Clinical Observation On The Treatment Of Bone Metastases With Kidney Deficiency And Blood Stasis By Combining Radiotherapy With Fuguzhuyu Granules

Objective: To observe the clinical effects of Fuguzhuyu Granules combined with the basic treatment plan of Western medicine in the treatment of bone metastases with kidney deficiency and blood stasis,as well as the effects on serum sRANKL,PTHrP,PINP,CTX-Ⅰ levels.To explore the possible mechanism of action and provide clinical theoretical basis for the conbined treatment of traditional Chinese medicine and western medicine of bone metastases with kidney deficiency and blood stasis.Methods: Eighty patients with bone metastases who attended the tumor center of Qingdao Hospital of Traditional Chinese Medicine(City Hai Ci Hospital)from June 2020 to January 2022 and met the inclusion criteria were selected and randomly divided into observation group and control group,40 patients in each group.The control group received local radiotherapy for bone metastases at a total dose of 40 Gy,2 Gy/time,5times a week,while zoledronate 4 mg was applied intravenously >15min,repeated every 3-4 weeks,applied for 1 year;the observation group was treated with Fuguzhuyu granules orally for 5 days from Monday to Friday,1 pair daily,divided into two oral doses,until the end of radiotherapy.The changes of physical strength score(KPS score),pain score(NRS score),TCM symptom score,sRANKL,PTHrP,PINP,CTX-Ⅰ and other indexes were compared between the two groups before and after treatment.Results: 4 patients were shed in the observation group and 3 patients in the control group,and a total of 73 patients were completed,including 36 patients in the observation group and 37 patients in the control group.The results of the study showed that: pain scores: the NRS scores of patients in both groups decreased after treatment compared with those before treatment,and there were statistical differences before and after treatment(P < 0.05);there was no significant difference in NRS scores between the two groups before treatment(P > 0.05),and there was also no significant difference in NRS scores between the two groups after treatment(P > 0.05).Regarding the application of analgesic drugs,there was no statistical difference in the dosage of Oxy Contin before treatment between the two groups(P>0.05),and the dosage of analgesic drugs in the observation group was lower than that in the control group after treatment,and there was a statistical difference(P<0.05).Physical condition and TCM symptom score: After treatment,the KPS scores of patients in both groups were higher than before,and the TCM symptom score was lower than before,and the difference was statistically significant(P < 0.05);there was no significant difference between the KPS scores and TCM symptom score of patients in both groups before treatment(P > 0.05).After treatment,the KPS score of the observation group was significantly higher than that of the control group,while the TCM symptom score was significantly lower than that of the control group,and the differences were statistically significant(P < 0.05).Serological indexes: The serum levels of bone metastasis-related sRANKL,PTHrP,PINP and CTX-Ⅰ were significantly lower in both groups after treatment than before treatment(P < 0.05);the levels of serum sRANKL,PTHrP,PINP and CTX-Ⅰ were not significantly different in both groups before treatment(P > 0.05),and the levels of serum sRANKL,PTHrP,PINP,CTX-Ⅰ levels in the observation group after treatment were significantly lower than those in the control group,and all of them were statistically different(P<0.05).Safety evaluation: No significant differences were found between the liver and kidney function indexes of the two groups before and after treatment(P > 0.05),and no serious adverse events were observed,suggesting that the safety of Fuguzhuyu granules is good.Conclusion: Fuguzhuyu granules combined with Western basic therapy can more effectively reduce pain in patients and improve patients’ TCM symptoms and physical condition than Western basic therapy.Combined treatment also more effectively reduce serum bone destruction-related serological indexes sRANKL,PTHrP,PINP,CTX-Ⅰ levels.It can better inhibit the bone destruction of bone metastasis with kidney deficiency and blood stasis,and have good safety.Therefore it can effectively improve the quality of life of patients with bone metastases.