| Objective Through theoretical research,the etiology and pathogenesis of lung cancer and the treatment of syndrome differentiation are summarized,and the status of radiotherapy for lung cancer is summarized.Through the clinical study of Modified Baihegujin decoction combined with radiotherapy,we evaluated the radiosensitization effect of it.To investigate the therapeutic effect of Modified Baihegujin decoction combined with radiotherapy on treatment of Lewis lung cancer models in nude mice.Methods By looking up ancient books,we summarized the TCM name,etiology and pathogenesis and syndrome differentiation of lung cancer,and summarized the radiotherapy technology and side effects of lung cancer through reading literatures.Refer to"guidelines for clinical research on new drugs in treating bronchopulmonary carcinoma",formulate diagnostic criteria for lung cancer.60 patients with stage III B-IV non-small cell lung cancer were randomly divided into radiotherapy group(control group)and Modified Baihegujin Decoction plus radiotherapy group(treatment group).The control group was treated with three dimensional conformal radiotherapy or intensity modulated radiation therapy.The treatment group:in addition to the same external radiation therapy,since the date of radiotherapy combined with Modified Baihegujin Decoction,one package at a time,twice a day.It continued until the end of the radiotherapy.To observe the change of TCM syndrome,the change of karnofsky performance status,the effect of solid tumor,the change of immune index and the occurrence of adverse reaction.We established the Lewis lung cancer models in nude mice,then randomly divided into control group,radiotherapy group,Modified Baihegujin decoction group(Chinese medicine group),Modified Baihegujin decoction+radiotherapy group(Chinese medicine+radiotherapy group),and cisplatin+radiotherapy group,whit 8nude mice of each group.Nude mice of radiotherapy group were irradiated with 6MeV electronic wire of medical linear accelerator.Nude mice of Chinese medicine group were given by gavage with 0.2mL Modified Baihegujin decoction.Nude mice of Chinese medicine+radiotherapy group were given by gavage with 0.2 mL Modified Baihegujin decoction,at the same time for being irradiated with 6MeV electronic wire.Nude mice of cisplatin+radiotherapy group were injected with 0.2 mL cisplatin by intraperitoneal injection,at the same time for being irradiated with 6MeV electronic wire irradiation.15 days after continuous intervention,the nude mice were killed and the subcutaneous tumor of the armpit was completely stripped,Weigh the weight of the tumor,count the tumor weight index,tumor suppressor rate,tumor growth delay time(TGD)and sensitization coefficient(EF).Detection of cell apoptosis in each group of transplanted tumors by TUNEL method.The expression of HIF-1α,P53 and Survivin mRNA in tumor tissues of nude mice was detected by qRT-PCR.The expression of HIF-1α,P53and survivin protein in tumor tissues of nude mice was detected by Western blot method.Results Theoretical research:diet,overwork,emotional injuries lead to deficiency of vital Qi,imbalance of Yin and Yang is the fundamental of lung cancer.Evil invasion,leading to pulmonary function abnormalities,body fluid can not normally distributed,phlegm and blood stasis,endogenous cancer toxin is an important condition for the occurrence of lung cancer.Lung cancer is a disease in which the whole body is weak and local is strong.Radiotherapy techniques for lung cancer include stereotactic radiotherapy,three-dimensional conformal radiation therapy,intensity modulated radiation therapy,and imaging guided radiation therapy.Clinical research:60 patients were diagnosed by pathological examination,age 31-75 years,median age was 58.9 years;33 males,27 females;including 26 cases of adenocarcinoma,31 cases of squamous cell carcinoma,other 3 cases;before the treatment,38cases with stage III_B,22 cases with stage IV;karnofsky performance status(KPS):19 cases≥90 points,34 in 80-89,and 7 in 70-79;all patients had no serious heart,liver and kidney dysfunction,the expected survival time more than 3 months.In the control group,2cases were exfoliated.The total effective rate of TCM syndrome score in the control group was 42.86%,the effective rate in the treatment group was 70.0%,and the difference between the two groups was significantly different(P<0.05).Cough,chest tightness,fatigue,dry mouth and throat,sweating and other symptoms improved significantly.The effective rate of the control group was slightly lower than that of the treatment group,but the difference was not statistically significant(P>0.05).The control rate in the treatment group was higher than that in the control group,but the difference was not statistically significant(P>0.05).After treatment,there was no significant difference in the ratio of CD8+between the treatment group and the control group(P>0.05).The CD3+,CD4+,CD4+/CD8+and NK cell values in the treatment group were significantly higher than those in the control group,with a statistically significant difference(P<0.05).There was no serious adverse reaction in the two groups after treatment.Experimental research:the fastest tumor growth rate was the control group,the slowest tumor growth rate was cisplatin+radiotherapy group.The tumor growth rate of the Chinese medicine+radiotherapy group was close to that of the cisplatin+radiotherapy group,and was slower than that of the Chinese medicine group and radiotherapy group(P<0.05).The tumor weight index of each experimental group was lower than that of the control group(P<0.05),and the tumor inhibition rate of each experimental group was higher than that of the control group(P<0.05),and the tumor weight index of the Chinese medicine+radiotherapy group was lower than that of the Chinese medicine group and radiotherapy group(P<0.05),and the tumor inhibition rate of the Chinese medicine+radiotherapy group was higher than that of the Chinese medicine group and radiotherapy group(P<0.05).The growth rate of transplanted tumor in nude mice was delayed,and the delayed effect of Chinese medicine+radiotherapy group and cisplatin+radiotherapy group were better(P<0.05).The EF values of Chinese medicine+radiotherapy group and cisplatin+radiotherapy group were greater than 1,suggesting that Modified Baihegujin decoction and cisplatin have radiosensitizing effect.The results of TUNEL staining showed that the apoptotic rate of each experimental group was significantly higher than that of the control group,and the apoptotic rate of the Chinese medicine+radiotherapy group was significantly higher than that of the Chinese medicine group and radiotherapy group.The results of qRT-PCR and western blot showed that the expressions of HIF-1α,P53 and survivin m RNA and proteins were significantly down-regulated in the tumor tissues of each experimental group compared with that of the control group(P<0.05).Moreover,the degree of reduction was most obvious in the Chinese medicine+radiotherapy group and the cisplatin+radiotherapy group.Conclusions1.Lung cancer looks strong,actually weak,the common types are deficiency of Qi and Yin and Yin deficiency and internal heat,treatment should be reinforcing Qi and nourishing blood,nourishing Yin and clearing heat.2.Modified Baihegujing decoction has good immune enhancement effect,can enhance the therapeutic effect of radiotherapy on non-small cell lung cancer,improve the clinical syndromes of TCM in patients,improve the quality of life of patients,and no obvious side effects.3.Modified Baihegujin decoction combined with radiotherapy could significantly inhibit the growth of Lewis lung cancer transplantation tumor in mice,and promote the apoptosis of tumor cells.4.Modified Baihegujin decoction combined with radiotherapy could significantly decrease the expression of HIF-1α,P53 and Survivin mRNA and protein.5.Modified Baihegujing decoction has good radiation sensitizing effect,it is worthy of clinical application. |
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