Professor Tian Fei's Traditional Chinese Medicine Diagnosis And Treatment Strategies For Advanced Non-small Cell Lung Cancer Based On Real-world Study

Objective:Established a real-world database for diagnosis and treatment of advanced NSCLC in Chinese medicine,analyzed the distribution of symptoms and syndrome types of advanced NSCLC from multiple perspectives,and instructed Professor Tian Fei's medication rules for treating advanced NSCLC,the clinical characteristics of the population with the greatest survival benefit,and integrated Chinese and western medicine combined treatment Program.To explore the strategy of TCM diagnosis and treatment of advanced NSCLC.Methods:This study is a real-world study,a retrospective study.By collecting and collating the clinical data of 195 patients with stage III-IV non-small cell lung cancer who were treated in the outpatient department of Professor Tian Fei from the Oncology Department of the First Teaching Hospital of Tianjin University of TCM from 2015.1.1 to 2019.3.1.The data were standardized and processed after screening.Established a real-world database of TCM diagnosis and treatment of advanced NSCLC,and conducted data mining through various statistical analysis methods such as frequency analysis,cluster analysis,association analysis,and survival analysis to analyze the distribution of symptoms and syndrome types of advanced NSCLC.NSCLC's prescriptions for prescriptions,clinical characteristics of the population with the greatest survival benefit,and integrated treatment plans of integrated traditional Chinese and western medicine.Results:1.The most frequent clinical symptoms of advanced NSCLC are cough,and the remaining high-frequency symptoms are fatigue,shortness of breath,lack of appetite,insomnia,expectoration,sputum or less sputum,chest tightness,shortness of breath,sputum stickiness,yellow sputum,constipation,chest pain,Hemoptysis,white phlegm,spontaneous sweating,nausea,diarrhea,hoarseness,dry mouth.The most common tongue image is red tongue and yellow fur.Other common tongue images are thin fur,dark tongue,greasy,little or no fur,white fur,and red tongue.The most common pulses are pulses.Other common pulses are pulse string,slippery pulse,pulse number,and weak pulse.2.The most common types of advanced NSCLC are qi and yin deficiency syndromes,with a frequency of 41.8%;followed by phlegm heat-blocking lung syndrome,with a frequency of29.4%;yin deficiency fever poisoning syndrome,with a frequency of 15.1%;The frequency is 13.8%.The empirical main symptoms are fever and phlegm,accounting for 53.5% and32.0%,respectively;the main symptoms of deficiency syndrome are lung qi deficiency and lung yin deficiency,accounting for 62.6% and 47.6%,respectively.3.Commonly used drugs for the treatment of advanced NSCLC are: Hedyotis diffusa,Ophiopogon,Chenpi,Baiziren,Salvia miltiorrhiza,Magnolia officinalis,Yanhusuo,Mulberry peel,bergamot,reed root and so on.According to the analysis of the classification and classification of sexual taste,the most frequent use of tonics and clearing heat drugs,cough,phlegm,asthma,qi,blood circulation,dampness,and soothe is also the main method for the treatment of NSCLC.And Pingganxifeng,diuresis,dampness,astringency,hemostasis and other methods play an adjuvant role in this disease.And mostly for the taste of peace.Guijing is mainly based on lung,spleen and stomach.The most commonly used recipe is the sage soup,followed by Sijunzi soup,reed stem soup,Qingjin Huatan soup,Shengmaisan,Lily Gujin soup,Yangyin Qingfei soup,Maiwei Dihuang soup,and Yangyin Qingfei soup.4.Through drug cluster analysis,18 commonly used counter medicines and 6 corner medicines were obtained.Including coltsfoot flowers with aster,lisianthus with mulberry peel,loquat leaves with perilla seed,Scutellaria barbata with white flower Hedyotis,scallops with panax notoginseng,atractylodes with echinacea and Ligustrum lucidum,cypress seed with jujube kernel and Shichangpu,Codonopsis with Yam and Poria.5.Through the scale-free network deduction,the core prescriptions for treating phlegm heat resistance lung syndrome are reed root,scutellaria baicalensis,chrysanthemum,Hedyotis diffusa,Ophiopogon japonicus and Chenpi.The core prescriptions for deficiency of lung and spleen qi are Astragalus,Pseudostellaria heterophylla,Poria,Atractylodes,Hedyotis diffusa and Chenpi.The core prescriptions of Qi and Yin Deficiency Syndrome are Astragalus membranaceus,A.ginseng,Ophiopogon,Chenpi,Hedyotis diffusa and Baiziren.The core prescriptions of yin deficiency fever and toxic syndrome are Ophiopogon japonicus,tangerine peel,beetle,salvia miltiorrhiza,and Hedyotis diffusa.The core prescriptions of Qi stagnation and blood stasis syndrome are Ophiopogon,Chenpi,Hedyotis diffusa,Panax notoginseng,Salvia miltiorrhiza and Yanhusuo.6.Through the analysis of association rules,the law of addition and subtraction is obtained as cough,then the medicinal mulberry bark,platycodon grandiflorum,loquat leaf,white flowering Hedyotis spp.,Scutellaria barbata,predictor,tangerine peel,perilla seed,chrysanthemum,honeysuckle,and winter wheat,Reed root,Fritillaria cirrhosa;medicinal herbs are Hydrangea,Astragalus,Ophiopogon,Pseudostellariae,Chenpi,Banzhilian,Codonopsis,yam,Magnolia,Atractylodes,and shortness of breath are medicinal white flowers Hedyotis,Prince Edward Ginseng,Platycodon grandiflorum,Codonopsis sibiricum,Chenpi,Lugen;etc.7.The results of TCM intervention in the treatment of advanced NSCLC showed a median OS of 26 months.The 2-year total cumulative survival rate was 62.1%(121/195),the 3-year total cumulative survival rate was 29.2%(57/195),and the 5-year total cumulative survival rate was 8.2%(16/195).The advanced NSCLC in the diagnosis and treatment of traditional Chinese medicine adopts the integrated treatment of traditional Chinese and western medicine.The longer the intervention time of traditional Chinese medicine,the better the treatment effect and the more obvious the benefits.Peripheral patients with no clinical history and early clinical stage have therapeutic advantages.Conclusion:1.In advanced NSCLC,cough is the main symptom,and the disease position is mainly in the lungs.It also includes fatigue,shortness of breath,lack of appetite,and insomnia.The main cause is lung cancer.Lung yin deficiency is mainly combined with spleen qi deficiency and kidney yin deficiency.The empirical evidence is mainly based on phlegm dampness and heat toxicity,combined with the evils of stasis,qi stagnation,and water drinking.The most common clinical syndromes are qi and yin deficiency.2.Tian Shifang's medication mostly follows the principle of "clearing heat and detoxifying,throughout the whole process,righteousness is the key,especially the spleen and stomach",and has the characteristics of "simple medication,light and pure,good at compatibility,flexible and changeable".Reed stem soup and Qingjin Huatan soup can be added or subtracted for the treatment of phlegm heat resistance lung syndrome.The core prescriptions are reed root,scutellaria baicalensis,chrysanthemum,Hedyotis diffusa,Ophiopogon andChenpi.Lung and spleen qi deficiency syndrome can be added and subtracted from Sijunzi Decoction.The core prescriptions are Astragalus membranaceus,Pseudostellaria heterophylla,Poria,Atractylodes,Hedyotis diffusa and Chenpi.The Qi and Yin deficiency syndromes can be modified with Shengmai Powder and Adenophyllum micrantha decoction.The core prescriptions for treatment are Astragalus membranaceus,A.ginseng,Ophiopogon,Chenpi,Baihua Hedyotis,Baiziren.The yin deficiency and heat poisoning syndrome can be added and subtracted from Lily Gujin Decoction and Yangyin Qingfei Decoction.The core prescriptions for treatment are Ophiopogon,Chenpi,Biejia,Danshen,Hedyotis diffusa.The core prescriptions of Qi stagnation and blood stasis syndrome are Ophiopogon,Chenpi,Hedyotis diffusa,Panax notoginseng,Salvia miltiorrhiza and Yanhusuo.And make good use of the right medicine and the corner medicine with the addition and subtraction with the card.3.There is no history of smoking in patients with advanced NSCLC,and peripheral patients with early clinical stage have the advantages of traditional Chinese medicine treatment.Traditional Chinese medicine treatment should be actively carried out.The integrated treatment of traditional Chinese medicine and western medicine is the best for traditional Chinese medicine diagnosis and treatment.,The more obvious the benefits.4.This research adopts real-world research,which is more in line with the academic characteristics of TCM complex interventions and personalized treatments.However,there are also many shortcomings,which are difficult to eliminate.Various statistical analysis methods such as frequency analysis,cluster analysis,association analysis,and survival analysis are used for multi-angle data mining.However,since the medical records only come from the outpatient clinic of Professor Tian Fei,the research results reflect the academic ideas.Different academic schools may have Different opinions.