A Real-World Study Of Professor Xie Jingri’s Experience In Using Harmonic Method To Treat Gastric Cancer

Objective: Combining the inheritance of Traditional Chinese Medicine with real-world big data research,we will analyze the Traditional Chinese Medicine from three aspects:meta-analysis,case analysis and network pharmacology analysis,to provide strong literature support and scientific evidence support for Professor Xie Jingri in treating gastric cancer by Harmonic method,this kind of big data research based on the real world can analyze and summarize professor Xie Jingri’s thought pattern and connotation of treating gastric cancer by Harmonic method from many angles and layers,it will provide a better reference for the clinical treatment of gastric cancer with Traditional Chinese Medicine.Methods: 1.Meta-analysis: To search and collect relevant literature on the clinical Randomized Controlled Trial of gastric cancer treated with combination therapy of Harmonic method from multiple Chinese and English databases of the whole network,from libraries self-built until December 31,2022.After multiple screening according to inclusion and exclusion criteria,the quality of the included literature was evaluated using Revman5.40 software,the original data of clinical curative effect,TCM syndrome score,Karnofsky,Quality of life qol,tumor marker content,immune index and adverse reaction were analyzed.2.Medical record analysis: Collected professor Xie Jingri’s medical records of gastric cancer treated in outpatient department from September 2012 to September 2022.After extracting and cleaning the medical record data,uploaded the data to the Traditional Chinese Medicine Inheritance Computing Software V3.0,with the help of statistical analysis,prescription analysis,symptom analysis and tongue and pulse analysis,this paper summarized and analyzed the characteristics of Professor Xie Jingri’s treatment of gastric cancer before and after operation.After the integration to extract the core prescription.3.Network pharmacological analysis: Searching and collecting the active ingredients of the core prescriptions in TCMSP,TCMIP and BATMAN databases,and supplementing them with the help of manual searching.Gastric cancer-related targets were searched and collected in Gene Cards,OMIM,and Dis Ge NET databases,drugs were crossed with disease targets,and the integrated “TCM-compound-target genes” network was plotted with Cytoscape 3.9.1,then the network topology is carried out by using the STRING platform software,and the GO and KEGG analysis is carried out by using David Database and R language.Results: 1.19 articles were included in the Meta-analysis,with a total sample size of1073 cases(535 in the control group and 538 in the trial group),the results were as follows:1)Objective response rate and control rate of gastric cancer treated with chemotherapy combined with Harmonic method were better than those treated with chemotherapy alone(Objective Response Rate: RR=1.42[1.22,1.66],P<0.05;Diseasee Control Rate: RR=1.14[1.07,1.22],P<0.05).2)Compared with chemotherapy alone,TCM syndrome score and clinical symptoms were reduced,and TCM therapeutic effect was more significant(TCM syndrome score MD=-4.24[-5.57,-2.90],P<0.05;TCM therapeutic effect: RR=1.73[1.52,1.98],P<0.05).3)The improvement of Karnofsky was better than that of chemotherapy alone,but the improvement of Quality of life qol was not obvious(Karnofsky:MD=8.54[4.71,12.36],P<0.05;Quality of life qol: MD=2.17[-1.94,6.27],P=0.3).4)The reduction of tumor markers CEA and CA199 was better than that of chemotherapy alone(CEA:MD=-2.42[-3.07,-1.78],P<0.05;CA199: MD=-4.23[-6.45,-2.00],P<0.05).5)Compared with chemotherapy alone,chemotherapy combined with TCM combined with Harmonic method could regulate the body’s immune function and reduce the occurrence of adverse reactions(CD4+:MD=7.13[5.49,8.78],P<0.05;CD4+/CD8+:MD=0.45[0.36,0.54],P<0.05;leucopenia: RR=0.64[0.54,0.75],P<0.05;thrombocytopenia RR=0.69[0.55,0.87],P<0.05;gastrointestinal symptoms: RR=0.54[0.46,0.64],P<0.05;neurotoxicity: RR=0.66[0.52,0.83],P<0.05)2.There were 224 cases of gastric cancer,105 cases before operation and 119 cases after operation.In preoperative cases of gastric cancer,57 cases(54%)were male and 48cases(46%)were female.91% of the patients were over 50 years old.119 Chinese herbs were used for 2115 times.Most of them were bitter,pungent and sweet,the main effects of medicine are regulating qi,tonifying deficiency and digestion.The most frequently used medicines were Bupleurum chinense DC,atractylodes macrocephala,scutellaria barbata,Hedyotis diffusa root,Shenqu,hyacinth worm,green bark,chicken inner gold,scorched hawthorn,and astragalus membranaceus.After analysis,70 patterns of medication and 39 association rules(support 50,confidence 0.9)were obtained.In postoperative cases of gastric cancer,87 cases(73%)were male,32 cases(27%)were female,and 82% were over50 years old,involving 117 Chinese medicine,the total frequency of use 2398 times,to bitter,sweet,pungent drugs used mostly,drug efficacy to fill deficiency,regulating qi and digestion based.The top ten drugs used were: Atractylodes macrocephala,Bupleurum root,shenqu,tangerine peel,chicken inner gold,hawthorn,astragalus root,radix pseudostellariae,Pinus kom,incense tree.After analysis,45 medication patterns and 79 association rules were obtained(support 70,confidence 0.9).Taking the repeated taste of high-frequency drugs before and after operation for gastric cancer,combined with the characteristics of gastric cancer and the results of communication with Professor Xie Jingri,finally,the core prescriptions are bupleurum root,atractylodes macrocephala,scutellaria barbata,Hedyotis diffusa root,Shenqu,hawthorn,orange peel,chicken inner gold,astragalus and hyacinth.3.The results of network pharmacology showed that there were 447 related active components and 187 active targets in the core prescription,4555 disease targets,118 crosstargets,and 118 cross-targets in the core prescription,the core targets of EGFR,PTGS2,SRC,ESR1,Akt1,AR,CYP19A1,PPARG and MMP9 were obtained by screening.The signal pathways of PI3K-Akt,PPAR,VEGF,MAPK and IL-17 were obtained by KEGG analysis.Conclusion: 1.The treatment of gastric cancer with the Harmonic method combined with chemotherapy has a better clinical effect than that of chemotherapy alone.It can improve clinical symptoms and Karnofsky with gastric cancer,decrease the content of tumor markers in serum,and regulate the immunity of the body,reduce the side effects of chemotherapy,such as bone marrow suppression,adverse reactions of digestive tract and neurotoxicity.2.Professor Xie Jingri paid attention to smooth qi,regulate liver and spleen and harmonize qi and blood,useing Harmonic method to replace excessive benefit.3.The anticancer mechanism of the core prescription may be achieved through the targeted regulation of proteins,by active ingredients such as flavonoids,sitosterol,stigmasterol and caffeic acid in the drug,thereby affecting the information transmission of signal pathways such as PI3K-Akt,PPAR,VEGF,MAPK and IL-17.