Clinical Observation And Experimental Study Of QilianFuzheng Capsule Inter-vening Inflammatory Indexes Of Non-small Cell Lung Cancer

Objective: The purpose of this study was to observe the intervention effect of Qilian Fuzheng capsule on inflammatory indexes in patients with non-small cell lung cancer(NSCLC)through clinical study,and to explore the mechanism of Qilian Fuzheng capsule in regulating the inflammatory microenvironment of lung cancer through related experimental studies,to provide theoretical and experimental support for clinical treatment of lung cancer.Methods:(1)Clinical study: In strict accordance with the inclusion criteria,80 patients with non-small cell lung cancer were selected.The patients were randomly divided into the control group and the observation group,40 cases each.The control group was given first-line chemotherapy,and the observation group was given Qilian Fuzheng capsule based on firstline chemotherapy.The changes of six inflammatory indexes of CRP,PCT,NLR,SII,ALI,and CAR in the two groups were observed before and after treatments.The curative effect was evaluated by objective remission rate,TCM lung cancer clinical symptom score,and Karnofsky performance status(KPS),and data were analyzed by SPSS 26.0 to explore the role of the Qilian Fuzheng capsule in regulating the inflammatory microenvironment of NSCLC patients.(2)Experimental study: First of all,the drug-containing serum was prepared.THP-1 cells were induced into macrophages to establish a co-culture system with A549 cells to simulate the inflammatory microenvironment.The effects of Qilian Fuzheng capsule on the co-culture system,the effects of Qilian Fuzheng capsule on the proliferation and migration of A549 cells under co-culture conditions,and the expression of TNF-α,IL-6,IL-1β m RNAs and NF-κB,IKKα,IKKβwere observed by experimental means.Results:(1)Clinical study: The levels of CRP,PCT,NLR,and CAR in the observation group were significantly lower than those in the control group after treatment(P<0.05),but there was no significant difference in the level of SII between the two groups after treatment.The level of ALI in the control group and the observation group increased after treatment,but the level in the observation group was higher than that in the control group(P<0.05).The objective remission rate was 55.00% in the control group and 62.50% in the observation group,but there was no statistical significance between the two groups(P>0.05).In terms of improving the symptom score of lung cancer in traditional Chinese medicine,the effective rate was 55.00% in the control group and 77.50% in the observation group(P<0.05).In terms of improving the KPS of patients,62.50% of the patients in the control group were improved and stable,while 80.00% of the patients in the observation group were improved and stable(P<0.01).During the study period,there were no shedding cases and no patients had adverse events due to taking the Qilian Fuzheng capsule.(2)Experimental study:Under the condition of co-culture,the morphology of A549 cells became longer and fibroblast-like.After adding the drug-containing serum of the Qilian Fuzheng capsule,A549 cells returned to epithelioid cell shape.The results of Ed U and Transwell experiments showed that the drug-containing serum of Qilian Fuzheng capsule could inhibit the proliferation and migration of A549 cells under co-culture conditions,and the inhibition of high dose was more obvious than that of low dose(P<0.05);The Real-Time PCR test showed that Qilian Fuzheng capsule could reduce the levels of TNF-α,IL-6,and IL-1β m RNA.Western blot test showed that the drug-containing serum of Qilian Fuzheng capsule down-regulated the expression of NF-κB and IKKαprotein and up-regulated the expression of IKKβ protein(P<0.05).Conclusion: The results of the clinical study show that the Qilian Fuzheng capsule can reduce the levels of CRP,PCT,NLR,SII,CAR and increase the level of ALI in patients with NSCLC.Qilian Fuzheng capsule may play an anti-lung cancer effect through anti-inflammation and has advantages in improving TCM symptom score and performance status of patients.Through the experimental study,it was found that the Qilian Fuzheng capsule could inhibit the proliferation and migration of A549 cells under simulated inflammatory conditions co-cultured with macrophages,and reduce the levels of TNF-α,IL-6,and IL-1β m RNA.Its anti-inflammatory mechanism may be related to the down-regulation of NF-κB,IKKα related proteins.