Retrospective Analysis And Mechanism Study On The Treatment Of Advanced Gastric Cancer By Yiqijianpi,Huayujiedu Herb

The therapy of Yiqi Jianpi,Huayu Jiedu is the clinical experience of Professor Xu Hefen,a national famous doctor of traditional Chinese medicine.It achieves success in dealing with advanced gastric cancer in past years.In this study,the big data platform of the hospital HIS system was used to retrospectively analyze the clinical data,and summarize the efficacy and mechanism of Yiqi Jianpi,Huayu Jiedu Therapy for advanced gastric cancer,which provides a theory basis for the clinical application of a Chinese herbal compound of Yiqi Jianpi,Huayu Jiedu in treating gastric cancer.Patients from 2010-01 to 2019-06,who were pathologically diagnosed as advanced Gastric Cancer were involved in our study.All of them are in-patients of our hospital and their Traditional Chinese Medicine(TCM)syndrome types were Pixu Qizhi,Yudu Neizu.These patients were divided into three groups according to treatments:chemotherapy group(group A),TCM group(group B),and TCM+chemotherapy group(group C).We use some indexes to compare the TCM symptoms and the synergism and attenuation on chemotherapy.The main observation indicators are the efficacy of TCM symptoms,and the secondary ones are median progression-free survival time(mPFS),median overall survival time(mOS),disease control rate(DCR),objective response rate(ORR)and the incidence of chemotherapy responses.We also use COX regression analysis to research factors affecting OS.The frequency of commonly used herbs of Yiqi Jianpi,Huayu Jiedu were analysed by Frequencies.Weikang granules which consists of Dangshen,Atractylodes,Pinellia,Teng Ligen and Rhodiola,is a typical formula of Yiqi Jianpi,Huayu Jiedu.It has achieved good success in clinic in past few years.This study intends to use the CCK-8 staining method to determine the effect of Weikang granules on the proliferation of MFC gastric cancer cells,and to compare the reverse effect of cisplatin(DDP)on cisplatin-resistant gastric cancer cell lines MFC/DDP.Through cell experiment and animal experiment,we initially explore the anti-tumor effects and mechanisms of Weikang granules in the way of PD-1/PD-L1 system,MAPK signaling pathway.The result shows that Yiqi Jianpi,Huayu Jiedu Therapy can improve the efficacy of TCM symptoms in patients with advanced gastric cancer.After treatment,the incidence of moderate and severe TCM symptoms in group B(81.00%)and group C(82.86%)is lower than that in group A(35.00%),which is statistically significant(P<0.001).There is no significant difference in PFS,OS,DCR,ORR between group A and group C,which has no statistical significance(P>0.05).However,? and ?degree chemotherapy responses are significantly lower in group C than in group A,with statistical significance(P<0.001).Subgroup analysis of OS in patients with advanced gastric cancer showes that patients with gastroesophageal junction/cardia gastric cancer,liver metastasis,and KPS of 60 to 80 points,and advanced age have short survival time and poor prognosis.The frequency analysis shows that highly used Yiqi Jianpi,Huayu Jiedu herbal are Dangshen,Astragalus,Atractylodes,Licorice,Hedyotis diffusa,Scutellaria barbata,Teng Ligen,Zedoary,Rhodiola,etc.Datas show that Weikang granules can inhibit the growth of gastric cancer cells,which is in a time-dependent manner.It also has reversal effects on cisplatin-resistant gastric cancer cell line MFC/DDP,which can inhibit the tumor growth in gastric carcinoma modern mice and decrease PD-L1 expression in gastric cancer cells and tumor tissues,which is not dose dependent.It can also control MAPK pathway by reducing the expression level of p-JNK,p-p38,p-ERR1/2 protein,which is partly dose-dependent.Conclusion:For patients with advanced gastric cancer,Yiqi Jianpi,Huayu Jiedu Therapy combined with chemotherapy can alleviate their clinical symptoms and reduce some chemotherapy responses,without reducing the efficacy of chemotherapy.Cell experiments and animal experiments have shown that Weikang granules can inhibit tumor growth and reverse resistance to cisplatin by regulating the PD-1/PD-L1 system and MAPK signaling pathway.