Study On Clinical Basis And The Mechanism Of Prevention And Treatment Of Gastric Cancer (Spleen Deficiency And Toxin Resistance Type) With Invigorating The Spleen And Removing Blood Stasis

Object: Through literature review and clinical research, to propose the commonsyndrome (spleen deficiency and toxin resistance type) and dialectical points of theadvanced gastric cancer, and to study its corresponding treatments. Kunshen Granule wasmade based on the treatment “invigorating the spleen and removing stasis”. Throughobserving the influence of Kunshen Granule on gastric tissue of rats with pathology,and theexpression of the P53、C-myc protein and nuclear transcription factor (NF-κB) of gastriccancer in rats, to study the mechanism of action of Kunshen Granule on prevention andtreatment of gastric cancer.Methods:1. Study on the syndrome and treatment: In this paper, retrievalling thepublished literature from2011.1to1979.9and506cases of advanced gastric cancer werestatistically analyzed to find the common syndromes of advanced gastric cancer. Furtheranalysis the case information of spleen deficiency and toxin resistance type to find out theclinical dialectical main points and the correlation with clinical indexes. Meta-analysis ofspleen and nourishing the stomach and activating blood detoxification method treatmentsfor advanced gastric cancer,to study its clinical curative effects.2. Experimental Study:Wistar rats were separated into five groups at random, normal group, model group,Shenlian capsule group, Kunshen high dose group and Kunshen low dose group.Except thenormal group,all groups used the comprehensive method “MNNG+ethanol+sodiumchloride” to replicate models of gastric cancer in rats, a total of61weeks.In the fiftiethweeks,7rats were randomly selected from all groups to observe the mold development.Except the normal group, rats in other groups were treated with drug. Drug intervention after sixty-first weeks, all rats specimens from gastric biopsy. Firstly, morphologicalobservation of gastric mucosa pathological changes of rats in each group, then detecte theexpression of P53protein, C-myc protein and nuclear factor-κB p65byimmunohistochemistry in rat gastric carcinoma.Result：1. Reviewing the Literature: Common syndrome types of advanced gastriccancer are Deficiency of the spleen and stomach type,Stasis toxin resistance type,Qi andblood deficiency type,Liver stomach disharmony and Stomach yin deficiency type.Clinical Study: Common syndrome types of advanced gastric cancer are Spleen deficiencyand Toxin resistance type,Qi and blood deficiency type,Spleen dampness condensationtype,Phlegm coagulation type and Stomach yin deficiency type. Strengthening the spleenand stomach and Huoxue Jiedu are effective methods in the treatment of advanced gastriccancer. These studies show that the most common syndrome type of advanced gastriccancer is Spleen deficiency and Toxin resistance type. The dialectical points of spleendeficiency and toxin resistance type include:①primary symptom: spiritlessness、feeble、anorexia、epigastric pain、blood stasis、purplish tongue、moss thin and forceless deep pulse;②secondary symptom: abdominal distension、sallow complexion、squamous and dry skin、loose stool、white and greasy fur、thready pulse;③accompanied symptom: nausea andvomiting、astriction、melena、coating thickness、slippery pulse. The objective evaluationindex are the position and course of disease、Borrmann type、the degree of histologicaldifferentiation、TNM stage、depth of tumor invasion、CA72-4、CA19-9、CEA、Karnofskyscore and QLQ-C30score of life quality. Meta-analysis of the literature shows thatnourishing the stomach and activating blood detoxification method are effective methodsin the treatment of advanced gastric cancer.3.Experimental Study:①Pathological changesin gastric mucosa: Gastric cancer incidence of Kunshen large dose group was significantlylower than that in the model group, there was significant difference(P<0.05). Gastricmucosa atrophy and dysplasia incidences of Kunshen large dose group were lower,compared with the model group, there were significant differences(P<0.01). Gastricmucosa atrophy incidence of Kunshen low dose group was lower than that of model group,there was significant difference(P<0.05).②P53protein: The expression of P53protein innormal group was weak, model group expressed strong, there was significant differencebetween the two groups(P<0.01). Compared with the model group, Kunshen large, lowdose group and Shenlian capsule group P53protein in gastric cancer were weakly expressed, there was significant difference(P<0.01),and there was significant differencebetween Kunshen large and low dose groups(P<0.01).The expression of P53protein ofKunshen large dose group was significantly lower than the Shenlian capsulegroup(P<0.01).③C-myc protein: The expression of C-myc protein in normal group wasweak, model group expressed strong, there was significant difference between the twogroups(P<0.01). Compared with the model group, Kunshen large, low dose group andShenlian capsule group C-myc protein in gastric cancer were weakly expressed, there wassignificant difference(P<0.01),and there was significant difference between Kunshen largeand low dose groups(P<0.01). there was no significant difference between Kunshen largedose group and Shenlian capsule group(P>0.05).④NF-κB p65:The expression of NF-κBp65in normal group was weak, model group expressed strong, there was significantdifference between the two groups(P<0.01). Compared with the model group, Kunshenlarge, low dose group and Shenlian capsule group NF-κB p65in gastric cancer wereweakly expressed, there was significant difference(P<0.01),and there was significantdifference between Kunshen large and low dose groups(P<0.01).The expression of NF-κBp65of Kunshen large dose group was significantly lower than the Shenlian capsule group(P<0.05).Conclusion：1. The most common syndrome type of advanced gastric cancer isSpleen deficiency and Toxin resistance type. The dialectical points of spleen deficiencyand toxin resistance type include:①primary symptom: spiritlessness、feeble、anorexia、epigastric pain、blood stasis、purplish tongue、moss thin and forceless deep pulse;②secondary symptom: abdominal distension、sallow complexion、squamous and dry skin、loose stool、white and greasy fur、thready pulse;③accompanied symptom: nausea andvomiting、astriction、melena、coating thickness、slippery pulse. The objective evaluationindex are the position and course of disease、type、stage、depth of tumor invasion、tumormarkers、score of life quality.2. Kunshen Granule can significantly reduce the incidence ofgastric cancer induced by MNNG in rats, its mechanism is possibly through inhibitingthe expression of abnormal P53protein, C-myc protein and nuclear transcription factorNF-κ B, thereby inhibiting the proliferation of tumor cells.