Report On The Effectiveness Of Yiqiyangxuebusuigao On The Cancer-related Fatigue Of Patients With Lung Cancer And Weak Syndrome

Objective:This study aims to evaluate the effectiveness of Yiqiyangxuebusuigao in treating cancer-related fatigue of patients with lung cancer and weak syndrome.The mechanism of“Codonopsis-Astragalus” pair in Yiqiyangxuebusuigao in the treatment of cancer-related fatigue based on network pharmacology is explored.Methods:1.A total of 60 patients who met the criteria were randomly assigned to either Yiqiyangxuebusuigao group(10g/day)(n=30)or usual care group(being guided on work,rest and appropriate exercise)(n=30)for 21 days.The endpoints were collected from the Revised Piper Fatigue Scale score,Traditional Chinese Medicine syndrome score,EORTC QLQ-C30 quality of life score and blood analysis.Vital signs,electrocardiogram,liver and renal function examination,urine analysis,fasting blood glucose and other adverse reactions would also be evaluated.All outcomes would be measured at baseline,and day 21 of the treatment.2.Based on the network pharmacological approach,the potential active components of“Codonopsis-Astragalus” were searched and screened out in TCMSP database and were imported to the Swiss Target Predict database as to screen out potential targets.Secondarily,mutual targets of drugs and diseases were obtained by searching with the keyword “cancer related fatigue” in OMIM and Gene cards database.Thirdly,the network of“drug-ingredient-target-disease” was constructed by Cytoscape 3.7.2 software.The PPI Network of main active components construct was analyzed,obtaining the core targets of“Codonopsis–Astragalus” and analyzing the interaction between targets by the STRING database.Lastly,using R software,enrichment analysis of the GO and KEGG functions of key targets were carried out.Results:1.A total of 60 patients were included in this study.Among the patients who completed the study,there were 28 cases in the treatment group and 29 cases in the control group.2.The scores of behavioral,emotional,sensory,cognitive dimensions and total scores in both groups were significantly lower than those before treatment(P<0.05).The scores of the four dimensions and the total score in the treatment group were statistically significant compared with those in the control group after treatment(P<0.05).3.The effective rate of the treatment group was 67.86%,while that of the control group was 37.93%.The difference in effective rate between both groups was statistically significant(P<0.05).The comparison between both groups before and after treatment was statistically significant(P<0.05).The total scores of qi deficiency,blood deficiency and TCM symptoms were lower than the baselines significantly(P<0.05).4.After treatment,the scores of physical function,emotional function,cognitive function,fatigue and sleep quality in two groups decreased,and the scores of life quality increased,with statistical significance(P<0.05).The scores of role function,social function and symptom areas(shortness of breath,appetite,nausea,vomiting,constipation,diarrhea and pain)in both groups were not significantly different from those before treatment(P>0.05).After treatment,compared with the control group,the physical function,emotional function,cognitive function,fatigue,sleep quality and life quality of the treatment group were improved with statistical significance(P<0.05).5.After treatment,HGB and RBC of the treatment group increased with statistical significance(P<0.05).The differences of HGB and RBC between both groups were statistically significant(P<0.05).There were no significant differences in WBC,NEU,LYM,NLR and PLT between the two groups after treatment(P>0.05).6.A total of 41 potential active components,604 drug targets of “Codonopsis-Astragalus”,929 disease targets,and 114 drug-disease common targets were screened.Five core drug components were found,including luteolin,isorhamnetin,galangin,quercetin and kaempferol.Five core genes were MCL1,NFKB1,CYP1B1,TOP1 and TOP2 A.7.GO analysis yielded 1991 biological pathways,59 cell components,121 processes related to molecular function.8.A total of 155 KEGG pathways were obtained by R software,involving cancer,hormone regulation,neuroendocrine regulation,cell cycle phase,substance metabolism and so on.Conclusions:Yiqiyangxuebusuigao can relieve cancer-related fatigue with good safety,with the characteristics of being multi-component,multi-target and multi-pathway.