| Objective:Based on the basic experimental study of Fugu Zhuyu granules combined with radiotherapy,this study explores the radiosensitizing effect of Fugu Zhuyu granules.Through the clinical study of Fugu Zhuyu granule combined with radiotherapy in the treatment of bone metastasis of lung cancer,to verify whether it has radiosensitization effect and whether it can change the changes of CHI3L1 index.Methods:1.Experimental study: A lung cancer bone metastasis model was established and 32 nude mice were randomly divided into 4 groups.Control group: normal saline was given intragastric administration,0.2ml/ piece,once a day,for 28 days;Traditional Chinese medicine group: Fugu Zhuyu granule(0.43g/m L)was given by gavage,and the frequency was the same as that of model group.Radiotherapy group:The nude mice were anesthetized and fixed on the wooden board.The 6Me V electron line of medical linear accelerator was used to irradiate the tumor site of the right lower limb.The irradiation field was 1*1cm2,the source skin distance was 100 cm,the dose rate was 400mu/min,and the other parts were shielded by lead blocks.The patients were treated for 2 weeks with a total dose of 6Gy.In the Chinese medicine+ radiotherapy group,the same treatment was given to the Chinese medicine group by gavage,and the same treatment was given to the radiotherapy group.The weight change of nude mice was recorded at the beginning of treatment and 28 days after continuous intervention.The tumor weight index,tumor inhibition rate,tumor growth delay time(TGD)and sensitivity enhancement coefficient(EF)were calculated.2.Clinical research: selecting 70 patients included in the standard,were randomly divided into control group and observation group.Control group using lung cancer bone metastases and local radiotherapy treatment(40 gy total dose,2 gy/times,five times a week)+ azole to phosphoric acid injection(4 mg,iv > 15 min,4weeks/times),the observation group based in oral Chinese medicine in the control group after bone by stasis granule(1,2 times/d/bag,continuous treatment of 30 d).The changes of pain score,TCM clinical syndrome,Karnofsky score,serological CHI3L1 index and adverse reactions were observed.Results:1.Experimental study: The nude mice developed a mass in the tibial region of the right lower limb on day 14,and osteolytic bone metastasis was identified by X-ray.General situation: the nude mice in the control group were in the worst condition,and the radiation group,the Chinese medicine group,and the radiation + Chinese medicine group were in the best condition.Tumor: the tumor growth rate of the control group was the fastest,and that of the traditional Chinese medicine + radiotherapy group was the slowest.Tumor weight index: compared with the control group,the other groups were lower,and there were differences among them(P < 0.05).The inhibition rate of tumor in the traditional Chinese medicine +radiotherapy group was the best.TGD: except for the control group,the tumor growth was delayed,and the Chinese medicine + radiotherapy group had the best delayed effect(P < 0.05).EF: Chinese medicine +radiotherapy group > 1,suggesting that Fugu Zhuyu granule may have radiosensitizing effect.2.Clinical research: into the group a total of 70 cases of patients,treatment of fall off in 7 cases,5 cases take other traditional Chinese medicine(TCM)during treatment,2 cases did not complete the entire monitoring.63 patients were completed,including32 in the observation group and 31 in the control group.There was no difference in the general situation(age,gender,pathological type)between the two groups,and there was no statistical difference in the efficacy indicators(NRS,TCM syndrome and KPS score,serological CHI3L1 index)before treatment(P > 0.05),indicating that the basic situation of the two groups of patients before treatment was similar and comparable.Results After treatment,NRS pain score: the scores of the two groups were lower than those before treatment,and there were statistically significant differences before and after treatment(P < 0.05);No significant difference was found between the two groups after treatment.The TCM syndrome scores of the two groups decreased after treatment,and the observation group was significantly lower than the control group,and the difference was statistically significant(P < 0.05).The KPS scores of the two groups after treatment were higher than those before treatment,and the KPS score of the observation group was higher than that of the control group,the difference was statistically significant(P <0.05).Serum CHI3L1 index: the levels of the two groups after treatment were significantly higher than those before treatment(P <0.05),and the level of the observation group was significantly lower than that of the control group,with statistical differences(P <0.05).Adverse reactions: the incidence of radiation pneumonitis,dermatitis,blood toxicity and other adverse reactions after radiotherapy in the observation group was significantly lower than that in the control group,the difference was statistically significant(P < 0.05).In addition,except for 1 case of grade ⅣWBC reduction in the control group,no grade Ⅳ adverse reactions occurred,and no treatment-related death occurred in the two groups.There was no abnormality of ALT,AST and creatinine in the two groups.Conclusions:1.The bone metastasis model of lung cancer was successfully established,and Fugu Zhuyu granule administration effectively slowed down the tumor growth,and its combination with radiotherapy significantly inhibited the tumor growth in nude mice,and it may have a good radiotherapy sensitization effect.2.Fugu Zhuyu granule enhanced the therapeutic effect of radiotherapy on bone metastasis of lung cancer,relieved pain,improved TCM clinical syndromes and physical status,and reduced the incidence of adverse reactions.At the same time,it was found that the serum CHI3L1 protein level was higher in patients with bone metastasis,and with the increase of time,the increase was lower in patients taking traditional Chinese medicine.This indicates that CHI3L1 has a predictive sensitivity for the development of bone metastasis in lung cancer,and Fugu Zhuyu Granule may reduce CHI3L1 levels. |
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