1.Meta-analysis of Aidi Injection Combined with S-1 for Advanced Gastric Cancer
Zhiheng CHI ; Shun YU ; Meng CUI
China Pharmacy 2017;28(33):4675-4678
OBJECTIVE:To evaluate therapeutic efficacy and safety of Aidi injection combined with S-1 for advanced gastric cancer systematically,and to provide evidence-based reference. METHODS:Retrieved from CJFD,Wanfang database,VIP, CBM,Cochrane Library,PubMed and EMBase,randomized controlled trials(RCTs)about Aidi injection combined with S-1(tri-al group) vs. S-1 alone (control group) for advanced gastric cancer were collected. Meta-analysis was conducted by Rev Man 5.3 software after data extraction and quality evaluation by risk bias evaluation tool of Cochrane Handbook Version 5.1.0. RESULTS:A total of 8 RCT were included,involving 690 patients. Results of Meta-analysis showed that there was no statistical significance in therapeutic efficacy of solid tumor between 2 groups [OR=1.19,95%CI(0.88,1.61),P=0.26]. The improvement rate of survival quality[OR=3.62,95%CI(2.48,5.30),P<0.001],immunoglobulin level [CD3:SMD=1.31,95%CI(1.06,1.56),P<0.001;CD4:SMD=1.71,95%CI(1.38,2.04),P<0.001;CD8:SMD=-1.46,95%CI(-1.68,-1.23),P<0.001;CD4/CD8:SMD=1.45,95%CI(1.14,1.76),P<0.001] in trial group was significantly higher than control group. The incidence of leukopenia [RR=0.52,95%CI (0.40,0.68),P<0.001],thrombocytopenia [RR=0.49,95%CI(0.36,0.67),P<0.001] and gastrointestinal disorder [RR=0.56,95%CI(0.43,0.71),P<0.001] in trial group were significantly lower than control group,with statistical significance. CONCLUSIONS:Compared to S-1 alone,S-1 combined with Aidi injection can not significantly improve therapeutic efficacy of solid tumor therapy, but can improve survival quality and immunity of patients,as well as reduce the occurrence of ADR.
2.Clinical Experience of Treating Metabolic Associated Fatty Liver Disease with Huangqi (Radix Astragali) in Lingnan (岭南) Area
Zhiheng CHEN ; Bowen GAO ; Chaozhen ZHANG ; Meijie SHI ; Huanming XIAO ; Yubao XIE ; Xiaoling CHI
Journal of Traditional Chinese Medicine 2023;64(17):1819-1823
Based on the unique syndrome characteristics of metabolic associated fatty liver disease (MAFLD) in Lingnan (岭南) area, this paper discussed the clinical experience of Huangqi (Radix Astragali) in the treatment of MAFLD in Lingnan area. It is summarized that spleen deficiency and yang weakness, and internal accumulation of damp-turbidity are the source of the disease, and at the early stage, Huangqi, commonly 15~30 g, could be used to fortify the spleen and warm the earth, thereby making the deficiency fire latent, as well as raise the clear and warm the exterior so as to inhibit damp-turbidity; medication needs to be progressively supplemented, and can be used together with Taizishen (Radix Pseudostellariae), Baizhu (Rhizoma Atractylodis Macrocephalae), Fuling (Poria), and Fangfeng (Radix Saposhnikoviae) to back up the earth and inhibit dampness. Qi stagnation and blood constraint, yin dampness and heat accumulation are the pathogenesis of disease progression. Huangqi should be taken to invigorate the spleen and flourish the liver, unblock yang, and move stagnation. The dosage is often maintained at 30~60 g, to circulate the qi and unblock yang qi in the middle jiao (焦), usually combined with Chaihu (Radix Bupleuri), Baishao (Radix Paeoniae Alba) and Yujin (Radix Curcumae) integrating warm and cool medicinals. Stubborn turbid and fat condensing in the liver is a severe stage of the disease and may be concurrent with various pathogens such as dampness, phlegm, and heat, for which 60~90 g Huangqi should be used to invigorate blood and disperse fat, reinforce healthy qi and expel pathogens, often with medicinals that can disperse fat and direct the turbid downward such as Shanzha (Fructus Crataegi), Juemingzi (Semen Cassiae), Lulutong (Fructus Liquidambaris) and Zexie (Rhizoma Alismatis). When prescribing, it is suggested to combine with other medicinals according to the season, thereby adjusting the ascending and descending of the property of Huangqi, thereby conforming to the nature of the four seasons.
3.TCM constitution distribution and clinical features of patients with hepatitis B cirrhosis and dysplastic nodules
Mengbing FANG ; Cheng LIU ; Yu ZHANG ; Jiayi ZENG ; Zhiheng CHEN ; Sheng LI ; Xiaoling CHI ; Huanming XIAO
Journal of Clinical Hepatology 2024;40(5):961-967
ObjectiveTo investigate the characteristics of TCM constitution distribution in hepatitis B cirrhosis patients with dysplastic nodules (DN), and to provide a basis for the prevention and treatment of precancerous lesions of liver cancer. MethodsThis study was conducted among 113 hepatitis B cirrhosis patients with DN, 105 hepatitis B cirrhosis patients with regenerative nodules (RN), and 70 hepatitis B cirrhosis patients with small hepatocellular carcinoma (sHCC) who were hospitalized in Guangdong Provincial Hospital of Traditional Chinese Medicine from May 2015 to March 2023. Related data were collected, including age, sex, liver function Child-Pugh class, TCM constitution type, and laboratory markers. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups; the chi-square test was used for comparison of categorical data between groups, and the Bonferroni correction method was used for further comparison between two groups. ResultsThe main TCM constitution types of hepatitis B cirrhosis patients with DN were Qi-deficiency constitution (27 patients, 23.89%), blood-stasis constitution (26 patients, 23.01%), and phlegm-dampness constitution (23 patients, 20.35%). There were significant differences between the three groups in the proportion of patients with phlegm-dampness constitution or damp-heat constitution (χ2=6.822 and 6.383, both P<0.05); the hepatitis B cirrhosis patients with RN had the highest proportion of patients with phlegm-dampness constitution (30.48%), followed by those with DN (20.35%) and those with sHCC (14.29%), while the hepatitis B cirrhosis patients with sHCC had the highest proportion of patients with damp-heat constitution (27.14%), followed by those with DN (16.81%) and those with RN (12.38%). There were significant differences between the hepatitis B cirrhosis DN patients with different TCM constitution types in sex, age, Child-Pugh class, prealbumin, albumin (Alb), aspartate aminotransferase, total bilirubin (TBil), total bile acid, and alpha-fetoprotein (all P<0.05). Compared with the male hepatitis B cirrhosis DN patients, female patients showed a significantly higher proportion of patients with Qi-deficiency constitution (χ2=4.895, P=0.027). Among the patients with Qi-deficiency constitution, the patients with Child-Pugh class A liver function accounted for a significantly lower proportion than those with Child-Pugh class B liver function (χ2=6.380, P=0.012), while among the patients with phlegm-dampness constitution, the patients with Child-Pugh class A liver function accounted for a significantly higher proportion than those with Child-Pugh class B liver function (χ2=8.515, P=0.004). The patients with phlegm-dampness constitution had significantly higher levels of prealbumin and Alb than those with the other four constitutions (all P<0.05), as well as significantly lower levels of TBil and total bile acid than those with damp-heat constitution (P<0.05); the patients with Yin-deficiency constitution had a significantly lower level of Alb than those with qi-deficiency constitution, blood-stasis constitution, or phlegm-dampness constitution (all P<0.05); the patients with Yin-deficiency constitution had a significantly lower proportion of patients with abnormal alpha-fetoprotein than those with non-Yin-deficiency constitutions (χ2=4.448, P=0.035). ConclusionHepatitis B cirrhosis patients with DN mainly have the TCM constitution types of Qi deficiency, blood stasis, and phlegm dampness. The patients with phlegm-dampness constitution seem to have a low probability of carcinogenesis, while those with damp-heat constitution and Yin-deficiency constitution have a relatively high risk of carcinogenesis.