Objective: To observe the effect of Yanghetang in chemotherapeutic enhancement response among advanced gastric cancer with syndrome of Yang deficiency

and investigate its mechanism from the perspective of cancer-related inflammation micro-environment. Method: A total of 120 patients of advanced gastric cancer with syndrome of Yang deficiency were randomly divided into two groups

the treatment group (60 cases) that was treated with modified Yanghe Tang plus Doxorubicin (DOX) chemotherapy (3 weeks for a course)

and the control group (60 cases) that was treated with the same chemotherapy alone. After three courses of chemotherapy

quality of life

short-term effectiveness of the two groups were valuated

and serum levels of inflammatory immune factors

and changes in ratio of peripheral Myeloid-derived suppressor cells (MDSCs)

regulatory T cells (Treg) in peripheral blood mononuclear cell (PBMC) between both groups were detected. Result: Improvement rate and effective rate of Karnofsky score in patients of the treatment group were 31.7% and 85.0%

respectively

which were higher than 13.3% and 55.0% of control group (P<0.05). Short-term effectiveness and disease control rate of treatment group were 45.0% and 85.0%

respectively

which were significantly better than 26.7% and 68.3% of control group (P<0.05). Compared with pre-treatment

treatment group showed significant decrease in serum hypoxia induced factor-1α (HIF-1α) (P<0.01)

interlukin-10 (IL-10)

transforming growth factor-β1 (TGF-β1)

tumor necrosis factor-α (TNF-α)

monocyte chemotactic protein-1 (MCP-1) and MDSCs

and percentage of Treg (P<0.05)

and increases in serum IFN-γ (P<0.05)

whereas control group only showed significant advantage of higher levels of IFN-γ and lower percentage of peripheral MDSCs than pre-treatment (P<0.05). In comparison between two groups after treatment

treatment group showed significantly lower serum levels of HIF-1α

IL-10

TGF-β

TNF-α

MCP-1

ratio of peripheral MDSCs

and Treg (P<0.05)

and higher serum levels of IFN-γ than control group (P<0.05). Conclusion: Yanghetang can significantly improve the efficacy and quality of life of gastric cancer patients with syndrome of Yang deficiency treated with chemotherapy. Its effect in chemotherapeutic enhancement response may be correlated with its important mechanisms in remodeling cancer immunity by improving the cancer-related inflammatory micro-environment.