Retrospective Clinical Study on Integrated Chinese and Western Medicine in Treatment of Limited-Stage Small Cell Lung Cancer / 中国结合医学杂志

OBJECTIVE@#To investigate the efficacy of integrated Chinese and Western medicine extending the progression-free survival (PFS) and overall survival (OS) of limited-stage small cell lung cancer (LS-SCLC) patients after the first-line chemoradiotherapy.@*METHODS@#The data of 67 LS-SCLC patients who received combined treatment of CM and Western medicine (WM) between January 2013 and May 2020 at the outpatient clinic of Guang'anmen Hospital were retrospectively analyzed. Thirty-six LS-SCLC patients who received only WM treatment was used as the WM control group. The medical data of the two groups were statistically analyzed. Survival analysis was performed using the product-limit method (Kaplan-Meier analysis). The median OS and PFS were calculated, and survival curves were compared by the Log rank test. The cumulative survival rates at 1, 2, and 5 years were estimated by the life table analysis. Stratified survival analysis was performed between patients with different CM administration time.@*RESULTS@#The median PFS in the CM and WM combination treatment group and the WM group were 19 months (95% CI: 12.357-25.643) vs. 9 months (95% CI: 5.957-12.043), HR=0.43 (95% CI: 0.27-0.69, P<0.001), respectively. The median OS in the CM and WM combination group and the WM group were 34 months (95% CI could not be calculated) vs. 18.63 months (95% CI: 16.425-20.835), HR=0.40 (95% CI: 0.24-0.66, P<0.001), respectively. Similar results were obtained in the further stratified analysis of whether the duration of CM administration exceeded 18 and 24 months (P<0.001).@*CONCLUSION@#The combination treatment of CM and WM with continuing oral administration of CM treatment after the first-line chemoradiotherapy for LS-SCLC patients produced better prognosis, lower risks of progression, and longer survival than the WM treatment alone. (Registration No. ChiCTR2200056616).

Clinical symptoms and distribution characteristics traditional Chinese medicine syndromes of pulmonary nodules / 中国中药杂志

A cross-sectional study method combined with two types of traditional Chinese medicine(TCM) syndrome differentiation methods was adopted to investigate the clinical symptoms and distribution characteristics of TCM syndromes in patients with pulmonary nodules from the perspectives of number, size, nature, and stability of pulmonary nodules by using the χ~2 test, systematic clustering and Apriori algorithm correlation analysis. The common clinical symptoms of pulmonary nodules were fatigue(77.35%) and irritability(75.40%), and 40 symptoms were clustered into 3 groups(digestive system symptoms, respiratory system symptoms, and emotional and systemic symptoms) and 8 major symptom categories. The proportion of cold and heat in complexity syndrome(63.43%) was higher based on cold-heat syndrome differentiation. The top two syndromes were Qi deficiency syndrome(88.03%) and Qi depression syndrome(83.17%) based on disease syndrome differentiation. Yang deficiency syndrome(60.52%) was more than Yin deficiency syndrome(50.16%). There were higher proportions of phlegm syndrome(78.67%) and Yang deficiency syndrome(69.33%) of so-litary pulmonary nodules in terms of the number of pulmonary nodules. In terms of size, the proportion of phlegm syndrome decreased as the mean diameter of pulmonary nodules increased, while the proportions of Yang deficiency syndrome and blood stasis syndrome increased. The distribution of Qi depression syndrome was more in those with mean diameter<10 mm(85.02%, P=0.044) and cold syndrome was more in those with mean diameter ≥10 mm(16.67%, P=0.024). In terms of the nature of pulmonary nodules, the proportions of Qi depression syndrome and heat syndrome decreased with the increase in solid components of pulmonary nodules, while the proportions of Yin deficiency syndrome and cold and heat in complexity syndrome increased. The blood stasis syndrome accounted for a higher proportion of pulmonary nodules with solid components. In terms of the stability of pulmonary nodules, dampness syndrome(72.97%), blood stasis syndrome(37.84%), and cold and heat in complexity syndrome(70.27%) accounted for higher proportions. In addition, patients with new nodules presented higher proportions in Qi inversion syndrome(52.00%, P=0.007) and cold and heat in complexity syndrome(66.00%, P=0.008). Meanwhile, 11 syndromes were associated and 4 common compound syndromes were obtained(Qi deficiency and depression syndrome, Qi depression and phlegm coagulation syndrome, Qi deficiency and phlegm coagulation syndrome, and Qi deficiency and dampness obstruction syndrome). Qi deficiency syndrome and Qi depression syndrome could be associated with other syndromes. The results show that the main clinical symptoms of pulmonary nodules are fatigue and irritability. The main TCM syndromes of pulmonary nodules are Qi deficiency syndrome, Qi depression syndrome, Yang deficiency syndrome, and cold and heat in complexity syndrome. The distribution of TCM syndromes is significantly correlated with the size of pulmonary nodules and the presence or absence of new nodules. The common compound syndromes are Qi deficiency and depression syndrome, Qi depression and phlegm coagulation syndrome, Qi deficiency and phlegm coagulation syndrome, and Qi deficiency and dampness obstruction syndrome.

Research of Feiliuping Gao and its combination with different types of drugs intervention on expression of PI3K/AKT/NF-κB in lung metastatic microenvironment / 中国中药杂志

The aim of this paper was to observe the effect of Feiliuping Gao and its combination with different types of drugs intervention on the expression of PI3K/AKT/NF-κB in lung metastatic microenvironment, and to reveal the advantage of Chinese medicine intervention time on the key molecule in lung metastatic microenvironment. The mouse model of Lewis lung carcinoma was established, and lung tissues were collected at 14 days, 21 days and 28 days after the intervention of Feiliuping Gao, and the expressions of PI3K, AKT and NF-κB were detected by immunohistochemistry and Western blot. At 14 days, there was no significant difference in PI3K expression between each group and the control group. The expression of AKT protein was significantly inhibited in the celecoxib (CLB) group, the Feiliuping Gao (FLP) combination with cyclophosphamide (FLP+CTX) group, and the Feiliuping Gao combination with celecoxib (FLP+CLB) group (<0.05). The inhibition of AKT protein expression in FLP+CLB group was superior. The FLP+CLB group can inhibit the expression of NF-κB protein (<0.05). At 21 days, compared with the control group, the expression of PI3K was inhibited in FLP group and the FLP+CTX group (<0.05), while the expression of PI3K was best inhibited in the FLP+CLB group (<0.001). Only the FLP+CLB group could significantly inhibit the expression of AKT protein (<0.01). The FLP+CTX group had the best effect in inhibiting the expression of NF-κB protein (<0.001). At 28 days, compared with the control group, the expression of PI3K and AKT was inhibited in the FLP+CLB group (<0.001). Feiliuping ointment combination with celecoxib has an advantage in regulating the expression of PI3K/AKT/NF-κB molecules in lung metastatic microenvironment.

Adjuvant effects of fermented red ginseng extract on advanced non-small cell lung cancer patients treated with chemotherapy / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the adjuvant therapeutic effects of fermented red ginseng (FRG) extract on non-small cell lung cancer (NSCLC) patients treated with chemotherapy.</p><p><b>METHODS</b>A total of 60 patients with advanced NSCLC were divided into two groups using a random number table, i.e., the gemcitabine plus cisplatin (GP) chemotherapy alone group (26 patients) and the FRG + GP chemotherapy group (34 patients), for 60-day treatment. Patients were then assessed according to the Fatigue Symptom Inventory, Chinese medicine symptoms score, Self-Rating Anxiety Scale, Self-Rating Depression Scale, Karnofsky Performance Status Scale, and Functional Assessment of Cancer Therapy-Lung. In addition, chemotherapy toxicity and tumor biomarkers were measured.</p><p><b>RESULTS</b>For NSCLC patients after chemotherapy, FRG extract significantly improved the FSI score, CM symptoms score, psychological status, physical conditions, and quality of life and reduced chemotherapy toxicity, but the expression levels of carcinoembryonic antigen, cytokeratin-19 fragments, and neuron-specific enolase were not significantly different between the chemotherapy alone and the FRG + chemotherapy groups or between pre- and post-treatments.</p><p><b>CONCLUSIONS</b>This study demonstrated that FRG extract had an adjuvant effect on advanced NSCLC patients treated with chemotherapy. Further studies with a larger sample size will verify the current findings.</p>

Comprehensive treatment with Chinese medicine in patients with advanced non-small cell lung cancer: A multicenter, prospective, cohort study / 中国结合医学杂志

<p><b>OBJECTIVE</b>To determine whether additional Chinese medicine (CM) could prolong survival and improve the quality of life (QOL) in patients with advanced non-small cell lung cancer (NSCLC) compared with Western medicine (WM) alone.</p><p><b>METHODS</b>This was a multicenter, prospective cohort study. A total of 474 hospitalized patients with stage III-IV NSCLC were recruited and divided into 2 groups. Patients in the WM group received radiotherapy, chemotherapy, and optimal supportive therapy according to the National Comprehensive Cancer Network (NCCN) guidelines. In the integrative medicine (IM) group, individualized CM (Chinese patent medicines and injections) and WM were administered. The primary end point was overall survival, and the secondary end points were time to disease progression, adverse events, and QOL. Follow-up clinical examinations and chest radiography were performed every 2 months.</p><p><b>RESULTS</b>The median survival was 16.60 months in the IM group and 13.13 months in the WM group (P<0.01). The incidences of loss of appetite, nausea, and vomiting in the IM group were significantly lower than those in the WM group (P<0.05). The QOL based on Functional Assessment of Cancer Therapy-Lung in the IM group was markedly higher than that in the WM group at the fourth course (P<0.05).</p><p><b>CONCLUSIONS</b>Additional CM may prolong survival and improve the QOL patients with NSCLC. The adverse effects of radio- and chemotherapy may be attenuated as CM is used in combination with conventional treatments.</p>

Discussion of tumor treatment from the theory of ascending and descending activities of qi / 中国中西医结合杂志

The theory of ascending and descending activities of qi is one basic theory that guides diagnosis and treatment of disease clinically. It has been esteemed by ancient physicians throughout their academic thinking and clinical diagnosis. As a kind of unbalanced disease in the whole body, the basic internal mechanism of tumor formation may be caused by unbalanced ascending and descending activities of qi. Better clinical efficacy is liable to get by applying the theory of ascending and descending activities of qi in cancer treatment. Therefore, we hope to provide a reference for clinicians from the following aspects: historical status and academic value of the theory of ascending and descending activities of qi, case examples and classical prescriptions.

Study on percutaneous absorption of xiaozheng zhitong cataplasm / 中国中药杂志

<p><b>OBJECTIVE</b>To study the transdermal behavior of Xiaozheng Zhitong cataplasm in rats.</p><p><b>METHOD</b>With tetrahydropalmatine as the index, the Franz diffusion cell method was adopted for the experiment. Sample content was determined with HPLC.</p><p><b>RESULT</b>The transdermal permeability and the transmission rate of tetrahydropalmatine accumulated for 24 h were 20.20% and 0.744 1 microg x cm(-2) x h(-1), respectively.</p><p><b>CONCLUSION</b>The transdermal behaviors of Xiaozheng Zhitong cataplasm were ideal in conformity with the zero order kinetic model.</p>

Safety evaluation of Chinese medicine on tumor therapy / 中国中药杂志

As a characteristic tumor therapy in China, Chinese medicine (CM) plays an important position in comprehensive treatment of tumor. It's a critical issue of objective realization, analysis and evaluation of CM safety for scientific decision-making in tumor safe medication and it also is a pivotal issue which affects the international communication. The safety evaluation of CM includes three phases: pre-clinical safety evaluation, clinical trials (micro-dose studies and traditional clinical trials) and post-marketing CM safety assessment. The key point of evaluation should be distinguished among different stages and various types of CM (such as classic formulas, Chinese herbal extracts, etc). Emphasis should be given to chronic toxicity when evaluating oral Chinese herbal , microdose studies and quality control must be underlined while injection is evaluated and more attention should be pay to the dose-effect relationship and time-effect relationship when turned to toxic Chinese medicine , and so as for the toxicity grading study. Moreover, we should constantly improve CM safety assessment method in various stages of tumor treatment, such as introducing the concept of syndrome classification theory, bringing in metabonomics and real-world research method which are similar to the CM therapeutic concept. Most importantly, we must keep its own feature of CM theory when we learn the concept of safety evaluation from abroad. Actively exploring the anti-tumor medicine safety evaluation methods and strategies is of great significance for clinical and experimental research, and it can provide supportability platform to CM's international communication.

Effect of feiliuping ointment and its disassembled prescriptions on dendritic cell of mice with transplanted Lewis lung cancer / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the possible immuno-regulating mechanism of action of Chinese drugs in different combinations (assembled depending different therapeutic principles) through observing the effects of Feiliuping ointment (FLP) and its disassembled prescriptions on dendritic cells (DC) in blood, spleen and tumor in mice with transplanted Lewis lung cancer (LLC).</p><p><b>METHODS</b>Percentages of DC in blood, spleen and tumor of mice with transplanted LLC treated by FLP and its disassembled prescriptions were estimated, and the S-100 protein expression in tumor tissue was detected by immunohistochemical method.</p><p><b>RESULTS</b>The percentage of DC (per thousand) in tumor bearing mice was 0.43 +/- 0.26 in peripheral blood, and 0.32 +/- 0.16 in spleen, significantly lower than those in normal mice 4.68 +/- 0.90 and 3.68 +/- 1.58, P<0.01); and S-100 protein expression in tumor was weakened. After FLP treatment, the percentages of DC (per thousand) in tumor bearing mice were increased to 2.55 +/- 0.29 in peripheral blood and 2.70 +/- 0.63 in spleen (P<0.01), with the S-100 protein expression in tumor tissue up-regulated significantly (P<0.01). Study on different assembled prescriptions of FLP showed that the qi supplementing components of FLP displayed the optimal actions.</p><p><b>CONCLUSION</b>FLP, a Chinese herbal prescription made depending on Chinese medicine therapeutic principle of strengthening body resistance and consolidating constitution, has an obvious anti-tumor effect, to improve the immunological anti-tumor function of organism by promoting the amount and expression of DC might be the possible intrinsic mechanism.</p>

Alleviation of cancerous pain by external compress with Xiaozheng Zhitong Paste / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the clinical effectiveness of a topical application of Xiaozheng Zhitong: Paste (, XZP) in alleviating the cancerous pain of patients with middle/late stage cancer</p><p><b>METHODS</b>By: adopting a random number table, 124 patients enrolled were randomized into the treatment group (64 patients) and the control group (60 patients). In addition to the basic therapy [including the three-ladder (3L) analgesia] used in both groups, topical application of XZP was given to patients in the treatment group for pain alleviation. The analgesic efficacy was recorded in terms of pain intensity, analgesia initiating time and sustaining time, and the optimal analgesic effect revealing time. Meanwhile, the quality of life (QOL) and adverse reactions that occurred in patients were recorded as well.</p><p><b>RESULTS</b>The total effective rate in the treatment group was: 84.38% (54/64), and in the control group it was 88.33% (53/60), showing no significant difference between them (P>0.05), but the analgesia initiating time and the optimal analgesia effect revealing time in the treatment group were significantly shorter (both P<0.01). Moreover, XZP was better in improving patients' QOL, showing more significant improvements in the treatment group than those in the control group in aspects of mental condition, walking capacity, working capacity, social acceptability, sleep and joy of living (P<0.05 or P<0.01). Lower incidence of adverse reactions, such as nausea, vomiting, mouth dryness, dizziness, etc., especially constipation, was noted in the treatment group (P<0.05 or P<0.01).</p><p><b>CONCLUSION</b>Applying an external compress: of XZP showed a synergistic action with 3L analgesia for shortening the initiating time and the optimal effect revealing time, and could evidently enhance patients' QOL with fewer adverse reactions.</p>

Clinical randomized controlled study on acupuncture for treatment of peripheral neuropathy induced by chemotherapeutic drugs / 中国针灸

<p><b>OBJECTIVE</b>To seek the effective treatment for peripheral neuropathy induced by chemotherapeutic drugs.</p><p><b>METHODS</b>Sixty-four cases of peripheral neuropathy induced by Paclitaxel or Oxaliplatin were randomly divided into an acupuncture group and a medication group, 32 cases in each group. The acupuncture group was treated with therapeutic principle of dredging meridians and collaterals, tonifying qi and eliminating blood stasis, supplementing liver and kidney, nourishing blood and tendon. Hegu (LI 4), Taichong (LR 3), Zusanli (ST 36), Qihai (CV 6) and Quchi (LI 11) etc. were selected. The medication group was treated with intramuscular injection of Cobamamide. The neurotoxicity of two groups was compared with questionnaire of peripheral neuropathy induced by chemotherapeutic drugs before and after treatment.</p><p><b>RESULTS</b>The total effective rate for sensory nerve disorder of acupuncture group was 66.7% (20/30), which was superior to that of 40.0% (12/30) in medication group (P < 0.05).</p><p><b>CONCLUSION</b>Acupuncture is more effective than Cobamamide for treatment of peripheral neuropathy induced by chemotherapeutic drugs, especially for moderate and severe sensory nerve disorder induced by paclitaxel.</p>

Effect of traditional Chinese medicine on quality of life and survival period in patients with progressive gastric cancer / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effect of traditional Chinese medicine (TCM) on quality of life (QOF) and survival period in patients with progressive gastric cancer, and thus exploring its clinical efficacy.</p><p><b>METHODS</b>TCM therapy applied in the 34 patients assigned in the TCM group (Group I ) included intravenous injection of Cinobufotalin, beta-elemene, or orally taking of anti-cancer Chinese herbs. The same TCM was also applied in the 36 of the combined treatment group (Group II), but in combined use of FOLFOX chemotherapeutic protocol. Twenty-one days was taken as one cycle and all the patients received 2 cycles of treatment.</p><p><b>RESULTS</b>The median survival period in group II was 31 months, while it was 30 months in group I; the 1-, 2-, 3-year survival rates in group II were 88.89%, 84.38% and 59.26%, and those in the group I were 82.35%, 71.43% and 65.00%, respectively with insignificant difference between the two groups (chi2 = 0.298, P > 0.05); QOF in group I was significantly superior to that in group II (P < 0.05), and the adverse reaction occurrence was significantly less in Group I than that in group II.</p><p><b>CONCLUSION</b>Chinese medicine treatment can improve the QOF and prolong the survival period of patients with progressive gastric cancer with few side effects.</p>

Progress on the treatment of chemotherapy-induced peripheral neuropathy by Chinese and Western medicine / 中国中西医结合杂志

Among all the adverse reactions of anti-tumor drugs, the incidence of chemotherapy-induced peripheral neuropathy elevated gradually in recent years, but no trustworthy treatment by Chinese and Western medicine for it has been found so far. The related clinical and experimental reports published in the latest 10 years were reviewed in this paper.

Clinical observation on the efficacy of Xiaoshui decoction combined with intrapleural perfusion of cisplatin in treating malignant pleural effusion / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the clinical efficacy of Xiaoshui decoction (XSD) combined with intrapleural perfusion of cisplatin in the treatment of malignant pleural effusion.</p><p><b>METHODS</b>Fifty-one patients with malignant pleural effusion were randomly assigned to two groups. The treated group (26 patients) received oral administration of XSD combined with intrapleural perfusion of cisplatin, and the control group (25 patients) was only treated with intrapleural perfusion of cisplatin. The effects of the short-term efficacy, quality of life scores and clinical symptom scores of malignant pleural effusion were evaluated.</p><p><b>RESULTS</b>The short-term efficacy in the treated group and the control group was 72.0% and 58.3%, respectively, and no significant difference was found (P>0.05). In contrast, the quality of life in the treated group was significantly improved compared to that of the control group (P<0.05), and so was the symptom remission (P<0.05).</p><p><b>CONCLUSIONS</b>The combined therapy of XSD and intrapleural perfusion of cisplatin did not show obvious improvement in short-term efficacy, but the therapy remarkably alleviated the symptoms and improved the quality of life of patients.</p>