| Objective:To observe the effect of moxibustion on bone marrow suppression and gastrointestinal toxicity of breast cancer patients after chemotherapy.At the same time,the effect of moxibustion combined with paclitaxel on tumor growth inhibition in breast cancer bearing mice was investigated through experimental research,and the possible mechanism of moxibustion regulating immune function was further explored from the Perspective of tumor microenvironment and immune regulation,so as to reduce the toxicity and side effects of chemotherapy in breast cancer patients It provides new ideas and solutions for tumor growth inhibition.Methods:Clinical study:The eligible breast cancer patients were randomly divided into control group and observation group,30 cases in each group.Patients in both groups were treated with weekly chemotherapy,while patients in control group were given granisetron hydrochloride for injection(3mg)30 min before each chemotherapy+9%sodium chloride injection),intravenous drip;moxibustion treatment group on the basis of the control group chemotherapy,the same day with the use of wheat moxibustion,each time take 60 mg of moxa fleece as the size of wheat grain,moxibustion in Zusanli(bilateral),Qihai,Guanyuan acupoints,9 strong,once a day,for 7 consecutive days.The degree of gastrointestinal reaction(nausea and vomiting)and bone marrow suppression(white blood cell,platelet and hemoglobin content)of the two groups were observed on the 1st,3rd and 7th day of chemotherapy.Experimental study:30 female BALB/c mice were inoculated with 4T1 breast cancer cells to establish tumor bearing mice model.They were randomly divided into model control group,paclitaxel intervention group,moxibustion intervention group and paclitaxel+moxibustion intervention group,with 6 rats in each group.Model control group:from the next day after tumor cell inoculation,no treatment and intervention;paclitaxel intervention group:when the tumor grew to 100-200 mm3,tail vein injection of cy7 paclitaxel 0.1 ml(1mg/ml);moxibustion intervention group:rub moxa velvet into wheat grain size(about 6 Mg)were placed on both Zusanli acupoints of mice and ignited with thread incense.After the moxa velvet was burned out,the ash was directly applied to the moxibustion site.Paclitaxel+moxibustion intervention group:when the tumor grew to 100-200 mm3,0.1 ml(1 mg/ml)of cy7 paclitaxel was injected into tail vein,then the moxa fleece was rubbed into wheat grain size(about 60 mg)and placed at Zusanli acupoints on both sides of the mice on the acupoints.After burning the moxa velvet,the ash was directly pressed on the moxibustion site.Each acupoint is 3 strong,once a day.The changes of body weight and tumor volume were observed within 2 weeks and the tumor weight of each group after 2 weeks.Spleen index and thymus index were calculated.The white blood cell count and its distribution were measured by hematology analyzer.The expression of IL-2,IFN-y,IL-10 and TGF-? 1 in serum were detected by ELISA.Immunohistochemistry,Western blot and qPCR were used to detect the expression of CD-34,HIF-1 a and VEGFA in tumor tissues,and the effects of moxibustion on angiogenesis and microenvironment in mice were observed.The expressions of PD-1 and PD-L1 were detected by immunohistochemistry,Western blot and qPCR.The effects of moxibustion on PD-1/PDL-1 signaling pathway in tumor tissue of tumor bearing mice were observed.Results:1.In the clinical study,on the 3rd and 7th day after chemotherapy,the nausea and vomiting symptoms in the treatment group were significantly improved compared with those on the 1st day after chemotherapy(P<0.05);compared with the 1st day before chemotherapy,the white blood cell content of the two groups decreased significantly(P<0.05),indicating that chemotherapy drugs can lead to the decrease of white blood cell count;in the treatment group,the 3rd and 7th day after chemotherapy were significantly improved(P<0.05)The content of WBC in the control group was significantly higher than that in the control group(P<0.05).There was no significant difference in hemoglobin and platelet between the two groups(P>0.05).2.In the experimental study,compared with the model control group,the weight loss trend of mice in the moxibustion+paclitaxel group was significantly slower,the total number of white blood cells in peripheral blood of mice was significantly increased(P<0.05),and the organ index(P<0.05);compared with the model control group,the levels of IL-2 and IFN-? were increased(P<0.05),and the levels of IL-10 and TGF-?1 were decreased(P<0.05).Compared with the model control group,the expressions of PD-1 and PD-L1 protein in the tumor tissues of moxibustion group and moxibustion+paclitaxel group were decreased by immunohistochemistry and Western blot;compared with the model control group,the expression of PD-1 and PD-L1 mRNA in the tumor tissues of moxibustion group and moxibustion+paclitaxel group was decreased(P<0.05).Conclusion:1.Moxibustion can improve bone marrow suppression and nausea and vomiting induced by chemotherapy of breast cancer to a certain extent.2.Moxibustion can enhance the inhibitory effect of paclitaxel on 4T1 breast cancer mice.Moxibustion can slow down the weight loss of tumor bearing mice caused by paclitaxel.Moxibustion combined with paclitaxel group can inhibit tumor growth by improving tumor microenvironment and affecting angiogenesis.Moxibustion can effectively improve the bone marrow suppression caused by paclitaxel and increase the level of leukocytes;moxibustion may increase the levels of IL-2 and IFN-?,and reduce the levels of IL-10 and TGF-?1,thus reducing the expression of PD-1,PD-L1 protein and their mRNA,and inhibiting the immune escape of tumor. |
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