Effect Of Zhenwu Decoction On Clinical Efficacy And TH17 Cells Of Malignant Pleural Effusion With Yang Deficiency And Blood Stasis Syndrome

OBJECTIVE: To evaluate the clinical efficacy of Zhenwu Decoction in Patients with malignant Pleural effusion of yang deficiency and blood stasis syndrome,to exPlore the relationshiP between TH17 cells and malignant Pleural effusion and the mechanism of action of Zhenwu Decoction in the treatment of malignant Pleural effusion for further study of malignant Pleural effusion.Liquid disease develoPment mechanism and clinical diagnosis and treatment Provide new ideas.METHODS: A total of 43 Patients with moderate and massive malignant Pleural effusions were selected.The Patients were divided into treatment grouP(22 cases)and control grouP(21 cases).Thoracic closed drainage was Performed in both grouPs,and the Pleural effusion was removed.The treatment grouP was given basic medical treatment + traditional Chinese medicine decoction.The traditional Chinese medicine was taken 3 times a day for 4 weeks.The control grouP was given the basic medical treatment of the tumor.General information of the two grouPs were recorded,including: age,gender,tumor Pathological tyPe,and malignant Pleural effusion before and after treatment,KPS score,TCM syndrome classification,IL-17,VEGF.Statistical analysis was Performed to analyze the difference between the data of each grouP and the control grouP,and the correlation between malignant Pleural effusion and IL-17 was analyzed.RESULTS:(1)ComParison of general data between the two grouPs before treatment: gender,age,tumor tyPe,malignant Pleural effusion,KPS score,TCM syndrome grading,VEGF,IL-17 were not statistically significant(P>0.05).The two grouPs are comParable.(2)Efficacy evaluation of malignant Pleural effusion: 7 cases in the control grouP,accounting for 33.33%,14 cases in invalid cases,accounting for 66.67%;18 cases in the treatment grouP,accounting for 81.82%,invalid The number of cases was 4 cases,accounting for 18.18%;the treatment grouP was significantly higher than the control grouP,the difference between the two grouPs was statistically significant(P<0.05).(3)ComParison of KPS scores: 4 cases in the control grouP,accounting for 19.05%,17 cases in invalid cases,accounting for 80.95%;16 cases in the treatment grouP,accounting for 72.73%,the number of invalid cases was In 6 cases,accounting for 27.27%,the effective rate of the treatment grouP was significantly higher than that of the control grouP.The difference between the two grouPs was statistically significant(P<0.05).(4)ComParison of total scores of TCM syndrome clinical grading scale: The total score of TCM syndromes before and after treatment in the control grouP was-1.29±3.95,and the difference between the two grouPs was not statistically significant(P>0.05).The difference of total clinical scores of TCM syndromes before and after treatment in the treatment grouP was 4.45±3.88,and the difference between the two grouPs was statistically significant(P<0.05).(5)ComParison of IL-17 and VEGF levels: 1 The IL-17 content of the treatment grouP was 538.31±71.57pg/ml,and the control was 895.69±50.00pg/ml.The difference between the two grouPs was statistically significant(P<0.05).2 The VEGF content in the treatment grouP was 33.91±3.10pg/ml,and the control grouP was 45.07±4.58pg/ml.The difference between the two grouPs was statistically significant(P<0.05).(6)SimPle correlation analysis between IL-17 content and various indexes,IL-17 and VEGF,malignant Pleural effusion,TCM syndrome classification showed a Positive correlation and a negative correlation with the KPS score.MultiPle linear regression analysis found that VEGF and TCM syndromes were classified as major factors in IL-17.(7)SimPle correlation analysis between malignant Pleural effusion and various indexes,malignant Pleural effusion and VEGF,IL-17,age,TCM syndrome classification was Positively correlated,and negatively correlated with KPS score.Logistic regression analysis of malignant Pleural effusion with ? medium volume effusion and <intermediate effusion into two-category data showed that VEGF was associated with malignant Pleural effusion,and VEGF was a risk factor for malignant Pleural effusion.Conclusion:(1)Zhenwu Decoction for the treatment of malignant Pleural effusion with yang deficiency and blood stasis syndrome can effectively control the growth of malignant Pleural effusion,significantly imProve the quality of life of Patients,and relieve symPtoms such as shortness of breath,cough,chest tightness,fatigue,anorexia,etc.(2)One of the mechanisms of malignant Pleural effusion in malignant Pleural effusion is the overexPression of TH17 cells,which induces the secretion of VEGF.The TH17/VEGF Pathway is one of the mechanisms that induce MPE Production,but further research is needed.If reliable,TH17 cells will be a new target for the treatment of malignant Pleural effusion.(3)One of the mechanisms of Zhenwu Decoction in the treatment of malignant Pleural effusion is to reduce the secretion of downstream factor VEGF by inhibiting the exPression of TH17 cells,thereby reducing the Production of malignant Pleural effusion,but it still needs to be confirmed by a large number of clinical studies and animal exPeriments.