Analysis Of Syndrome Types And Related Factors Of Brain Metastasis Of Lung Cancer And The Rules Of Chinese Medicine Us

Purpose:To investigate the correlation between TCM evidence type and gender,age,smoking history,pathological type,Primary tumor condition,regional lymph nodes,total amount and place of brain metastasis,brain metastasis span time,clinical treatment methods,KPS,lung malignancy treatment surgery,use of targeted drugs,multiple metastases,and the pattern of Chinese medicine use by reviewing and analyzing the clinical data of lung cancer brain metastasis patients.and the correlation of factors such as the pattern of Chinese medicine use,opening up new ideas of clinical application of Chinese medicine evidence corresponding to different stages and states,and providing objective basis and treatment direction for brain metastasis of lung cancer in clinical practice.Material and method:Eighty-nine samples of brain metastases from lung cancer from January,2020 to December,2022 were collected from the Department of Oncology,Liaoning University of Traditional Chinese Medicine,and all patients were analyzed for TCM staging and related prognostic factors and herbal medicine use.Statistical analysis was performed using SPSS27,Pearson chi-square test and Fisher’s exact probability method with P<0.05 for significance.Then two-by-two comparisons were made to see if they were statistically significant.Medication analysis was performed to create an Excel database of all prescriptions included in each evidence type,and high-frequency drugs and high-frequency pairs were screened by matrix and pivot view production,and high-frequency pairs were derived by association rule analysis using SPSS Modeler 18.0.Results:1.The highest proportion of brain metastases from lung cancer was due to phlegm and heat,followed by liver and wind with phlegm,liver and kidney with yin deficiency,qi stagnation and blood stasis,and spleen deficiency with phlegm and dampness.The ratio of men to women was 1:1.3.Except for Phlegm,stagnant heat and stagnant phlegm,the number of patients with no smoking history was higher in all the other types of metastases,and there was a difference in the number of patients with no smoking history in liver-kidney yin deficiency compared with other types of metastases.Spleen deficiency with phlegm-dampness and liver wind with phlegm had the highest percentage of supramural sites,Qi stagnation with blood stasis had the highest submural transfer,and phlegm-stasis with heat nodules had the highest supramural and submural transfer.In comparison,there were differences between the distribution of other sites of phlegm-stasis-heat nodules and the rest of the evidence types.Except for Qi stagnation and blood stasis and liver and kidney yin deficiency,all the other patterns were more in patients without targeted drugs than in patients with targeted drugs.In the two comparisons,there was a difference in the use of targeted drugs in the Qi stagnation and blood stasis evidence compared with the other evidence types.2.Among the pathological types of brain metastases from lung cancer,squamous carcinoma accounted for the most in the evidence of phlegm-stasis-heat nodules,and adenocarcinoma accounted for the most in all other types;brain metastases <12 months were more common in the evidence of phlegm-stasis-heat nodules,liver wind with phlegm and liver-kidney yin deficiency,and the highest percentage in the remaining types >12 months;patients who underwent radical lung cancer surgery accounted for the most in the evidence of liver wind with phlegm and spleen deficiency with phlegm-dampness;all types were more common in patients who did not undergo radical lung cancer surgery,and the highest percentage in the evidence of phlegm-stasis-heat nodules.The highest proportion of patients with KPS ≥ 70 were found in phlegm-stasis-heat-junction evidence and qi-stagnation-blood-stasis evidence,and the rest of the evidence types were found in KPS<70,with statistical differences between all the above included factors and TCM evidence types(p<0.05).3.There was no statistically significant difference between patients’ age,gender,smoking history,regional lymph node metastasis,depth of tumor infiltration,single multiple cases,brain metastasis sites,treatment modality,and whether to use targeted drugs for more or less metastasis and TCM evidence type(p>0.05).4.In the study of the related herbal medication pattern,phlegm-stasis-heat knot evidence more calamus and other phlegm-transforming drugs and angelica and other blood-activating drugs and Chen Pi-Fu Ling and other qi-transforming drug pairs.Liver wind phlegm evidence of the use of wind and phlegm dispersing drugs such as Stiphula,Tian Ma,the use of Stiphula-Zhe Bei Mu and other phlegm antispasmodic drug pairs;liver and kidney yin deficiency evidence of the use of nourishing Yin drugs such as Bei Sha Shen,Sheng Di Huang and Bei Sha Shen-Poria and other nourishing Yin and benefiting Qi;Qi stagnation and blood stasis evidence of the use of Chai Hu,Curcuma and Angelica,Zi Cao and other activating blood to dispel blood stasis,the use of Chai Hu-Angelica and other Qi activating drug pairs;spleen deficiency phlegm and dampness evidence of the use of Bai Zhu,Poria and other strengthening the spleen to dispel dampness and Chen Pi-Hanxia and other spleen-strengthening,qi-transforming and phlegm-transforming herbal pairs.Conclusion:1.The causative factors of brain metastasis of lung cancer are mainly "phlegm","stasis" and "deficiency".2.Among patients with brain metastases from lung cancer,there were correlations between pathological type,time of brain metastasis,radical lung cancer surgery,KPS score and the distribution of TCM evidence type(p<0.05),while there were no significant correlations between age,smoking history,gender,primary tumor,regional lymph node metastasis,single and multiple metastases,brain metastasis site,treatment mode,targeted drugs,multiple metastases and TCM evidence type(p>0.05).3.In brain metastasis of lung cancer,the prognosis of phlegm-stasis-heat node certificate is relatively poor,the prognosis of spleen deficiency-phlegm-damp certificate is relatively good,and liver wind with phlegm certificate is most likely to occur in brain metastasis.4.Brain metastasis from lung cancer has the most phlegm-stasis-heat nodules,followed by liver and wind with phlegm,liver and kidney yin deficiency,qi stagnation and blood stasis,and spleen deficiency with phlegm-dampness.In the case of phlegm-stasis-heat nodules,calamus and angelica are mostly used to remove phlegm and eliminate stasis;in the case of liver wind with phlegm,stiff silkworm and asparagus are used to remove wind and phlegm and stop spasm;in the case of liver-kidney yin deficiency,northern ginseng and raw groundnut are used to nourish yin;in the case of qi stagnation and blood stasis,Chai Hu and angelica are used to move qi and eliminate stasis;in the case of spleen deficiency and phlegm-dampness,Bai Zhu and Fu Ling are used to strengthen the spleen and eliminate dampness.