM in the treatment group was effectively reduced, but it was raised in the control group in early treatment, maybe the patients is too sensitive to western medicine’s side effect. KPS:The treatment group drug can more effectively increase the KPS. Physiological Status Rating:The medicine of the treatment group can effectively reduce the physiological status score, and get better effect with long time, medicine of control group did not get significantly effect with time. Social and family situation:Drug in treatment group can increase the social and family status, and with the prolongation of treatment time significantly; the control group had no obvious effect on early. Emotional health:The medicine in the treatment group was more effective in reducing the emotional state score, and the effect was obvious with the prolonging of the time, while there was no significant effect in the control group. Functional status:The medicine in treatment group was more effective in raising functional status score than the control group, it shows that Fu Zheng Xiaoyu Sanjie Recipe can improve the functional status obviously. Additional concern:In the treatment group, the drug can raise additional attention score in 3th month when the control group has no effect on it which may be because of the different evaluation scores in the individual evaluation scores.Gonclusion:1. The experimental conclusionsFu Zheng Xiaoyu Sanjie Recipe can inhibit tumor growth in nude mice, promotes apoptosis of PC-3 cells, which may be the role of apoptosis by upregulating the expression of Bax, downregulation of Bcl-2 protein increase expression of PTEN protein to achieve.2. Clinical ConclusionsCompared with the control group, Fu Zheng Xiaoyu Sanjie Recipe combined with hormonal therapy for prostate cancer can more effectively reduce PSA, testosterone levels and increase hemoglobin and improve the quality of life of patients and their subjective feelings associated score. Fu Zheng Xiaoyu Sanjie Recipe curing of advanced prostate cancer patients can play a significant therapeutic effect, while comprehensive enhance patient physical function, improve quality of life. Therefore Fu Zheng Xiaoyu Sanjie Recipe combined with endocrine to therapy PCa stageⅢ, Ⅳ, is worthy of clinical application. |
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