| Objective:To Evaluation of the Clinical Efficacy of Modified Tongli Xiexia decoction in the Perioperative period of Colon cancer surgery.To observe the anti colonic tumor characteristics of Thunder god vine extract from human HTB-39 colon cancer cells and xenograft mice model,and to find out the mechanism of the effect of Modified Tongli Xiexia decoction and Thunder god vine extract on the anticancer treatment of patients with colon cancer.Methods:Clinical part:Using a randomized controlled method,66 patients with colon cancer undergoing elective surgery were divided into two groups,including 33 patients in the TongLiXieXia treatment group and 33 in the control group.The patients in the treatment group received conventional Oral diarrhea treatment for three days before surgery.Granules(Rhubarb 12g,Fructus Citrifolia 12g,Magnolia 12g,Tripterygium wilfordiiHook.f.1g),Oral 1g potassium chloride 500ml before surgery,no routine placement of gastric tube before surgery,oral administration continued for 3 days The granules of traditional Chinese medicine are diarrhea(whether or not the patient resumes ventilation).The patients in the control group were routinely treated with paraffin oil,metronidazole,and norfloxacin for three days before surgery.Oral cleanser was taken at 18pm before the operation and fasted after 20pm.The morning drink was forbidden and the stomach tube was preoperatively.After the patient fasted until the patient recovered anus exhaust.Both groups received conventional anti-infection and fluid support after surgery.Observe and record the patient's preoperative and postoperative comfort,the degree of intraoperative bowel cleanliness,postoperative incision infection rate,the incidence of anastomotic leakage,postoperative gastrointestinal function recovery time,postoperative drainage tube removal time;measurement before surgery and surgery After 72 hours,the patient's peripheral blood C-reactive protein(CRP),white blood cell count(WBC)and immune indicators,including immune Index(IgA,IgG,IgM)and serum cytokines(TNF-?,IL-6).At the same time,in order to verify whether modified Tongli Xiexia decoction has anti-cancer effect on colon cancer,further experimental studies were conducted.Experimental part:Thunder god vine extract prepared standard solution,kept at a constant temperature 4? environment.The inhibitory effect of Thunder god vine extract on the proliferation of human colon cancer HTB-39 cells was detected in vitro by CCK-8 assay;Apoptosis was detected by DAPI and annexin V/PI;Cell cycle was detected by flow cytometry;Bax and Bcl-2 expression level.In vivo xenograft tumor mouse models use calipers to determine tumor size weekly and calculate tumor volume according to the formula;after 4 weeks,mice are sacrificed by deep isoflurane anesthesia and organs are harvested to assess tumor growth and other studies.Results:Clinical research:The total score of symptoms in the treatment group decreased by 5.71 ± 1.94,while that in the control group decreased by 2.91 ±0.77.There was a statistically significant difference(P<0.05).The treatment group had better clinical symptoms(abdominal pain,abdominal distension)than the control group(P<0.05),but there was no difference in efficacy between the two groups(P>0.05).There was no difference in the degree of bowel cleanliness between the two groups,and there was no statistical significance(P>0.05).The incision infection rate,the incidence of anastomotic leakage,and the control group were significantly decreased in the treatment group,and the difference was statistically significant(P<0.05).The recovery time of gastrointestinal function and removal time of drainage tube in the treatment group were significantly shorter than those in the control group,and the difference was statistically significant(P<0.05).Serum WBC and CRP levels after treatment in both groups were significantly lower than before treatment,and the decline in the treatment group was significantly greater than that in the control group.There was a statistically significant difference between the two groups(P<0.05).The serum IgA,IgG,and IgM levels after treatment in both groups were significantly higher than before treatment,and the elevated levels in the treatment group were significantly higher than those in the control group.There was a statistically significant difference between the two groups(P<0.05).Experimental research:In the currentstudy we evaluated the anticancer effects of thunder god vine extract against colon cancer both in vitroand in vivo.Our results revealed that thunder god vine extract reduces the cell viability of HTB-39 colon cancer cells in a concentration dependent manner.The IC50 of T thunder god vine extract was found to be 25?g/ml against the HTB-39 colon cancer cells as compared to the IC50 of 130?g/ml against normal CRL-1459 cells.DAPI and annexinV/PI staining revealed that thunder god vine extract triggered apoptosis inHTB-39 colon cancer cells which was associated with upregulation of Baxand downregulation of Bcl-2 expression.Additionally,thunder god vine extract could also induce G2/M cell cycle arrest inHTB-39 colon cancer cells at IC 50 and the concentrations above it.thunder god vine extract was also evaluated in vivo in xenograft mice models and it was found that thunder god vine extract could reducet umorgrowth andvolumein vivoindicating its anticancerous potential.We conclude that thunder god vine extract its anticancer effects via induction of apoptosis andcell cycle arrest.We strongly believe that thunder god vine extract could prove a source of important anticancer molecules.Conclusion:In the Modified Tongli Xiexia decoction group,patients with colorectal cancer undergoing perioperative period had significant advantages of improvement in clinical symptoms,rate of disappearance of symptoms,the symptom disappearance rate,postoperative incision infection rate,anastomotic fistula incidence,postoperative gastrointestinal function recovery time,drainage tube extraction time,postoperative inflammation control,improving postoperative immunity and improving prognosis compared with control group,Modified Tongli Xiexia decoction promotes the recovery of colon cancer patients rapidly,based on the experimental results,it is inferred that the mechanism of the treatment of Modified Tongli Xiexia decoction may be the extract of thunder god vine can induce apoptosis and cell cycle stagnation,thus play the role in anti-tumor. |
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