| Background:Neuroblastoma is the most common extra cranial solid tumor in children, which mainly happens in the adrenal has complicated clinical, high malignant degree, rapids progression, prones to recurrence and distant metastasis, so it is currently one of the main cancer threaten to children’s lives. The etiology and pathogenesis of neuroblastoma is not yet clear, but recently studies have shown that neuroblastoma cells with certain genetic. The treatment of neuroblastoma includes surgery, chemotherapy and radiotherapy.For refractory neuroblastoma, also applies methods of hematopoietic stem cells transplantation based on strengthening the dose of strengthen chemotherapy. Neuroblastoma is hard to detect, which has large tumor, is easy to distant metastasis and difficult to operate, so generally the first treatment is take chemotherapy. Surgical treatment can perform, when the tumor has become small or the transfer site eliminated. Operation always effectively for early stage of neuroblastoma, but for the children with advanced neuroblastoma chemotherapy is still the main treatment method. But the children wit neuroblastoma in the young age, their organ function has not been perfect, after received chemotherapy they had side effects of chemotherapy, like nausea and vomiting, anorexia, constipation, fatigue, alopecia, reduction of blood cells, liver and kidney damage. This side effects has become the main factors made the children can’t successfully completion of the chemotherapy. Many children had to postpone the chemotherapy, or directly refused chemotherapy, which seriously affects the patient’s quality of life, timing of surgery and prognosis. So it’s necessary to control the adverse reaction of chemotherapy in the treatment of neuroblastoma. But at present modern medicine still has no effective drugs reducing the adverse reaction of chemotherapy, and which can do only symptomatic treatment. From the point of view of traditional Chinese medicine, chemotherapy on cancer cells and normal cells lacks an ideal effect, the relative righteousness is a kind of evil, some scholars thought it belongs to the toxin, in the treatment of tumor at the same time of viscera, Qi blood and body fluids has serious toxic effects. Traditional Chinese medicine in the treatment of neoclassic diseases has unique advantage. It pays more attention to the holistic concept, syndrome differentiation and treatment, strengthening vital qi and eliminating pathogens through the combined treatment of tumors. Many studies showed that the tumor chemotherapy process at the same time with the treatment of traditional Chinese medicine, Pro Card clockwise for different individuals and different period of dialectical theory of governance, better in the chemotherapy of smooth, upright support, reduce the adverse reaction of chemotherapy, improve the body’s resistance to disease, and improve the quality of life, and improve the curative effect, reduce the recurrence rate.Neuroblastoma in TCM study no relevant records, but according to the symptom and the correlation inspection, classified as "the blood", "consumptive", "mass in the abdomen", "pain", "accumulation", "timpanists" disease category. Traditional Chinese medicine considers the neuroblastoma has the same pathogenesis with another tumors, first it emphasized the vital qi of the human body is of important significance in neuroblastoma pathogenesis. Ancient physicians that the occurrence of the disease, due to lack of innate endowment, heritage from mother, or because of acquired dystrophy, deficiency of spleen and kidney, resulting in organs dysfunction, the deficiency of vital qi, endogenous pathogenic factors caused Phlegm Blood Stasis and dampness accumulation and cancer drug. The TCM syndrome differentiation of neuroblastoma is no uniform classification standard. In recent years, there have been reported of combined treatment of TCM and chemotherapy can relieve the nerve in children with neuroblastoma chemotherapy adverse reaction and reduce the occurrence of iatrogenic disease, improve the life quality of children. So in advanced neuroblastoma chemotherapy combined with traditional Chinese medicine treatment, the prevention of the adverse reaction of chemotherapy is an effective clinical method.Professor Lv Ying based on the theory of "Qi monism" inductive neuroblastoma pathogenesis of congenital Yuanyang endowment is insufficient, yin ice V, six climatic factors snagging. Professor Lv Ying thought that Qi is the origin of life, personal material all by the vitality of life, and the occurrence of disease is due to congenital vitality of partial; spleen and stomach is the acquired constitution, not only to absorb the essence of water and grain transfer body, nutrition, organs, limbs and fully support strength, therefore the weakness of spleen and stomach, strength is not sufficient, and the human will sick; "vitality, the foundation in the kidney, budding in the liver." That kidney qi, stewards in the Qi Sheng service organs, to stimulate and promote life activity, liver for burgeoning vitality of dirty is embodiment of the vitality of all things, human body stretch circumfluence in addition to the power of the germinal, poised to take off the germination force is strong, is another key point; so the root qi,Zhongqi, germination due to the corresponding the three yin Sanyang Shaoyin, Taiyin, Jueyin, therefore three and said the three yin qi, vitality, and close contact. Summary of Professor Lv Ying neuroblastoma in children with chemotherapy adverse reaction is mainly manifested in the Zhongqi, germination of two aspects, Professor Lv Ying often uses lizhong or Laifu decoction for treatment the children with neuroblastoma,who had less of three yin and the qi, to restore the original to righting children acquired, good curative effect.Objective:Based on Jueyin and Zhongqi law, using lizhong or Laifu decoction respectively, and combining with chemotherapy in the treatment of advanced neuroblastoma to sum up the method can effectively reduce the adverse reaction of chemotherapy and improve the quality of life in children with traditional Chinese medicine treatment.Method:Confirmed by histopathology or bone marrow detection for neuroblastoma, reference INSS staging, clinical stage III to IV of the children and the chemotherapy regimen with Ⅲ-Ⅳ postoperative chemotherapy scheme, and according to chemotherapy in patients with clinical symptoms, included in comply with the new drugs of traditional Chinese medicine clinical research guiding principle (for Trial Implementation) "on Qi deficiency, spleen deficiency syndrome diagnosis standard of cases. The strict standard screening cases, a total of 25 cases of neuroblastoma patients met the inclusion criteria,25 patients were retrospectively studied 3 cycles of treatment, by using the method of self-control, divided into treatment before and after treatment with pure chemotherapy plus traditional Chinese medicine clinical observation on clinical symptoms during chemotherapy spirit fatigue, lack of Qi to breath, wheezing or shortness of breath, sweating, thready pulse or pulse, the card is Jueyin less germination, selection of reflex Decoction; clinical symptoms during chemotherapy to see anorexia or loss of appetite, food intake decreased significantly, weight loss, muscle weakness, or nausea shit, soft rotten or dry hard soft rotten, pale tongue, thready pulse or sink, the card is Zhongqi in poor health, loss of transportation of division, selection of modified Lizhong decoction.Through the statistics before and after treatment of adverse reaction of chemotherapy and score, the improvement of clinical symptoms and therapeutic effect, changes of blood, a comparative analysis before and after the adverse reaction of chemotherapy in the treatment of. Data were analyzed by SPSS 19.0 statistical software. The measurement data of normal distribution test, accord with normal distribution data using t test, does not meet the normal distribution of data using non parametric test. Count data using chi square analysis of 2 test methods, with P<0.05 as the difference was statistically significant.Results:The incidence of adverse reaction of chemotherapy and score, compared before and after the treatment, the treatment of traditional Chinese medicine in children with nausea, loss of appetite, weight loss, abnormal stool, fatigue, sweating, shortness of breath were decreased, compared with before treatment, the differences were statistically significant (P<0.05); the children with nausea, shortness of breath the symptoms, second courses of treatment is better than first, the difference was statistically significant (P<0.05); loss of appetite, stool is not moved symptom, compared to second and first courses of treatment, the difference was not statistically significant (P>0.05); body weight, fatigue, sweating symptoms, compared with first for the treatment, the symptoms were not reduced, no statistically significant difference (P>0.05), and compared with the second course of treatment, the difference was statistically significant (P<0.05). Before and after the pain, insomnia, hair loss treatment, there were no significant differences (P>0.05).To observe the curative effect of clinical symptoms,12 cases improved part of traditional Chinese medicine in the treatment of first courses in (48%), no improvement in 13 cases (52%) clinical symptom remission rate (significantly improved+part improvement) 48%. The second course of treatment in Chinese medicine treatment was significantly improved in 1 case (4%), some improvement in 17 cases (68%), no improvement in 7 cases (28%), clinical symptoms of the total effective rate was 72%. Chinese medicine treatment of second course of treatment compared with first, the difference was statistically significant (P<0.05).Comparison of blood, traditional Chinese medicine in the treatment of 2 courses, the decline before and after chemotherapy in children with peripheral white blood cell, hemoglobin and platelet count were compared with those before treatment decreased, with statistically significant difference (P<0.01); and Chinese medicine the first course of treatment with traditional Chinese medicine second course of contrast, there is no difference between traditional significant (P> 0.05).Conclusion:From Jueyin and Zhongqi in the treatment of the traditional Chinese medicine combined with chemotherapy, in a certain extent alleviate effect in late neurologic blastoma chemotherapy in children with adverse reactions, and with the extension of traditional Chinese medicine in the treatment of time and increase clinical therapeutic effect and on chemotherapy induced bone marrow suppression have certain mitigation and improve the quality of life for children; but to pain, insomnia, hair loss symptoms remission had no obvious effect.Discuss:The study of traditional Chinese medicine after treatment with nausea, loss of appetite, weight loss, abnormal stool, fatigue, sweating, shortness of breath, the symptoms were relieved; including nausea, shortness of breath, weight loss, fatigue, sweating, obvious improvement in traditional Chinese medicine second courses of treatment, the clinical symptoms of traditional Chinese medicine second course of remission there are first high efficiency than the traditional Chinese medicine treatment, Chinese medicine treatment time and clinical efficacy are closely related, although after 1 cycles of treatment, but the reason for the three yin with qi shortage, need long time to recover the qi treatment, correct the constitution, traditional Chinese medicine can play a role, improve the symptoms; the children before and after pain, insomnia, hair loss symptoms compared with no significant improvement in clinical symptoms, due to the complex, such as pain, its root for Yuanyang, three yin ice V, but considering the patient " After the treatment of three yin and the insufficiency of Qi is deficient, qi loss, Jue Yin Sheng ineffective and should not be adopted directly "ice breaking back to Yang" to cure, only by regulating the qi, Jue Yin to recover the qi, therefore the symptoms remission is not obvious. Treatment of traditional Chinese medicine, decline before and after chemotherapy in children with peripheral white blood cell, hemoglobin and platelet count were compared with those before treatment decreased, indicating that Chinese medicine therapy to chemotherapy bone marrow inhibition has a mitigating effect, but with the increase of the course of chemotherapy, three yin and the qi more deficiency, traditional Chinese medicine also difficult to alleviate chemotherapy resulted in bone marrow inhibition. |
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