Literature Research On Traditional Chinese Medicine Prescriptions For Non-small Cell Lung Cancer

Objective:Lung cancer is the malignant tumor with the highest morbidity and mortality,and the most pathological type is non-small cell lung cancer(NSCLC).Traditional Chinese medicine(TCM)has its own characteristics and advantages in the treatment of NSCLC.Collect and collate ancient and modem literature data to discuss the characteristics of syndrome and treatment of ancient and NSCLC-related diseases;data mining method was used to explore the characteristics of ancient and modem medicines and prescriptions rules.The efficacy and safety of TCM in the treatment of elderly advanced NSCLC were evaluated by Meta-analysis taking TCM combined with chemotherapy in the treatment of elderly advanced NSCLC as an example,to discuss the advantages of TCM in the treatment of NSCLC.Methods:1.Treatises of NSCLC related diseases including Feiji,Xiben and Xiji in ancient Chinese medical literatures were collected and sorted out,to analyze the characteristics of syndromes and treatment and analyze the thoughts in treating NSCLC.2.Public literatures of modem Chinese medicine in treating NSCLC were collected and organized.A database of prescriptions through Access was established.The characteristics and compatibility of ancient and modem medicines were analyzed by data mining methods including association rules,cluster analysis,and network analysis.3.Randomized controlled trials(RCTs)of TCM combined with chemotherapy were chosen in the treatment of elderly advanced NSCLC.The efficacy and safety of TCM combined with chemotherapy were evaluated in treating elderly advanced NSCLC by Meta-analysis.Results:1.It was shown that accumulation,stagnation,and stagnation in lung could be caused by qi deficiency,emotional disorder,phlegm and heat stagnation,cold coagulation and internal stagnation,etc.in the ancient literature.The main symptoms of Xiji in the Huangdi Neijing were fullness under the threat,and reversed qi;the main symptoms of Xiben in the Dysmenorrhea were as large as a cup,cold,hot,and coughing.In the development of the past dynasties,treatment methods have been formed and developed,such as supporting the right and reinforcing the deficiency,attacking evil and eliminating accumulation,warming stomach and tonifying qi,dissolving phlegm and relieving depression,and treating the disease by stages.2.A total of 157 ancient prescriptions and 1649 modern prescriptions(1347 after deduplication)were collected.Modern literatures included 1023 radiotherapy and chemotherapy combined with traditional Chinese medicine prescriptions,365 unsurgery prescriptions,318 TCM prescriptions alone,and 44 postoperative prescriptions.A total of 444 medicines appeared,in which 413 medicines from modern prescriptions and 132 medicines from ancient prescriptions.Data mining results showed that the medicines with high support in ancient prescriptions were Citri Reticulatae Pericarpium,Aucklandiae Radix,Glycyrrhizae Radix et Rhizoma,Cinnamomi Ramulus,Euodiae Fructus,Ginseng Radix et Rhizoma,Zingiberis Rhizoma,Arecaesemen,Platycodonis Radix,Citri Reticulatae Pericarpium Viride and other medicines for regulating Qi and resolving phlegm,tonifying and warming yang;in modern prescriptions,the medicines with high support were Astragali Radix,Atractylodis Macrocephalae Rhizoma,Poria,Glycyrrhizae Radix et Rhizoma,Ophiopogonis Radix,Hedyotis diffusa,Glehniae Radix,Radix Codonopsis,Pinelliae Rhizoma,Coicis Semen,etc.for replenishing qi and nourishing yin,clearing heat and removing toxin,resolving phlegm and eliminating dampness.The ancient TCM had higher support for Arecaesemen-Aucklandiae Radix,Cinnamomi Ramulus-Citri Reticulatae Pericarpium,Citri Reticulatae Pericarpium Viride-Citri Reticulatae Pericarpium,Platycodonis Radix-Ginseng Radix et Rhizoma,etc.,and the higher support level of the medicine groups were Coptidis Rhizoma-Aconite-Magnoliae Officinalis Cortex,Coptidis Rhizoma-Aconite-Ginseng Radix et Rhizoma,Coptidis Rhizoma-Magnoliae Officinalis Cortex-Ginseng Radix et Rhizoma,etc.,mainly based on the combination of regulating qi medicine and warming yang medicine or regulating qi medicine and tonifying medicine;the modern TCM had higher support for Atractylodis Macrocephalae Rhizoma-Astragali Radix,Poria-Atractylodis Macrocephalae Rhizoma,Poria-Astragali Radix,Glehniae Radix-Ophiopogonis Radix,etc.,the group with higher support was Poria-Atractylodis Macrocephalae Rhizoma-Astragali Radix,Glycyrrhizae Radix et Rhizoma-Poria-Atractylodis Macrocephalae Rhizoma,Glycyrrhizae Radix et Rhizoma-Poria-Astragali Radix,etc.,mainly for replenishing qi and nourishing yin medicines.The network diagram showed that the ancient prescriptions Coptidis Rhizoma-Crotonis Semen Pulveratum,Caryophylli Flos-Piperis Fructus,Aquilariae Lignum Resinatum-Piperis Fructus,modern prescriptions had high correlation between Fritillariae Cirrhosae Bulbus-Schisandrae Chinensis Fructus,Cremastrae Pseudobulbus Pleiones Pseudobulbus-Schisandrae Chinensis Fructus,Fritillariae Cirrhosae Bulbus-Agrimoniae Herba,Cremastrae Pseudobulbus Pleiones Pseudobulbus-Agrimoniae Herba.3.Meta analysis showed that a total of 63 RCTs were included,involving 4976 cases.Meta analysis showed clinical effectiveness[RR:1.25,95%CI(1.16,1.33),p=0.000],clinical control rate[RR:1.11,95%CI(1.07,1.15,p=0.000)],KPS score change Situation[WMD:7.136,95%CI(3.913,10.360),p=0.000],KPS increase and stability rate[RR:1.842,95%CI(1.621,2.094),P=0.000],weight gain[RR:1.749,95%CI(1.398,2.188),P=0.000],weight loss[RR:0.505,95%CI(0.402,0.633),P=0.000];the results of the immune indicators showed that the treatment group was better than that in the control group with significantly statistical difference.In terms of adverse reactions,the incidence of adverse reactions in the treatment group was lower than that in the control group;the results of Meta analysis showed that there were significantly statistical differences in the efficacy between the groups,including leukopenia,hemoglobin,neutropenia,platelet reduction,nausea and vomiting,liver damage,kidney damage,rash,fever,etc.The Egger's test showed that there was no obvious publication bias in clinical effectiveness,clinical control rate,hemoglobin reduction,platelet reduction,?+? degree leukopenia,?+? degree platelet reduction,?+? degree nausea and vomitingConclusions:1.There was no concept of lung cancer in ancient Chinese medicine literatures.It was originated from the theories of pneumoconiosis,apnea,and apnea in the Qin and Han Dynasties,which had a guiding role in the understanding and treatment of lung cancer.The theory was enriched and developed in the evolution of the past generations as well.Doctors from different generations formed the treatment concepts of attacking and supplementing,internal and external treatment in the continuous enrichment and development.2.The results of data mining showed that the medicines used to treat Feiji,Xiben,and Xiji were mainly phlegm and Qi medicines such as Citri Reticulatae Pericarpium,Aucklandiae Radix,Platycodonis Radix,etc.,and were often supplemented with warming Yang and dredging channel medicines such as Euodiae Fructus,Zingiberis Rhizoma;modern medicines in the treatment of NSCLC mainly included Astragali Radix,Atractylodis Macrocephalae Rhizoma,Poria,Glycyrrhizae Radix et Rhizoma,Ophiopogonis Radix,,Glehniae Radix,etc.,which were mainly used for supplementing qi and nourishing yin,and were often used in combination with Hedyotis diffusa,Pinelliae Rhizoma,Coicis Semen and other heat-clearing and detoxifying,phlegm-resolving and eliminating dampness medicines.3.Meta analysis results showed that in the treatment of elderly advanced NSCLC,Chinese medicine combined with chemotherapy could improve the clinical therapeutic effect and the quality of life,stabilize body weight,reduce nausea,vomiting,leukopenia,hemoglobin reduction,liver and kidney function damage,as well as alieviate other adverse reactions.