The Clinical Therapeutic Effect Of The Treatment Of The Cancer Pain Of Bone Metastasis By Bushenhuoxue Decotion And The Abirritation Mechanism Which Affects The Cancer Pain Of Bone Metastasis

Objective:Observe the clinical therapeutic effect of the treatment of the cancer pain of bone metastasis by Bushenhuoxue Decotion. Appraise the life quality improvement. Observe the abirritation mechanism which affects the cancer pain of bone metastasis.Methods:Part ?:Clinical effect study of Bushenhuoxue Decotion treatment of the cancer pain of bone metastasis.60 patients with bone metastasis cancer pain were divided into observation group and control group. On the base of letting the observation group taking the oxycodone hydrochloride sustained-release tablets, they will be treated with traditional Chinese medicine, Bushenhuoxue Decotion, as well. The control group only takes the oxycodone hydrochloride sustained-release tablets. The clinical effect study Bushenhuoxue Decotion will be evaluated scientifically through the pain grades (NRS), life quality grades (KPS) and the compare the effects before and after the treatment.Part II:Research of the abirritation mechanism which affects the cancer pain of bone metastasis though the Bushenhuoxue Decotion.KM mice were divided into whole prescription group, Oxycodone group and blank group. And all of these three groups were received their medical treatment separately. After 14 days, I observed the abirritation mechanism of Bushenhuoxue Decotion through the hot plate method and the acetic acid twisting body method. I established the large SD murine bone cancer pain model which was divided into whole prescription group, zoledronic acid group, model group, fake surgery group. After finishing establishing the model, they began to be given medicine. And it lasted for 3 weeks consecutively. I observed the tibial tumor structure and measured the tumor size by the imaging methods. Besides, I observed the pathological morphology and determined the bone density and the bone mineral content through HE staining. And I detected spinal cord using PCR and Western blot method dorsal horn GFAP, p-p38 MAPK and tibia tumor tissue OPQ RANKL, RANK expression.Results:Part I:Clinical effect study of Bushenhuoxue Decotion treatment of the cancer pain of bone metastasis.LAfter the medical treatment, the NRS grade levels of both of the two patient groups reduced progressively. After 14 days medication, the NRS grade level of observation group reduced much more obviously than the control group (P<0.05). The observation group had improved the pain killing significantly at 7th day's and 14th day's medical treatment (P<0.05).2.The observation patient group is taking much less oxycodone hydrochloride sustained-release tablets (P<0.05). And taking oxycodone hydrochloride sustained-release tablets maintenance dose titrated up time was significantly shortened (P<0.05).3.After 14 days treatment, two groups'life quality improved significantly. The observation group's KPS grade level improved much more than the control group (P<0.05).Part II:Research of the abirritation mechanism which affects the cancer pain of bone metastasis though the Bushenhuoxue Decotion.1.Compared with the blank group, the pain threshold of the whole prescription mice group was enlarged significantly. And the mice writhing times reduced (P<0.05)2.Compared with the model group, the damage to the mice tibia was reduced in the whole prescription group. The tumor size didn't increase a lot. The bone mineral density and bone mineral levels were elevated (P<0.05)3.Compared with the model group, the whole prescription mice's spinal dorsal horns GFAP, p-p38 MAPK mRNA and protein expression were decreased (P<0.05).4.Compared with the model group, the whole prescription mice's tibia tumor OPG mRNA and protein expression increased. RANKL, RANK mRNA and protein expression reduced (P<0.05).Conclusion:1.Bushenhuoxue Decotion can improve the therapeutic effect of controlling the bone metastasis patient cancer pain and improve their life quality. Reducing the oxycodone hydrochloride sustained-release tablets and shortening the titrated up time didn't cause any adverse reactions much.2.Bushenhuoxue Decotion can inhibit the growth of bone metastasis tumor and has good abirritation effect. It may be related to the inhibition of astrocyte activation, reducing the expression of p-p38 MAPK, adjusting p38 MAPK pathway and blocking central pain sensitized.3.Bushenhuoxue Decotion may up-regulate the OPG expression and down-regulate the RANKL and RANK expression to promote osteoblasts secrete OPG. So it increased the binding to RANK, thereby decreased the osteoclast activity. And then the RANKL synthesis reduced, thereby the pain would be relieved.