Clinical Efficacy And Mechanism Of Buyinyiqi Decoction In The Treatment Of Cancer-related Fatigue Of Non-small Cell Lung Cancer

Objective:To investigate the clinical efficacy of Buyinyiqi decoction in the treatment of cancer-related fatigue of non-small cell lung cancer.To investigate the effect of Buyinyiqi decoction on cancer-related fatigue in mice with lung adenocarcinoma induced by transplanted tumors.Methods:A total of 78 patients with stageⅣnon-small cell lung cancer were randomly divided into two groups,39 cases in each group.The treatment group(dexamethasone)and the control group(Buyinyiqi decoction+dexamethasone)were treated for 14 days.The revised Piper fatigue scale score,TCM syndrome score,blood routine and T lymphocyte subsets were observed in the two groups.Lewis lung cancer mouse models were established and divided into blank group,cancer model group,cisplatin group,Buyinyiqi decoction group and Buyinyiqi decoction+cisplatin group.After 14 days of intervention,the behavioral performance and tumor volume of mice in each group were observed.The organ index,HE staining and Ki67 expression were measured.The content of ATP in skeletal muscle and liver glycogen was detected by Elisa.The percentages of CD3~+,CD4~+,CD8~+T lymphocytes and CD4~+/CD8~+ratio in peripheral blood were detected by flow cytometry.The expressions of IL-2,IL-10,TNF-αand INF-γin serum were detected by Elisa.The number of NK cells and myeloid-derived suppressor cells in spleen was detected by flow cytometry.Serum levels of cortisol and thyroid stimulating hormone were measured by Elisa.Based on the JAK/STAT signaling pathway,the protein expressions of JAK1,STAT1 and SOCS1 in brain tissues and JAK2 and STAT3 in tumor tissues were detected by Western Blot.Results:1.Results of clinical trial:after 14 days of intervention,the total score and scores of each dimension of the revised Piper Fatigue scale in the treatment group were better than those in the control group(P<0.05).The effective rate was 79.49%in the treatment group and 30.77%in the control group.The total score of TCM syndromes in the treatment group was better than that in the control group(P<0.05).There was no significant difference in white blood cell,red blood cell,hemoglobin and platelet count between the treatment group and the control group(P>0.05).There was no significant difference in the percentage of CD3~+,CD4~+and CD8~+T lymphocytes between the treatment group and the control group(P>0.05).Buyinyiqi decoction has good safety.2.Results of basic experiment:(1)Fatigue-like behavior:in the weight-bearing swimming test,the degree of fatigue in the TCM group was lower than that in the cancer model group;In the tail suspension immobility test,the degree of fatigue in the TCM group was lower than that in the cancer model group.(2)Tumor volume:tumor volume from large to small was the cancer model group>TCM group>DDP group>TCM+DDP group(P<0.05).(3)Organ index:the spleen index of the TCM group was higher than that of the TCM+DDP group,DDP group and blank group(P<0.05).There was no significant difference in thymus index and adrenal index between the TCM group and the other groups(P>0.05).(4)Ki67 expression:many Ki67 positive cells were observed in the tumor tissue of the cancer model group.The number of Ki67 positive cells in the TCM group and TCM+DDP group was significantly reduced.(5)Energy metabolism:the content of ATP in the TCM group was higher than that in the cancer model group,DDP group and TCM+DDP group(P<0.05).The content of liver glycogen in the TCM group was higher than that in the blank group,cancer model group,DDP group and TCM+DDP group(P<0.05).Protein expression of JAK/STAT pathway:(1)Tumor tissue:the relative protein expression of JAK2 and STAT3 in the TCM+DDP group was lower than that in the DDP group(P<0.05).(2)In brain tissue,the relative protein expressions of JAK1 and STAT1 in the TCM group were lower than those in the cancer model group(P<0.05),while SOCS1was higher than that in the cancer model group(P<0.05).Conclusion:Buyinyiqi decoction can effectively improve cancer-related fatigue in patients with stageⅣnon-small cell lung cancer with good safety.Buyinyiqi decoction can delay tumor proliferation,increase the content of energy metabolism substances,improve organ index,regulate peripheral blood and immune inflammatory factors,regulate spleen immune function,improve endocrine function,regulate the expression of key target proteins in JAK/STAT signaling pathway,thereby inhibiting tumor cell growth and improving immune function of the body.To improve the mental fatigue and physical fatigue of mice with transplanted tumor.