| Objective: In this study,patients with the Ground Glass Noudle(GGN)were studied.The clinical symptoms,quality of life,and clinical symptoms of lung cancer were observed by observing the physical condition,tongue characteristics and traditional Chinese medicine treatment of GGN.The effects of tongue image parameters and safety,etc.,to explore the possibility of TCM in the prevention and treatment of early lung cancer characterized by GGN,and provide a preliminary basis for future clinical treatment strategies of TCM in GGN.Methods:(1)Using the cross-sectional study of epidemiology,using the TCM Constitution and Judgment Scale to determine the physique types of TCM in 242 patients with GGN,for general information(gender,age,smoking history,family history),GGN Characteristics(size,number,degree of malignancy,etc.)were analyzed for TCM constitution types.(2)Logistic analysis was performed on the prognosis of 222 patients with GGN by retrospective study.Logistic regression analysis of prognosis was performed for factors related to GGN,such as gender,age,smoking history,and family history.(3)Using a prospective,non-randomized controlled study method,using a propensitymatching score,97 patients with GGN were enrolled,and the patients were treated with a softening and dispersing softening soup(n=33),and the syndrome differentiation treatment of traditional Chinese medicine(n=64).Evaluation indicators:(1)general conditions of patients;(2)quality of life: American lung cancer quality of life scale(FACT-L version 4.0),lung cancer symptom scale,TCM clinical syndrome scale and TCM clinical syndrome and adverse reactions(NCI-CTC 4.03).(4)Using highthroughput omics technology,RNA sequencing was performed to detect differential gene expression in 3 GGN patients treated with traditional Chinese medicine for 4 months.The above data were statistically analyzed using SPSS 21.0 software,with a statistical difference of P < 0.05.RESULTS:(1)in this study,there were 99 cases(40.91%)of 242 GGN patients with mild constitution distribution and 143 cases(59.09%)of biased constitution.The patients with biased constitution were mainly middle-aged(60.84%)and female(80.42%).Among the biased constitutions,49 cases(20.25%)of Yang deficiency and nature,21 cases(8.68%)of qi stagnation and nature,and 17 cases(7.02%)of qi deficiency and nature.(2)age,TCM intervention and TCM constitution are significantly correlated with GGN size.Among them,the probability of occurrence of GGN 8mm in non-elderly population is 2.82 times higher than that in elderly population,the probability of occurrence of GGN 8mm in patients receiving TCM treatment is 2.18 times higher than that in patients not receiving TCM treatment,and the probability of occurrence of GGN 8mm in patients with biased constitution is 0.43 times higher than that in patients with mild constitution.(3)the function improvement of the softening decoction for disease differentiation treatment is superior to the TCM treatment based on syndrome differentiation in the treatment of GGN population with dry mouth,spontaneous sweat and night sweat,loss of appetite,five upset heat,cough and sputum,and social/family status.The incidence of adverse events was low in TCM intervention of GGN patients.The safety of the two methods is higher than that of traditional Chinese medicine,and the incidence of adverse events in respiratory reaction and systemic symptoms is significantly lower than that of softening decoction.(4)mrna-seq sequencing results: after 4 months of TCM intervention,265 differentially expressed genes(P<0.01)were screened with FPKM>1 |log2|>1,q<0.05,among which 96(36.23%)were up-regulated and 169(63.77%)were down-regulated.Through GO and KEGG enrichment analysis,it can be found that the mechanism of TCM in the treatment of GGN is mainly to achieve anti-lung cancer effect by regulating tumor transcription disorder,cytokine receptor interaction,TNF,MARK and other signaling pathways,which involves the regulation of cell cycle,apoptosis,immunity and other biological functions.Conclusion:(1)most GGN patients have biased constitution,which is dominated by Yang deficiency,qi stagnation and qi deficiency;Among them,biased physique in middle age(40-65 years old),women more prone to biased physique characteristics.(2)factors significantly associated with GGN size include age,TCM intervention and TCM constitution.Among them,the probability of occurrence of GGN 8mm in nonelderly population is 2.82 times higher than that in elderly population,the probability of occurrence of GGN 8mm in patients receiving TCM treatment is 2.18 times higher than that in patients not receiving TCM treatment,and the probability of occurrence of GGN 8mm in patients with biased constitution is 0.43 times higher than that in patients with mild constitution.(3)the softening decoction with the function of soft and firm dispersing and the traditional Chinese medicine with the treatment based on syndrome differentiation based on the body bias have certain benefits on the quality of life of GGN population.However,the treatment based on syndrome differentiation has better advantages in improving the symptoms related to lung cancer,such as cough,pain and fatigue.TCM has good safety in the intervention of GGN patients,and toxic and side effects are mainly focused on mild gastrointestinal reactions.(4)TCM intervention can play an early anti-lung cancer role by regulating immune function,cell cycle and inducing apoptosis through a variety of cellular signaling pathways. |
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