| Objective:In order to investigate the clinical effect of spleen strengthening and kidney tonifying prescription assisted anlotinib in the treatment of small cell lung cancer(SCLC),and to observe the effect on reducing the anti-tumor toxic and side effects.Meanwhile,the genes and signaling pathways enriched in SCLC were analyzed by bioinformatics,and the relevant mechanisms were explored in order to provide ideas for further research in the future.Methods:1.Clinical study:A total of 65 patients with SCLC who received second-line treatment,diagnosed by histopathology,were collected from July 2018 to October 2019 in Shandong provincial hospital.7 patients were excluded.30 patients with single-drug oral administration(21 cases of male,9 cases of female and median age was 63),28 patients with combined spleen strengthening and kidney tonifying prescription(24 cases of male,4 cases of female,median age was 58),There were no patients with shedding and elimination.Clinical symptoms,therapeutic evaluation,gender,age,AJCC stage,TNM stage,weight,leukocyte,neutrophil absolute value,erythrocyte,hemoglobin,platelet,CEA,CA125,cyfra21-1 and NSE before and after two cycle treatment were obtained by inquiring medical records and telephone follow-up.SPSS 21.0 was used to analyze the differences between groups and before and after treatment,and to compare the occurrence of toxic and side effects in blood routine,tumor markers and therapeutic effects.2.Bioinformatics analysis:Matching human SCLC and normal lung tissue gene expression data download from ArrayExpress database,for freedom in Vienna,Austria Kastner S upload submit E-GEOD-40275 data set,which contains 84 sample data,we extract a total of 68 normal tissue and SCLC samples,using R software for data processing and analysis.Results:1.Clinical research:(1)The comparison of the indexes between the single drug group and the combined TCM group suggested that the difference in the absolute values of platelets in the single drug group and neutrophils in the combined TCM group before and after treatment was statistically significant(P<0.05).(2)The comparison between the two groups before and after treatment showed that the absolute values of body weight,white blood cells and neutrophils fluctuated significantly before and after treatment,with statistically significant differences(P<0.05).(3)The efficacy evaluation of the two groups was compared,and the results showed that the total effective rate of the two groups was significantly different(P<0.05).(4)The weight changes of the two groups were compared,and the results showed that there was a significant difference between the two groups(P<0.05).(5)By comparing the occurrence of toxic and side effects between the two groups,it was found that the incidence of toxic and side effects was lower in the combination group of anlotinib and TCM than the single drug group(P=0.047).(6)Toxicity and side effects were mainly reflected in hemoglobin(40%),platelet(40%),bilirubin(20%),glutamic aminotransferase(10%)and digestive reaction(60%)in the single drug group,among which the incidence of hemoglobin reduction and digestive reaction was more than that in the combined TCM group,and thrombocytopenia was more serious.Toxicity and side effects were mainly reflected in hemoglobin(35.71%),glutamic aminotransferase(21.43%)and digestive reaction(35.71%)in the combined TCM group,among which the incidence of elevated glutamic aminotransferase was higher than that in the single drug group.2.Bioinformatics:we screened the first 100 differentially expressed genes,among which 55 genes were low-expressed in tumor tissues and 45 genes were highly expressed in tumor tissues,and the differentially expressed genes were mainly different in DNA,chromosome and immune microenvironment.The signaling pathways enriched by differentially expressed genes included human t-cell leukemia virus 1 infection,systemic lupus erythematosus,viral myocarditis,adhesive plaque,alcoholism,cell cycle,etc.Conclusions:1.Strengthening the spleen and kidney can alleviate the toxic and side effects caused by antitumor treatment with anlotinib,especially bone marrow suppression.However,attention should be paid to drug-induced liver injury and it is helpful to stabilize the disease.2.The differentially expressed gene functions between SCLC tissues and normal lung tissues mainly lie in DNA,chromosome,immune microenvironment,etc.,while the signaling pathways are significantly different in the expression of immune,DNA,chromatin and other functional genes,especially the functional genes related to neutrophils,which will contribute to the later in-depth research of Chinese herbs. |
