Radiosensitization Of Yangyin Yiqi Granules On Nasopharyngeal Carcinoma And Related Basic Research

Objective: We observed the composition of traditional Chinese medicine(TCM)syndromes,the distribution characteristics of syndromes and the trend of syndrome transformation before and after radiotherapy.It provides the basis for the standardization of TCM syndromes and the exploration of TCM pathogenesis in clinical nasopharyngeal cancer(NPC),and provides better guidance for clinical TCM medication.To observe the sensitization effect of Yangyin Yiqi Granules on radiotherapy of nasopharyngeal carcinoma,and to provide a theoretical basis for the radiosensitization effect of TCM in radiotherapy.At the same time,we investigated whether Trichoderanthin(TCS),an effective drug extract of Yangyin Yiqi granules,had radiosensitizer effect on human nasopharyngeal carcinoma cell line C666-1,to reveal the scientific connotation of the mechanism of action of TCM compounds,and to open up new ideas for improving the radiosensitizer effect of NPC.Methods: Clinical study: 1.Analysis of TCM syndromes before and after radiotherapy in patients with nasopharyngeal carcinoma(NPC).The clinical data of 71 patients with NPC were collected and analyzed to observe the composition of TCM syndromes,the distribution characteristics of syndromes and the trend of syndrome transformation before and after radiotherapy.2.Sensitization effect of Yangyin Yiqi Granules on radiotherapy of NPC.The NPC patients meeting the inclusion criteria were randomly divided into the Chinese medicine group and the control group.The Chinese medicine group received radiation therapy while taking orally Yangyin Yiqi Granules,while the control group received radiation therapy while taking orally placebo granules.The reduction of nasopharyngeal primary lesions and cervical metastatic lymph nodes in the two groups were observed,and the results of skin,mucosa,salivary glands,digestive tract reactions and blood routine were evaluated and analyzed for statistical analysis.Basic experimental research: Radiosensitization effect of trichosanthin on nasopharyngeal carcinoma cell line C666-1.The inhibitory effect of TCS on C666-1 proliferation was detected by CCK8 method,and the IC50 and non-cytotoxic concentration of TCS on C666-1 were calculated.CCK8,colony formation test and flow cytometry were used to detect the inhibitory effect of TCS combined with radiation on cell proliferation and enhance cell apoptosis,and survival curves were fitted.Finally,the radiosensitization effect of TCS on NPC was confirmed in vivo by a nude mouse model of tumor transplantation.Result: 1.TCM syndrome analysis of patients with NPC before and after radiotherapy:After radiotherapy,the patients’ symptoms and signs,such as dry nasal cavity(88.7%),dry mouth and thirst(71.8%),upset and insomnia(57.7%),lip color light(56.3%),fatigue(54.9%),night sweats(52.1%),sphoria with feverish sensation in chest,palms and soles(50.7%),red tongue(83.0%),less moss(47.8%),no moss(33.8%),significantly higher occurrence of relatively before radiotherapy.Before radiotherapy,NPC patients were slightly more common with internal obstruction of phlegm and dampness(17 cases,23.9%),followed by deficiency of both Qi and Yin(15 cases,21.1%).After radiotherapy,the syndrome of deficiency of both Qi and Yin was more common(52 cases,accounting for 73.2%).2.Sensitization effect of Yangyin Yiqi Granules on radiotherapy of nasopharyngeal carcinoma: The total effective rate of TCM group was higher than that of control group(p<0.05),and the difference was statistically significant.It shows that Chinese medicine can improve the short-term and long-term curative effect of nasopharyngeal carcinoma.In addition,the adverse reactions(mucosal reaction,salivary gland,leukopenia)in the TCM group were less than those in the control group(p < 0.05),and the difference was statistically significant.There was no significant difference in adverse reactions between the two groups(p > 0.05)in gastrointestinal reaction,skin reaction,leukocytosis and hemoglobin reduction.3.Radiosensitization effect of TCS on NPC cells:(1)TCS combined with radiation can inhibit the proliferation of C666-1 cells.(2)The radiosensitivity of TCS+IR group was stronger than that of IR group alone.(3)TCS could enhance radiation-induced apoptosis of C666-1 cells(p<0.05).(4)Radiotherapy alone can significantly inhibit the growth of NPC tumors in mice,and TCS combined with radiotherapy is more effective than radiotherapy alone.Conclusion: Before radiotherapy,nasopharyngeal carcinoma patients were slightly more prone to phlegm and dampness internal obstruction,while after radiotherapy,nasopharyngeal carcinoma patients were more likely to be prone to qi and Yin deficiency.Radiotherapy has a tendency to promote nasopharyngeal carcinoma patients to change into the syndrome of deficiency of both Qi and Yin.Therefore,most patients can use TCM nourishing Yin and replenishing qi to reduce complications during radiotherapy.In clinical practice,Yangyin Yiqi Granules has a significant clinical effect of radiosensitization on the treatment of nasopharyngeal carcinoma.Trichoderanthin,its active component,can enhance the radiosensitivity of nasopharyngeal carcinoma cells,which may be one of the reasons for the radiosensitization of Yangyin Yiqi Granules.