| Objective:Through clinical studies,we observed the differences in survival,clinical symptoms,quality of life and hematological toxicity between Jian-pi-hua-ji recipe combined with pemetrexed maintenance regimen in patients with advanced non-squamous non-small cell lung cancer compared with monotherapy pemetrexed maintenance.The effects of Jian-pi-hua-ji recipe on tumor-bearing mice were observed through experimental research,and its mechanism of action was explored.Methods:(1)Clinical study:Through a prospective cohort study,in strict accordance with the inclusion criteria,60 patients with advanced non-small cell lung cancer were selected.Random number table method was used to divide patients into observation group and control group,30 cases each.The treatment group was given Jian-pi-hua-ji recipe combined with pemetrexed for maintenance treatment,and the control group was given pemetrexed for maintenance treatment,which was applied until the disease progressed.The effect of Jian-pi-hua-ji recipe combined with pemetrexed on prolonging the progression-free survival(PFS),clinical symptoms,quality of life,and hematological toxicity in patients with advanced non-small cell lung cancer was analyzed,and data were analyzed by SPSS 25.0.(2)Experimental study:The effects of Jian-pi-hua-ji recipe on subcutaneously transplanted tumors of lung cancer A549 cells in BALB/c-nu mice were observed by tumor formation,Western Blot and Real-time PCR.Results:(1)Clinical study:A total of 60 patients were included,30 in each of the observation group and the control group,there was no statistical difference in gender,age,TNM stage,KPS score,weight and previous first-line treatment efficacy of each group of patients(P>0.05),indicating that the baselines of the two cohorts are comparable.The average PFS in the observation group was 7.55 and the median PFS was 6.10;the average PFS in the control group was 6.60 and the median PFS was 5.20;The results showed that although the observation group was better than the control group in progression-free survival,there was no significant statistical difference between the two group(P>0.05).In terms of improving the score of TCM lung cancer symptoms,the total effective rate of Jian-pi-hua-ji recipe combined with pemetrexed group was 66.67%,and the total effective rate of single medicine pemetrexed group was 40.00%.The difference between the two groups was statistically significant(P<0.05).In terms of improving the quality of life of patients,86.67%of the patients in the observation group improved and stabilized,and 63.33%of the patients in the control group improved and stabilized;30.0%of patients in the observation group weighed compared with the previous increase,53.3%patients had stable weight and 16.7%patients lost weight,while the control group only had 10.0%patients with increased weight,46.7%patients had stable weight and 43.3%patients lost weight.According to the analysis of the test,it can be seen that the difference between the two groups has statistical significance(P<0.05),and it shows that Jian-pi-hua-ji recipe can improve the quality of life of patients.In terms of hematological toxicity,4 patients in the observation group developed I bone marrow suppression,accounting for 13.3%of all patients;a total of 11 patients in the control group developed bone marrow suppression,of which Ⅰ,Ⅱ,Ⅲ,Ⅳ were 5,3,2,1,accounting for 36.67%;after analysis,we can see that the difference between the two groups is statistically significant(P<0.05).(2)Experimental study:After intervention of nude mice in each group for 14 days,tumors were stripped after sacrifice,and the tumor volume of each group was compared.Compared with the DDP group and the model group,the tumor volume of the Jian-pi-hua-ji recipe group was significantly reduced;Up-regulates the expression of E-cad and down-regulates the expression of N-cad,thereby inhibiting tumor metastasis;it can down-regulate the expression of Twist1 gene,and can inhibit tumor proliferation and metastasis.Conclusion:Through clinical research,we know that Jian-pi-hua-ji recipe combined with Pemetrexed compared with single-agent pemetrexed chemotherapy,which prolonged the patient’s PFS(7.55 months vs.6.60 months,P>0.05),and it has obvious advantages in improving patients’ TCM symptom scores,improving patients’quality of life,and reducing the occurrence of blood toxicity(P<0.05).Through experimental studies,it was found that A can effectively inhibit the proliferation of lung cancer xenografts in nude mice,and its mechanism may be related to the up-regulation of E-cad,down-regulation of N-cad and Twistl expression,and thus the reversal of epithelial mesenchymal transformation. |
PDF Full Text Request