1.Investigation on Correlation of Yang Deficiency and Blood Stasis Syndrome with Cardiac Function and Serum NT-proBNP Expression in Chronic Heart Failure Patients and Their Influence on Prognosis
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(5):1097-1103
Objective To investigate the correlation of yang deficiency and blood stasis syndrome with cardiac function and serum B-type N-terminal pro-brain natriuretic peptide(NT-proBNP)expression in patients with chronic heart failure and their influence on the prognosis of patients.Methods A total of 320 patients with chronic heart failure admitted to Tangshan Hospital of Traditional Chinese Medicine from January 2019 to January 2021 were selected as the research objects.According to the results of traditional Chinese medicine(TCM)syndrome differentiation,160 patients differentiated as yang deficiency and blood stasis syndrome were allocated to the observation group,and 160 patients differentiated as qi deficiency and blood stasis syndrome or qi and yin deficiency syndrome were allocated to the control group.The patients with chronic heart failure of yang deficiency and blood stasis syndrome were followed up for one year after discharge.Based on the follow-up results,the followed-up patients were divided into good prognosis group(104 cases)and poor prognosis group(56 cases).Spearman correlation analysis was used to analyze the correlation of TCM syndromes with serum NT-proBNP levels and cardiac function indicators such as left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),stroke volume per minute(SV),and cardiac output(CO).Multivariate logistic regression analysis was used to explore the risk factors affecting the poor prognosis of patients.Results(1)The serum NT-proBNP level and LVEDD value of the observation group were significantly higher and the LVEF,SV and CO values were lower than those of the control group,and the differences were statistically significant(P<0.05 or P<0.01).(2)Pearson correlation analysis showed that TCM syndromes in patients with chronic heart failure were positively correlated with serum NT-proBNP level and LVEDD value,and were negatively correlated with LVEF,SV and CO values,the differences being statistically significant(P<0.01).(3)The levels of serum NT-proBNP and LVEDD in the poor prognosis group were significantly higher and the values of LVEF,SV and CO were lower than those in the good prognosis group,and the differences were statistically significant(P<0.01).(4)The area under the curve(AUC)of serum NT-proBNP combined with cardiac function indicators for predicting the poor prognosis was 0.942.Logistic regression analysis showed that high levels of serum NT-proBNP and LVEDD were the risk factors for poor prognosis(P<0.01),while high levels of LVEF,SV and CO were the protective factors(P<0.05 or P<0.01)in the patients with chronic heart failure of yang deficiency and blood stasis syndrome.Conclusion The serum NT-proBNP level in patients with chronic heart failure of yang deficiency and blood stasis syndrome is increased.Yang deficiency and blood stasis syndrome is closely related to the serum NT-proBNP level and cardiac function indicators,and NT-proBNP level and cardiac function indicators are correlated with the prognosis of the patients.
2.Analysis of Traditional Chinese Medicine Constitution Types of Nonspecific Low Back Pain and the Influencing Factors for the Thickness of Ligamentum Flavum
Zhou-Hang ZHENG ; Yu ZHANG ; Long CHEN ; Dong-Chun YOU ; Wei-Feng GUO ; Xing-Ming LIU ; Huan CHEN ; Rong-Hai WU
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(5):1103-1108
Objective To investigate the distribution of the traditional Chinese medicine(TCM)constitution types in the patients with nonspecific low back pain(NLBP)and to explore the correlation of the thickness of ligamentum flavum with the age,body mass index(BMI),gender,the presence of diabetes mellitus,and the grading of hypertension.Methods Sixty patients with NLBP admitted to Guangdong Second Traditional Chinese Medicine Hospital from January 2023 to June 2023 were selected as the study subjects.The TCM constitution types of the patients were identified,the thickness of the ligamentum flavum at lumbar vertebrae 4/5 segment(L4/5)disc level was measured by computerized tomography(CT)scanning,and the patients'age,genders,TCM constitution types,BMI,the presence or absence of diabetes mellitus,and hypertension grading were recorded.Correlation analysis and linear regression analysis were used for the exploration of the relevant influencing factors for the thickness of the ligamentum flavum of patients with NLBP.Results(1)The average thickness of ligamentum flavum in the 60 patients with NLBP was(2.60±0.72)mm.(2)The TCM constitutions of NLBP patients were classified into four types,of which blood stasis constitution was the most common,accounting for 21 cases(35.0%),followed by 19 cases(31.7%)of damp-heat constitution,12 cases(20.0%)of phlegm-damp constitution,and 8 cases(13.3%)of qi deficiency constitution.(3)The results of correlation analysis showed that BMI,gender,TCM constitution type and the presence or absence of diabetes mellitus had no influence on the thickness of ligamentum flavum in NLBP patients(P>0.05),while the age and hypertension grading had an influence on the thickness of ligamentum flavum(P<0.01).(4)The results of linear regression analysis showed that the age had an influence on the thickness of the ligamentum flavum(b = 0.034,t = 6.282,P<0.01),while the influence of the hypertension grading had no influence on the thickness of the ligamentum flavum(P>0.05).Conclusion The TCM constitution type of NLBP patients is predominated by blood stasis constitution,the thickness of ligamentum flavum is significantly affected by the age,and hypertension may be a potential factor affecting the thickness of ligamentum flavum.
3.Study on TCM Syndromes of Retinal Vein Occlusion Based on Optical Coherence Tomography Angiography
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(5):1108-1116
Objective To explore the distribution of traditional Chinese medicine(TCM)syndromes in retinal vein occlusion(RVO)and to study the characteristics of optical coherence tomography angiography(OCTA)in RVO patients with various TCM syndrome types.Methods A total of 63 patients(involving 126 eyes)with RVO were selected for retrospective analysis.The Ward hierarchical cluster method was used for the cluster analysis of the patients'syndromes,and then the syndrome types were defined.The clinical information of the patients were summarized and analyzed to explore the distribution of syndrome types.And then the OCTA characteristics of each syndrome type were explored by the OCTA technology and through statistical analysis.Results(1)The analysis of general data showed that among the 63 patients,there were 33 cases of central retinal vein occlusion(CRVO)and 30 cases of branch retinal vein occlusion(BRVO).There were no significant differences in the distribution of gender and the affected side between the two groups(P>0.05),but there was significant difference in the distribution of onset seasons between the two groups(P<0.05).(2)The results of Ward hierarchical clustering showed that the clustering of 4 categories of syndromes was accorded with the clinical practice,and the 4 categories corresponded to qi stagnation and blood stasis type,yin deficiency and yang hyperactivity type,phlegm and blood stasis blocking collaterals type and heart-spleen deficiency type.(3)The analysis of the distribution of TCM syndromes showed that among the 63 patients,qi stagnation and blood stasis type accounted for the highest proportion,being 42.86%(27/63),and the other syndrome types in descending order were phlegm and blood stasis blocking collaterals type[31.75%(20/63)],yin deficiency and yang hyperactivity type[14.29%(9/63)],heart-spleen deficiency type[11.10%(7/63)].(4)The analysis of OCTA characteristics of each syndrome type showed that compared with the healthy eyes,the blood flow density of each retinal layer of in RVO patients with qi stagnation and blood stasis type and phlegm and blood stasis blocking collaterals type was significantly decreased(P<0.05),and the retinal thickness was significantly increased(P<0.05).There was no significant difference in retinal blood flow density and retinal thickness between the affected eyes and the healthy eyes of the other syndromes(P>0.05).The comparison of affected eyes among various syndrome types showed that the blood flow density of each retinal layer of the affected eyes in RVO patients with qi stagnation and blood stasis type was lower than that of the other types(P<0.05),and the blood flow density of phlegm and blood stasis blocking collaterals type was lower than that of yin deficiency and yang hyperactivity type and heart and spleen deficiency type(P<0.05),while there was no significant difference between yin deficiency and yang hyperactivity type and heart-spleen deficiency type(P>0.05).The retinal thickness of each retinal layer of the affected eyes in RVO patients with phlegm and blood stasis blocking collaterals was higher than that of the other types(P<0.05),and the retinal thickness of qi stagnation and blood stasis type was higher than that of yin deficiency and yang hyperactivity type and heart-spleen deficiency type(P<0.05),while there was no significant difference between yin deficiency and yang hyperactivity type and heart-spleen deficiency type(P>0.05).There were no significant differences in macular foveal avascular zone area(FAZ),perimeter(PERIM),blood flow(FLOW)and acircularity index(AI)among RVO patients with various syndrome types(P>0.05).Conclusion The decreased retinal blood flow density is presented in RVO patients with qi stagnation and blood stasis type and phlegm and blood stasis blocking collaterals type,particularly in RVO patients with qi stagnation and blood stasis type.The increased retinal thickness can be found in RVO patients with phlegm and blood stasis blocking collaterals type and qi stagnation and blood stasis type,particularly in RVO patients with phlegm and blood stasis blocking collaterals type.No specific OCTA characteristics are presented in RVO patients with other syndrome types.There are no significant differences in FAZ,PERIM,FLOW and AI among the RVO patients with various syndrome types,either.
4.Analysis of Correlation Between the Occurrence of Seasonal Allergic Rhinitis in Ren-Yin Stem-Branch Year of Chinese Lunar Calendar and Innate Circuit Qi Endowment of the Patients
Zhao-Qian WANG ; Xiang-Ting MA ; Chang GAO ; Ting-Ting CAI ; Zhi-Han CHEN ; Jing LIU
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(5):1116-1122
Objective To analyze the innate circuit qi endowment of patients with seasonal allergic rhinitis(SAR)in Renyin year(Ren-Yin stem-branch year of Chinese lunar calendar).Methods A retrospective study was conducted in 8 918 SAR patients who were treated in the Department of Otorhinolaryngology of Xiyuan Hospital,China Academy of Chinese Medical Sciences in pollen seasons of the spring and autumn(i.e.,the period of March 5 to May 21,and the period of August 7 to September 23)in 2022(Renyin year).The characteristics of circuit qi at birth date of the SAR patient were analyzed.Results The occurrence of SAR in Renyin year was related to the suiyun(yearly circuit phase),sitian(the first half of the alterable yearly circuit qi),dominant qi,and circuit qi combination.The two-factor model analysis showed that the occurrence of SAR in Renyin year was closely related with suiyun-sitian and dominant qi-guest qi.High morbidity of SAR was shown in the patients born in the year of heavenly-stem Ren and earthly-branch Xu,and with the circuit qi features of five circuits being wood circuit,Suiyun being excessive wood circuit,sitian of yangming dryness-gold,zaiquan(the second half of the alterable yearly circuit qi)of shaoyin monarch-fire,dominant qi being yangming dryness-gold,and circuit qi combination being disharmony.The two-factor model analysis showed that the morbidity of SAR was increased in the year with the circuit qi features of suiyun-sitian being excessive wood circuit and taiyang cold-water,and the combination of dominant qi and guest qi being yangming dryness-gold and taiyang cold-water.Conclusion Among the innate circuit qi factors,suiyun,sitian,dominant qi,and circuit qi combination have an impact on the occurrence of SAR.The interaction between innate circuit qi and circuit qi at onset may be one of the important mechanisms leading to the occurrence of SAR.
5.Effect of Huoxue Yiqi Decoction Combined with Pinggan Qianyang Muzu Powder on Blood Lipid Metabolism and Cardiac Function in Female Patients with Essential Hypertension
Xi-Xun LIAO ; Kai-Ge ZHOU ; Yue-Hua LI ; Jie CHEN
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(5):1123-1129
Objective To investigate the effects of Huoxue Yiqi Decoction(composed of Carthami Flos,Crataegi Fructus,Salviae Miltiorrhizae Radix et Rhizoma,and Astragali Radix)combined with Pinggan Qianyang Muzu Powder(composed of Uncariae Ramulus cum Uncis,Prunellae Spica,Chrysanthemi Flos,Lonicerae Japonicae Flos and Cassiae Semen)on blood lipid metabolism and cardiac function in female patients with essential hypertension.Methods A total of 220 female patients with essential hypertension of qi deficiency and blood stasis type were randomly divided into observation group and control group,with 110 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Huoxue Yiqi Decoction orally combined with Pinggan Qianyang Muzu Powder for foot bath on the basis of treatment for the control group.The course of treatment for the two groups covered one month.Before and after treatment,the two groups were observed in the changes of blood pressure,blood lipid,traditional Chinese medicine(TCM)syndrome scores and cardiac function indicators of left ventricular ejection fraction(LVEF)and stroke volume(SV).After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After one month of treatment,the total effective rate of the observation group was 95.45%(105/110),and that of the control group was 84.55%(93/110).The intergroup comparison(tested by chi-square test)showed that the efficacy of the observation group was superior to that of the control group(P<0.01).(2)After treatment,the TCM syndrome scores of primary symptoms and secondary symptoms in the two groups were decreased when compared with those before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.01).(3)After treatment,the levels of systolic blood pressure(SBP)and diastolic blood pressure(DBP)in the two groups were lower than those before treatment(P<0.05),and the decrease of SBP and DBP levels in the observation group was significantly superior to that in the control group(P<0.01).(4)After treatment,the levels of blood lipid indicators of total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)in the two groups were lower than those before treatment(P<0.05),and the levels of high density lipoprotein cholesterol(HDL-C)were higher than those before treatment(P<0.05).The decrease of TC,TG and LDL-C levels and the increase of HDL-C level in the observation group were significantly superior to those in the control group(P<0.01).(5)After treatment,the levels of cardiac function indicators of LVEF and SV in the two groups were higher than those before treatment(P<0.05),and the increase of LVEF and SV levels in the observation group was significantly superior to that in the control group(P<0.01).Conclusion The combination of Huoxue Yiqi Decoction and Pinggan Qianyang Muzu Powder exerts certain effect in the treatment of female patients with essential hypertension of qi deficiency and blood stasis type.The combined therapy is effective on controlling blood pressure,improving blood lipid metabolism and cardiac function indicators.
6.Observation on the Clinical Efficacy of Dongj ing Tiaoshen Comprehensive Therapy Combined with Computerized Cognitive Behavioral Therapy for Insomnia in the Treatment of Chronic Insomnia of Liver Depression and Spleen Deficiency Type
Tian-Hui TAN ; Yu GUO ; Jie-Lin HUANG ; Jiang-Ning QIU ; Xiao-Min XIE ; Xue-Mei CAO
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(5):1129-1136
Objective To observe the clinical effect of Dongjing Tiaoshen Comprehensive Therapy combined with computerized cognitive behavioral therapy for insomnia(CCBT-I)in the treatment of chronic insomnia patients with liver depression and spleen deficiency syndrome.Methods A total of 60 patients with chronic insomnia of liver depression and spleen deficiency type were randomly divided into observation group and control group,30 cases in each group.Both groups of patients were treated with CCBT-I as the basic treatment,the observation group was additionally treated with Dongjing Tiaoshen Comprehensive Therapy,i.e.,mind-regulating acupuncture therapy combined with regular aerobic exercises and Dantian Qigong exercises,and the control group was additionally treated with cranial electrotherapy stimulation.The course of treatment for the two groups covered 4 weeks.The changes of Pittsburgh Sleep Quality Index(PSQI)score,Self-rating Anxiety Scale(SAS)score and Self-rating Depression Scale(SDS)score in the two groups were observed before and after treatment,and the clinical efficacy of the two groups was evaluated after treatment.Results(1)After 4 weeks of treatment,the total effective rate of the observation group was 86.67%(26/30),and that of the control group was 70.00%(21/30).The intergroup comparison(tested by rank sum test)showed that the curative effect of the observation group was significantly superior to that of the control group,and the difference was statistically significant(P<0.05).(2)After treatment,the PSQI scores of the two groups were significantly lower than those before treatment(P<0.05),and the decrease of PSQI scores in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(3)After treatment,the SAS and SDS scores of the two groups were significantly lower than those before treatment(P<0.05),and the decrease of SAS and SDS scores in the observation group tended to be superior to that in the control group,but there was no significant difference between the two groups(P>0.05).Conclusion For the treatment of chronic insomnia of liver depression and spleen deficiency type,the combination of Dongjing Tiaoshen Comprehensive Therapy with CCBT-I can significantly improve the sleep quality,relieve anxiety and depression,and improve the quality of life of the patients,which exerts significant efficacy.
7.Effect of TCM Constitution Correction on Early Asymptomatic Diabetic Peripheral Neuropathy
Yan LONG ; Huan JING ; Shuai-Li HUANG ; Rong FU ; Jian-Fang HU
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(5):1136-1143
Objective To observe the clinical efficacy and safety of traditional Chinese medicine(TCM)constitution correction based on the theory of preventive treatment of disease on the patients with early asymptomatic diabetic peripheral neuropathy(DPN).Methods A total of 87 patients with early asymptomatic DPN were randomly divided into the control group with 43 cases and the trial group with 44 cases.The control group was required to have standard diet,do exercises and take medicines for diabetes.On the basis of treatment for the control group,the trial group was given the corresponding TCM constitution correction regimen according to the predominated constitution types of the patients.The course of treatment for the two groups lasted for 48 weeks.Before and after intervention,the two groups were observed in the alteration of TCM constitution types,and the changes of body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)and nerve conduction velocity(NCV).Moreover,the safety of the two groups was evaluated.Results(1)After the intervention,the constitution of 17 patients in the trial group was transformed into the balanced constitution,while only the constitution of 5 patients in the control group was transformed into balanced constitution.There was a statistically significant difference in the distribution of TCM constitution between the two groups(P<0.05).(2)Before intervention,there were no significant differences in the levels of BMI,SBP,DBP,FPG,HbA1c,TC,TG,HDL-C and LDL-C between the two groups(P>0.05).After intervention,the levels of BMI,SBP and DBP in the two groups and the levels of HbA1c,TC,TG and LDL-C in the trial group were lower than those before intervention(P<0.05 or P<0.01),while the levels of FPG and HDL-C in the control group were higher than those before intervention(P<0.05 or P<0.01).The intergroup comparison showed that the levels of FPG,HbA1c,TG and LDL-C in the trial group were significantly lower than those in the control group(P<0.05 or P<0.01).(3)After the intervention,10 cases in the control group had typical clinical symptoms of DPN,while only 6 cases in the trial group had the clinical symptoms of DPN.Before intervention,there was no significant difference in the motor nerve conduction velocity(MNCV)of bilateral tibial nerve and common peroneal nerve and in the sensory nerve conduction velocity(SNCV)of bilateral sural nerve and superficial peroneal nerve between the two groups(P>0.05).After intervention,the MNCV of bilateral tibial nerve and common peroneal nerve and the SNCV of bilateral sural nerve and superficial peroneal nerve in the control group were slower than those before intervention(P<0.05),while the above indicators of nerve conduction velocity in the trial group were mildly increased compared with those before intervention,but the differences were not significant(P>0.05).The intergroup comparison showed that the MNCV of bilateral tibial nerve and SNCV of bilateral sural nerve and superficial peroneal nerve in the trial group were higher than those in the control group,and the differences were statistically significant(P<0.05).(4)During the intervention,no obvious adverse reactions occurred in the two groups,with high safety.Conclusion The TCM constitution correction can adjust the biased constitution of patients with early asymptomatic DPN,and has certain protective effect on the glucose and lipid metabolism,MNCV of tibial nerve,and SNCV of bilateral sural nerve and superficial peroneal nerve.
8.Study on the Curative Effect of Shenshuai Formula on Patients with Chronic Kidney Disease Stage 3-4 of Spleen-Kidney Qi Deficiency with Internal Accumulation of Turbid-Phlegm and Stasis Type
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(5):1144-1151
Objective To observe the therapeutic effect of Shenshuai Formula(composed of Pinelliae Rhizoma Praeparatum Cum Zingibere et Alumine,Citri Reticulatae Pericarpium,Poria,Atractylodis Macrocephalae Rhizoma,Bambusae Caulis in Taenia,Morindae Officinalis Radix,Centellae Herba,Rhei Radix et Rhizoma,etc.)on patients with chronic kidney disease(CKD)at stage 3-4 of spleen-kidney qi deficiency with internal accumulation of turbid-phlegm and stasis type.Methods Seventy patients with CKD at stage 3-4 of spleen-kidney qi deficiency with internal accumulation of turbid-phlegm and stasis type were randomly divided into a treatment group and a control group,with 35 patients in each group.The control group was given the conventional western medicine integrated treatment for CKD,and the treatment group was given the Chinese herbal decoction of Shenshuai Formula on the basis of treatment for the control group.The course of treatment for the two groups covered 8 weeks.The changes of traditional Chinese medicine(TCM)syndrome scores,renal function indicators of serum creatinine(Scr),blood urea nitrogen(BUN),serum cystatin C(CysC),blood uric acid(UA)and estimated glomerular filtration rate(eGFR),and the level of hypersensitive C-reactive protein(hs-CRP)in the two groups before and after the treatment were observed.Moreover,the TCM syndrome efficacy and clinical safety in the two groups were evaluated.Results(1)During the trial,5 cases in the treatment group and 3 cases in the control group fell off,and eventually a total of 62 patients were included in the trial,including 30 cases in the treatment group and 32 cases in the control group.(2)After 8 weeks of treatment,the total effective rate for TCM syndrome efficacy of the treatment group was 86.67%(26/30),and that of the control group was 59.38%(19/32).The intergroup comparison showed that the TCM syndrome efficacy in the treatment group was significantly superior to that in the control group(P<0.01).(3)After treatment,the scores of TCM syndromes in the two groups were significantly decreased when compared with those before treatment(P<0.01),and the decrease in the treatment group was more obvious than that in the control group(P<0.01).(4)After treatment,the renal function indicator levels of Scr,BUN,CysC and UA in the two groups were decreased when compared with those before treatment(P<0.05),and the level of eGFR was increased when compared with that before treatment(P<0.05).The intergroup comparison showed that the decrease in the levels of Scr,BUN,CysC and UA and the increase in the level of eGFR in the treatment group were superior to those in the control group(P<0.05).(5)After treatment,the inflammatory factor level of serum hs-CRP in the two groups was improved when compared with that before treatment(P<0.05),and the improvement in the treatment group was superior to that in the control group(P<0.05).(6)During the treatment period,no significant changes in the safety indicators such as blood routine test,stool routine test and occult blood test,liver function,electrolyte,and electrocardiogram were presented in the two groups.Conclusion Shenshuai Formula exerts certain effect in the treatment of patients with CKD at stage 3-4 of spleen-kidney qi deficiency with internal accumulation of turbid-phlegm and stasis type.It can relieve the clinical symptoms of the patients to certain extent,effectively decrease the levels of Scr,BUN,CysC and UA,increase the eGFR,improve renal function,lower the level of serum hs-CRP,reduce the micro-inflammatory state of patients,and delay the progress of the disease.
9.Observation on the Safety of Chinese Medicine Combined with Immune Checkpoint Inhibitors for the Treatment of Non-small Cell Lung Cancer at Stage Ⅲ-Ⅳ
Lin ZHOU ; Si-Chong QIU ; Liu-Ning LI ; Xiao-Shu CHAI
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(5):1152-1159
Objective To investigate the clinical safety of Chinese medicine combined with immune checkpoint inhibitors(ICIs)for the treatment of non-small cell lung cancer(NSCLC)at stage Ⅲ-Ⅳ,and to explore the influencing factors of immune-related adverse events(irAEs)in the treatment of stage Ⅲ-Ⅳ NSCLC with ICIs.Methods A retrospective analysis was carried out for the investigation of the distribution of traditional Chinese medicine(TCM)syndromes,related medication information and the occurrence of irAEs in the hospitalized patients diagnosed as stage Ⅲ-Ⅳ NSCLC and treated with Chinese medicine combined with ICIs in the Oncology Department of Guangdong Provincial Hospital of Chinese Medicine(University-town Branch)from September 1,2019 to August 31,2022.And the levels of adverse reactions and their possible influencing factors were analyzed.Results(1)The treatment for the 90 NSCLC patients involved 4 regimens,namely ICIs monotherapy,ICIs combined with chemotherapy,ICIs combined with anti-angiogenic drugs,and ICIs combined with chemotherapy and anti-angiogenic drugs.Among them,ICIs combined with chemotherapy and anti-angiogenic drugs were used most frequently for 52 cases(49.1%).A total of 8 kinds of ICIs drugs were used,of which Tislelizumab accounted for the highest proportion(43 cases,40.6%).(2)All of the patients were classified into 5 syndrome types,namely qi deficiency and phlegm-stasis syndrome,phlegm-stasis obstructing the collateral syndrome,qi and yin deficiency syndrome,qi and blood deficiency syndrome,and phlegm-heat accumulation syndrome.Among them,qi deficiency and phlegm-stasis syndrome was the most common type(80 cases,88.9%).(3)The overall incidence of irAEs was 38.9%(35/90),and irAEs being or above grade 3(G3)level in the patients only accounted for 5.6%(5/90).The initial irAEs usually occurred at the immunotherapy course 1-3(17 cases,48.6%).The incidence of irAEs being or above G3 level in the patients treated with ICIs monotherapy was higher than that in the patients treated with the combined therapy(33.3%vs 3.6%).(4)The Eastern Cooperative Oncology Group(ECOG)performance status(PS)score of 0-1(OR=8.218,95%CI:1.607-42.023,P = 0.011)and adrenal metastasis(OR=4.497,95%CI:1.237-16.354,P=0.022)were the independent risk factors for irAEs in patients with stageⅢ-Ⅳ NSCLC treated by ICIs(P<0.05).Conclusion Chinese medicine has the potential to reduce the incidnence of adverse reactions of ICIs in the treatment of stage Ⅲ-Ⅳ NSCLC.PS score of 0-1 and adrenal metastasis may be the independent risk factors for irAEs in patients with stage Ⅲ-Ⅳ NSCLC treated by ICIs.
10.Effects of Anchang Formula Combined with Aluminium Phosphate Gel on Inflammatory Factors,Immune Function and Intestinal Flora in Patients with Radiation Enteritis Induced by Radiotherapy for Cervical Cancer
Yue-Hong SUN ; Xin-Ying HE ; Da-Peng JIA ; Qiang DU ; Ting-Ting HU ; Hong-Juan YANG ; Yun-Chuan SUN
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(5):1160-1166
Objective To observe the effect of Anchang Formula(mainly composed of Agrimoniae Herba,Sanguisorbae Radix,Poria,Pulsatillae Radix,Atractylodis Macrocephalae Rhizoma,and fried Paeoniae Radix Alba)combined with Aluminum Phosphate Gel on inflammatory factors,immune function and intestinal flora in patients with radiation enteritis caused by radiotherapy for cervical cancer.Methods Seventy-eight patients with radiation enteritis caused by radiotherapy for cervical cancer were randomly divided into combined group(41 cases)and reference group(37 cases).The reference group was treated with Aluminum Phosphate Gel,and the combined group was treated with Anchang Formula combined with Aluminum Phosphate Gel.The course of treatment for the two groups lasted for 15 days.The changes of traditional Chinese medicine(TCM)syndrome scores,serum interleukin 2(IL-2),procalcitonin(PCT),T lymphocyte subsets CD4+,CD8+,CD4+/CD8+ levels and intestinal flora in the two groups were observed before and after treatment.After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After 15 days of treatment,the total effective rate of the combined group was 90.24%(37/41),and that of the reference group was 70.27%(26/37).The intergroup comparison showed that the clinical efficacy of the combined group was significantly superior to that of the reference group(P<0.05).(2)After treatment,the scores of TCM symptoms of mucopurulent bloody stool,diarrhea,tenesmus and abdominal pain in the two groups were lower than those before treatment(P<0.05),and the decrease in the combined group was significantly superior to that in the reference group(P<0.01).(3)After treatment,the levels of serum inflammatory factors of IL-2 and PCT in the two groups were lower than those before treatment(P<0.05),and the decrease in the combined group was more obvious than that in the reference group(P<0.01).(4)After treatment,the levels of immune function indicators of T lymphocyte subsets CD4+ and CD4+/CD8+ in the two groups were higher than those before treatment(P<0.05),and the level of CD8+ was lower than that before treatment(P<0.05).The increase of CD4+ and CD4+/CD8+ levels and the decrease of CD8+ levels in the combined group were more obvious than those in the reference group(P<0.01).(5)After treatment,the levels of intestinal flora of Lactobacillus,Bifidobacterium and Escherichia coli in the two groups were higher than those before treatment(P<0.05),and the increase in the combined group was more obvious that in the reference group(P<0.01).Conclusion Anchang Formula combined with Aluminum Phosphate Gel exerts significant efficacy for the treatment of patients with radiation enteritis caused by radiotherapy for cervical cancer.The combined therapy can effectively relieve the clinical symptoms of patients,reduce the inflammatory reaction,improve the immune function,and balance the intestinal flora.

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