

浏览全部资源
扫码关注微信
扬州大学 医学院(扬州大学 转化医学研究院),国家中医药管理局胃癌毒邪论治重点研究室, 扬州大学 肿瘤防治重点实验室,江苏 扬州 225001
Received:05 May 2019,
Published Online:16 August 2019,
Published:05 April 2020
移动端阅览
Ze-wen CHU, Yan-qing LIU. Effect of Traditional Chinese Medicine in Treatment of Lymphatic Metastasis of Gastric Cancer[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(7): 225-231.
Ze-wen CHU, Yan-qing LIU. Effect of Traditional Chinese Medicine in Treatment of Lymphatic Metastasis of Gastric Cancer[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(7): 225-231. DOI: 10.13422/j.cnki.syfjx.20192324.
胃癌的发病率和死亡率在所有肿瘤中均较高,我国因为胃癌死亡的人数每年高达49.8万人。由于早期胃癌的发病特征不明显,多数到医院治疗的患者均已是中晚期胃癌,给家庭和社会都带来了沉重的负担。中晚期胃癌的术后生存期显著低于早期胃癌,其中最重要的原因在于胃癌的淋巴转移。淋巴转移是胃癌的主要转移途径,进展期胃癌的淋巴转移率高达70%左右,早期胃癌也可有淋巴转移。胃癌的淋巴结转移率和癌灶的浸润深度呈正相关。目前的治疗手段除手术切除、淋巴化疗及分子靶向治疗外,中医药因其中毒性低、治疗效果好、价格低的优势也发挥了重要的作用。中医认为胃癌的发生多因饮食不洁、情志失调、素体亏虚而致痰凝、气阻、血瘀与胃发为本病,病机总属本虚标实,临床中医治疗多以化痰解毒、健脾益气、温中散寒为主。近年来,多项研究证明中医药治疗胃癌淋巴转移在临床中疗效显著、作用广泛,其可能通过抑制基质金属蛋白酶对基底膜和细胞外基质(ECM)的水解,激发肿瘤失巢凋亡,抑制淋巴管新生,调控与肿瘤相关基因的表达等途径来治疗胃癌淋巴转移。文章从近年来中医药在治疗胃癌淋巴转移中的理论研究、实验研究以及临床研究的进展进行综述,揭示中药作用的机制及其作用靶点,以期为中医药治疗胃癌淋巴转移的深入研究以及临床上的应用提供科学依据。
The incidence and mortality of gastric cancer are higher among all kinds of tumors
and the number of deaths due to gastric cancer in China is as high as 498 000.Because the pathogenesis of early gastric cancer is not obvious
most patients who have been treated in hospitals are already in middle and advanced stages of gastric cancer
which brings a heavy burden to families and the society. The postoperative survival of patients of advanced gastric cancer is significantly lower than those of early gastric cancer. The most important reason is lymphatic metastasis of gastric cancer. Lymphatic metastasis is the main metastasis pathway of gastric cancer. The lymphatic metastasis rate of progressive gastric cancer is as high as 70%
and early gastric cancer can also have lymphatic metastasis. The lymph node metastasis rate of gastric cancer was positively correlated with the infiltration depth of the tumor. In addition to surgical resection
lymphatic chemotherapy and molecular targeted therapies
traditional Chinese medicine(TCM) has also played an important role due to the advantages of a low toxicity
good therapeutic effect and low price. According to the theory of TCM
the occurrence of gastric cancer is caused by unclean diet
emotional disorders
and deficiencies
which result in phlegm
Qi resistance
blood stasis
and attack the stomach. The pathogenesis is the asthenia in origin and asthenia in superficiality
and clinical TCM therapies mostly focus on phlegm and blood stasis
spleen and Qi
warm and cold. In recent years
a number of studies have proved that TCM has a significant and effective effect in the treatment of lymphatic metastasis of gastric cancer. It may inhibit the anoikis and the tumor by inhibiting the hydrolysis of matrix metalloproteinase on the basement membrane and extracellular matrix (ECM)
stimulating tumor anoikis
suppressing lymphatic neovascularization
regulating tumor-associated gene expression and other pathways
so as to treat lymphatic metastasis of gastric cancer. This article reviews the advance of theoretical research
experimental research and clinical research of TCM in the treatment of lymphatic metastasis of gastric cancer in recent years
and reveals the mechanism of TCM and its targets
in order to provide scientific basis for further studies and clinical application of the effect of TCM on the lymphatic metastasis of gastric cancer.
F BRAY , J FERLAY , I SOERJOMATARAM , et al . Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J]. CA Cancer J Clin , 2018 , 68 : 394 - 424 .
S W PAN , P WANG , H W HUANG , et al . A proposal of a personalized surveillance strategy for gastric cancer: a retrospective analysis of 9191 patients [J]. Gastroenterol Res Pract , 2019 , 2019 : 3248727 .
G NARDONE . Molecular basis of gastric carcinogenesis [J]. Aliment Pharmacol Ther Symp Ser , 2003 , 17 ( S2 ): 75 - 81 .
何裕隆 . 胃上部癌消化道重建方式的合理选择与争议 [J]. 中国实用外科杂志 , 2011 , 31 ( 8 ): 730 - 731 .
刘喜平 , 李沛清 , 张炜 . 中医药防治胃癌腹膜转移的思路与方法 [J]. 中医杂志 , 2012 , 53 ( 4 ): 288 - 290 .
赵颖 , 修丽娟 , 王晓炜 , 等 . 魏品康从痰论治胃癌学术思想初探 [J]. 中国中医药信息杂志 , 2017 , 24 ( 5 ): 106 - 109 .
贺静静 , 马春燕 , 侯爱画 . 侯爱画教授运用中药联合化疗治疗中晚期胃癌经验总结 [J]. 世界最新医学信息文摘 , 2019 , 19 ( 12 ): 161 , 163 .
陈伟霞 , 陈彬 , 竹永宝 , 等 . 邱佳信教授健脾类复方胃肠安在胃癌治疗中的研究进展 [J]. 世界中医药 , 2017 , 12 ( 11 ): 2864 - 2868 .
金一顺 . 郁仁存教授治疗胃癌经验 [J]. 光明中医 , 2017 , 32 ( 24 ): 3536 - 3539 .
曹超 , 黄秋林 . 扶正抑瘤方联合新辅助化疗、腹腔镜辅助胃癌根治术治疗进展期胃癌痰瘀毒结证患者的疗效观察 [J]. 中国实验方剂学杂志 , 2018 , 24 ( 8 ): 176 - 182 .
侯天将 , 由凤鸣 , 祝捷 , 等 . 从中医对淋巴组织生理特性的认识论治恶性淋巴瘤 [J]. 辽宁中医杂志 , 2017 , 44 ( 4 ): 741 - 743 .
K Y JIANG , H M LIU , D Y XIE , et al . Differentially expressed genes and are potential prognostic biomarkers for gastric cancer [J]. Oncol Lett , 2019 , 17 ( 3 ): 3191 - 3202 .
Q WU , B ZHANG , Z H WANG , et al . Integrated bioinformatics analysis reveals novel key biomarkers and potential candidate small molecule drugs in gastric cancer [J]. Pathol Res Pract , 2019 , 215 : 1038 - 1048 .
王瑞平 , 朱超林 , 刘包欣子 , 等 . 健脾养正消癥方对裸鼠胃癌移植瘤及肝转移灶的生长转移及相关基因的影响 [J]. 中国实验方剂学杂志 , 2015 , 21 ( 3 ): 164 - 168 .
张彦博 , 李琦 , 刘艳娜 , 等 . 左金丸通过Wnt/ β -catenin信号通路对幽门螺杆菌感染的人胃癌细胞转移的影响 [J]. 上海中医药大学学报 , 2015 , 29 ( 2 ): 44-47,52 .
李丹 , 金凤 , 陶丽 , 等 . 金龙胶囊对胃癌细胞MGC-803和BGC-823侵袭转移能力的影响 [J]. 中国实验方剂学杂志 , 2018 , 24 ( 19 ): 117 - 123 .
王海波 , 顾昊 , 赵雪煜 , 等 . 南蛇藤提取物通过调控基质金属蛋白酶组及其抑制因子抑制人胃癌SGC-7901细胞侵袭转移的研究 [J]. 中草药 , 2016 , 47 ( 8 ): 1345 - 1350 .
S G KIM , J H YOOUN , D E KIM , et al . A novel anti-cancer agent, FPDHP, induces anoikis in various human cancer cells through activation of calpain, and downregulation of anoikis-related molecules [J]. J Cell Biochem , 2018 , 119 ( 7 ): 5620 - 5631 .
P GUPTA , N GUPTA , N FOFARIA , et al . HER2-mediated GLI2 stabilization promotes anoikis resistance and metastasis of breast cancer cells [J]. Cancer Lett , 2018 , 442 : 68 - 81 .
Y YUAN , H Q YE , Q C REN . Upregulation of the BDNF/TrKB pathway promotes epithelial-mesenchymal transition,as well as the migration and invasion of cervical cancer [J]. Int J Oncol , 2018 , 52 : 461 - 472 .
A CAMPOS , C SALOMON , R BUSTOS , et al . Caveolin-1-containing extracellular vesicles transport adhesion proteins and promote malignancy in breast cancer cell lines [J]. Nanomedicine (Lond) , 2018 , 13 ( 20 ): 2597 - 2609 .
K WANG , X ZHU , D MEI , et al . Caveolin-1 contributes to anoikis resistance in human gastric cancer SGC-7901 cells via regulating Src-dependent EGFR-ITGB1 signaling [J]. J Biochem Mol Toxicol , 2018 , doi: 10.1002/jbt.22202 http://dx.doi.org/10.1002/jbt.22202 .
沈克平 , 刘威 , 胡兵 , 等 . 四藤方对人胃癌SGC-7901细胞抗失巢凋亡的影响 [J]. 世界中西医结合杂志 , 2010 , 5 ( 12 ): 1025 - 1028 .
肖真真 , 邓海霞 , 陈更新 , 等 . 养正散结汤对人胃癌MKN-45细胞增殖、凋亡及ERK通路的影响 [J]. 中国实验方剂学杂志 , 2019 , 25 ( 3 ): 39 - 44 .
何立丽 . 养胃抗瘤冲剂对中晚期胃癌预后的影响及诱导细胞凋亡的分子机制 [D]. 北京 : 中国中医科学院 , 2010 .
惠怡然 . Bit1在食管鳞癌细胞耐药中的作用及其机制初探 [D]. 郑州 : 郑州大学 , 2018 .
郑佳露 , 闫霞 , 沈克平 , 等 . 藤梨根抗肿瘤作用及机制 [J]. 中华中医药学刊 , 2017 , 35 ( 10 ): 2562 - 2564 .
J H CHOI , Y H OH , Y W PARK , et al . Correlation of vascular endothelial growth factor- D expression and VEGFR-3-positive vessel density with lymphnode metastas is in gastric carcinoma [J]. J Korean Med Sc , 2008 , 23 ( 4 ): 592 - 597 .
C MASSIMILIANO , B SIMONE , M JOACHIM , et al . Platelet-derived growth factor- D enables liver myofibroblasts to promote tumor lymphangiogenesis in cholangiocarcinoma [J]. J Hepatol , 2019 , 70 ( 4 ): 700 - 709 .
F KATO , N WADA , T HAYASHIDA , et al . Experimental and clinicopathological analysis of HOXB9 in gastric cancer [J]. Oncol Lett , 2019 , 17 : 3097 - 3102 .
X DAI , D LIU , M LIU , et al . Anti-metastatic efficacy of traditional Chinese medicine (TCM) ginsenoside conjugated to a VEFGR-3antibody on human gastric cancer in an orthotopic mouse model [J]. Anticancer Res , 2017 , 37 ( 3 ): 979 .
叶民峰 , 林方琴 , 周秋利 , 等 . 参麦注射液对晚期胃癌血清VEGF和MMP-3水平的影响 [J]. 浙江临床医学 , 2017 , 19 ( 2 ): 248 - 250 .
曾进浩 , 潘华峰 , 赵自明 , 等 . 健脾化瘀解毒复方治疗胃癌前病变的临床疗效及对HIF-1 α 、VEGF表达的影响 [J]. 时珍国医国药 , 2018 , 29 ( 7 ): 1544 - 1548 .
刘晓菲 , 李静蔚 , 孙庆颖 , 等 . 阳和化岩汤对HER-2高表达型裸鼠荷瘤模型微淋巴管生成及PI3K/Akt交互调控通路的影响 [J]. 中医杂志 , 2019 , 60 ( 1 ): 51 - 56 .
陈应凯 , 蒋迎九 . 肿瘤新生淋巴管生成的研究进展 [J]. 现代医药卫生 , 2017 , 33 ( 15 ): 2300 - 2303 .
米志宽 , 赵菊梅 . 抑癌基因甲基化与胃癌关系研究进展 [J]. 陕西医学杂志 , 2019 , 48 ( 5 ): 679 - 681 .
裘敬平 . 抑癌基因ARHI对BGC823胃癌细胞自噬、侵袭转移的影响及机制研究 [D]. 沈阳 : 中国医科大学 , 2018 .
宋艳琦 , 霍永利 , 董笑一 , 等 . 浊毒1号方对胃癌前病变大鼠胃黏膜细胞凋亡及Bcl-2基因表达的影响 [J]. 新中医 , 2019 , 51 ( 4 ): 19 - 21 .
钱晓兰 , 左云 . 八珍颗粒辅助化疗对晚期胃癌细胞免疫指标和P53蛋白、IL-6表达的影响 [J]. 现代医学 , 2018 , 46 ( 12 ): 1339 - 1344 .
R ZHANG , G WANG , P F ZHANG , et al . Sanguinarine inhibits growth and invasion of gastric cancer cells via regulation of the DUSP4/ERK path-way [J]. J Cell Mol Med , 2017 , 21 ( 6 ): 1117 .
黄丽萍 , 陈国忠 , 刘锟荣 , 等 . 基于TFF3、ERK/NF- κ B信号通路探讨加味七方胃痛颗粒对人胃癌细胞株SGC7901增殖凋亡的影响 [J]. 辽宁中医杂志 , 2018 , 45 ( 7 ): 1516 - 1521 .
胡志辉 . 复方斑蝥胶囊联合XELOX方案对胃癌术后血清转移相关指标水平和T淋巴细胞亚群的影响 [J]. 中医学报 , 2018 , 33 ( 4 ): 536 - 540 .
吴金成 . 复方斑蝥胶囊联合化疗治疗老年晚期胃癌疗效观察 [J]. 光明中医 , 2015 , 30 ( 12 ): 2642 - 2643 .
李兆元 , 宁四清 , 易铁男 , 等 . 复方斑蝥胶囊联合化疗及放疗治疗中晚期原发性肝癌的疗效观察 [J]. 中华全科医学 , 2013 , 11 ( 8 ): 1250 - 1251 .
张公正 , 刘素娜 , 宋秋岗 . 消癌平联合XELOX方案对晚期胃癌恶性分子表达的影响 [J]. 安徽医学 , 2017 , 38 ( 5 ): 568 - 571 .
倪冲 , 裴志东 , 张镓小 , 等 . 乌骨藤中白桦酯酸的提取分离及抗肿瘤活性 [J]. 中国实验方剂学杂志 , 2012 , 18 ( 9 ): 172 - 175 .
J OLUGBAMI , G MICHAEL , O OYERONKE . In vitro free radical scavenging and antioxidant properties of ethanol extract of terminalia glaucescens [J]. Pharmacognosy Res , 2015 , 7 ( 1 ): 49 - 56 .
李爱峰 , 印海林 , 蔺梅 , 等 . 华蟾素片联合SOX方案治疗晚期胃癌的临床研究 [J]. 现代药物与临床 , 2019 , 34 ( 3 ): 714 - 718 .
倪腾洋 , 李丹 , 王海波 , 等 . 华蟾素通过调控基质金属蛋白酶抑制人胃腺癌细胞MGC-803侵袭与迁移 [J]. 中国实验方剂学杂志 , 2018 , 24 ( 19 ): 106 - 111 .
闫兵杰 , 韩娜娜 . 复方苦参注射液联合改良FOLFOX6化疗方案对晚期胃癌患者血清T细胞亚群、CEA水平及生存质量的影响 [J]. 北方药学 , 2019 , 16 ( 2 ): 136 - 137 .
靳祎祎 , 林久茂 . 中医药对肿瘤化疗药物增效减毒作用的研究进展 [J]. 福建中医药 , 2019 , 50 ( 1 ): 85 - 88 .
温映华 , 梁健 , 邓鑫 , 等 . 中医药联合化疗预防胃癌术后复发的Meta分析 [J]. 湖南中医杂志 , 2016 , 32 ( 9 ): 145 - 147 .
许国彩 , 赞梅 . 参芪扶正注射液联合恩度治疗中晚期胃癌疗效及对患者免疫功能和生活质量的影响 [J]. 世界华人消化杂志 , 2015 , 23 ( 7 ): 1130 - 1135 .
李英芝 , 杜君 . 自拟清腹通排汤联合中西医结合护理对胃癌术后胃肠道功能影响 [J]. 辽宁中医药大学学报 , 2019 , 21 ( 5 ): 204 - 207 .
徐薇 . 健脾解毒方辅助化疗治疗晚期胃癌的疗效及安全性观察 [J]. 光明中医 , 2019 , 34 ( 5 ): 767 - 769 .
丁芋友 . 健脾益肾汤防治含顺铂化疗所致恶心呕吐的临床研究 [D]. 成都 : 成都中医药大学 , 2014 .
王瑛 , 段和力 , 袁鹤立 . 胃癌综合治疗的研究进展 [J]. 临床合理用药杂志 , 2018 , 11 ( 3 ): 168 - 169 .
0
Views
19
下载量
2
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621