Research Of Traditional Chinese Medical Therapy Of Cancer-Related Anemia

Objects:Patients with cancer-related anemia(CRA) were retrospectively analyzed, including the gender, the age, anemia degree, tumor stage, clinical characteristic, Traditional Chinese Medicine(TCM) syndromes, pattern of Chinese herbal usage and so on. Data on epidemiology, TCM syndrome and TCM treatment were explored in order to provide evidence for better management of CRA.Methods:CRA patients admitted in the wards of Jiangsu provincial hospital of TCM for the herbal treatment between September 2008 and September 2014 were retrospectively studied. Their general information(including anemic status, gender, age and tumor stage), clinical feature, TCM syndrome and TCM therapies were recorded and analyzed by SPSS 17.0 statistical software.Results:In this study, there were 1253 cases involving six types of tumor, including gastric cancer(492 cases,39.27%), lung cancer(339 cases,27.06%), colorectal cancer(236 cases), esophageal cancer(68 cases), breast cancer(61 cases) and lymphomas(57 cases), respectively. Except for breast cancer, the incidence of CRA was more with male patients(66.80%) than those with females(33.20%). Most of the patients were in their middle or elderly age and the average age was 63.06±11.40. Mild or moderate anemia was found mostly(77.81%+19.87%), and the majority was at advanced stage(73.82%). Clinical feature of CRA was diverse, including asthenia(11.68%), limbs pain(8.69%), emaciation(3.92%), poor appetite(10.31%), insomnia(5.62%) or with masses, or with cough(6.64%) and expectoration, or with abdominal distension(4.21%), nausea(4.16%), pale tongue(34.21%), thin white coating(39.69%), or with greasy coating(37.21%) and thin pulse(23.11%), ect. Evaluated in TCM, CRA was manifested as deficiency syndrome(522 cases,41.66%), intermingled deficiency and excess syndrome (498 cases,39.74%) and excess syndrome(233 cases,18.60%). Ranked by constituent ratio, main TCM syndromes of CRA were deficiency of spleen and stomach syndrome(15.96%), depletion of qi and blood syndrome(12.96%), deficiencies of qi and yin syndrome and connotation of cancerous toxin syndrome(5.11%), phlegm-damp retention syndrome(4.95%), connotation of phlegm-heat syndrome(3.43%) and qi-deficiency and blood-stasis syndrome (3.27%), and the cumulative frequency of the above syndromes was 74.46%. The herbs taken by the 1253 patients covered twenty categories of the herbal medicine and the accumulated herb usage was 23683. Ranked by frequency, they were tonic medicinal(30.31%), heat-clearing medicinal(11.13%), digestant medicinal(10.81%), dampness-draining diuretic medicinal(9.27%). qi-regulating medicinal(8.54%). phlegm-resolving. cough and dyspnea-relieving medicinal(8.39%), blood-activating and stasis-transforming medicinal(6.78%), respectively, and the cumulative frequency was 85.22%. In the 45 tonic medicinal, qi-tonifying medicinal(56.59%) was ranked first, followed by yin-tonifying medicinal(24.23%) and blood-enriching medicinal(16.41%). In the 67 heat-clearing medicinals, heat-clearing and toxicity-removing medicinal(56.43%) was on the top, followed by heat-clearing and blood-cooling medicinal(18.22%) and heat-clearing and dampness-drying medicinal(14.99%). Categorized by property and flavor, the drugs were mainly sweet(28.21%), bitter(28.02%) and hot(19.8%) in taste; warm(38.23%), neutral (29.53%) and cold(25.90%) in nature. For meridian tropism, spleen meridian(22.82%) was the most common, followed by stomach meridian(18.35%), lung meridian(16.80%), liver meridian(12.95%), heart meridian(8.84%) and kidney meridian(8.34%), respectively.Conclusions:As obviously observed, breast cancer was female dominant disease. Other than this, the gender, age, anemia degree and tumor stage of CRA patients were pretty similar among different type of cancers. Epidemiologically, CRA was found primarily in patients middle-aged, presenting with mild and moderate anemia and at advanced stage. Digestive cancer was in the majority with gastric cancer dominated. Clinical feature of CRA was closely related to tumor features, anemia degree, therapeutic intervention and therapeutic effect. Vital qi deficiency might be the pathology of CRA and deficient root with excess superficial also could be recognized as the characters of CRA. CRA located in marrow; meanwhile, it closed to spleen, stomach, heart, lung, liver and kidney. TCM syndromes of the CRA mainly are dominated by deficiency syndrome, followed by intermingled deficiency and excess syndrome. Chinese herbal medicine management of CRA was mainly tonifying medicinal, accompanied with effects of heat-clearing and toxicity-removing, phlegm resolving and blood stasis removing and phlegm softening and resolving and so on. The tonic herbs were always with sweet and hot in taste, herbs with bitter taste and cold nature provided heat-clearing and toxicity-removing effect, while, the pungent taste could resolve. Meridian tropism of the herbs turned to be spleen meridian primarily, meanwhile, closely related with lung meridian, liver meridian, heart meridian and kidney meridian.