Background: The incidence and mortality of lung cancer is the highest among malignant tumors worldwide, and it seriously threatens human life and health. Surgery is the primary radical treatment for lung cancer. However, patients often experience discomfort, changes in social roles, economic pressures, and other postsurgical challenges. These factors frequently cause various psychological disorders such as anxiety and depression, significantly diminishing the quality of life and elevating the risks of recurrence, metastasis, and mortality. Therefore, effective strategies for mental function rehabilitation should be urgently developed. Traditional Chinese medicine can significantly improve psychological function and physical symptoms after lung cancer surgery, and prolong patient survival. However, its effectiveness for mental function rehabilitation after lung cancer surgery remains unclear. This study aimed to investigate the effects of Chinese medicine on mental function recovery after lung cancer surgery through a systematic review and meta-analysis. Methods: This study will systematically search the following databases: PubMed, Cochrane Library, EMBASE, Web of Science, ClinicalTrials.gov, China National Knowledge Infrastructure, Wanfang database, VIP database, and Chinese BioMedical Literature database. Search for studies published from the inception of each database until April 22, 2024. This study will be limited to clinical randomized controlled trials (RCTs). The primary outcome will be depression or anxiety, as indicated by the scale score. Data analysis will be performed using RevMan 5. The Cochrane Risk of Bias Assessment Tool will be used to evaluate the quality of included studies. Finally, the quality of the evidence will be classified using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) System. Results: This meta-analysis aims to offer comprehensive evidence of the effectiveness of traditional Chinese medicine in mental function rehabilitation after lung cancer surgery. The study will assess the quality of the reports and conduct a subgroup analysis based on various postoperative stages, intervention measures, intervention duration, and sex to gather more evidence to fill the gap in psychological function rehabilitation after lung cancer surgery. These data can be used to guide clinical practice and inform future studies. More importantly, the results of this study will provide evidence to support the development of expert consensus and clinical guidelines in the field of mental function rehabilitation after lung cancer surgery.
OBJECTIVE:This study was conducted to elucidate the distribution characteristics of predominant unbalanced constitutions and TCM syndrome elements in patients with recurrent and metastatic gastric cancer. This study was also undertaken to analyze the potential relationship between the body constitutions of patients, syndrome elements, and biological indicators, as well as to investigate the effect of Yiqi Wenyang Jiedu prescription (YWJP) on symptoms and biological indicators before and after treatment. RESULT:Yang-deficiency and Qi-deficiency were identified as prevalent imbalanced constitutions among patients with recurrent and metastatic gastric cancer. The primary syndrome factors associated with disease localization included the spleen-stomach and liver, with the main syndrome elements being Qi-deficiency, Yang-deficiency, and Qi-stagnation. Patients with Qi-deficiency and Yang-deficiency constitutions exhibited lower BMI and higher monocyte-to-lymphocyte ratio (MLR). A notable positive correlation was observed between cold (Yang-deficiency) and BMI, as well as between Qi-deficiency constitution and neutrophil-to-lymphocyte ratio (NLR). Furthermore, YWJP demonstrated efficacy in alleviating symptoms associated with Qi-deficiency and Yang-deficiency in patients with recurrent and metastatic gastric cancer, including dyspnea, fatigue, diaphoresis, cold intolerance, abdominal sounds, postural changes, and abdominal distension. DISCUSSION:Yang-deficiency and Qi-deficiency emerged as prevalent constitutional patterns in patients with recurrent and metastatic gastric cancer. Notably, BMI, MLR, and NLR may serve as physiological indicators of these conditions. Furthermore, YWJP treatment demonstrated potential efficacy in alleviating symptoms associated with Qi-deficiency and Yang-deficiency in this patient population. CLINICAL TRIAL REGISTRATION:Chinese Clinical Trial Registry: ChiCTR2200055826.
BACKGROUND Gastric cancer (GC) is the fifth most commonly diagnosed malignancy worldwide, with over 1 million new cases per year, and the third leading cause of cancer-related death. AIM To determine the optimal perioperative treatment regimen for patients with locally resectable GC. METHODS A comprehensive literature search was conducted, focusing on phase II/III randomized controlled trials (RCTs) assessing perioperative chemotherapy and chemoradiotherapy in treating locally resectable GC. The R0 resection rate, overall survival (OS), disease-free survival (DFS), and incidence of grade 3 or higher nonsurgical severe adverse events (SAEs) associated with various perioperative regimens were analyzed. A Bayesian network meta-analysis was performed to compare treatment regimens and rank their efficacy. RESULTS Thirty RCTs involving 8346 patients were included in this study. Neoadjuvant XELOX plus neoadjuvant radiotherapy and neoadjuvant CF were found to significantly improve the R0 resection rate compared with surgery alone, and the former had the highest probability of being the most effective option in this context. Neoadjuvant plus adjuvant FLOT was associated with the highest probability of being the best regimen for improving OS. Owing to limited data, no definitive ranking could be determined for DFS. Considering nonsurgical SAEs, FLO has emerged as the safest treatment regimen. CONCLUSION This study provides valuable insights for clinicians when selecting perioperative treatment regimens for patients with locally resectable GC. Further studies are required to validate these findings.
Introduction Postoperative recurrence and metastasis of gastric cancer (GC) are primary factors that contribute to poor prognosis. GC recurs at a rate of approximately 70%-80% within 2 years after local treatment and approximately 90% within 5 years. "Yang-deficient toxic node" is the core pathogenesis of GC recurrence and metastasis. The Yiqi Wenyang Jiedu prescription (YWJP), a form of complementary and alternative medicine in China, is an empirical remedy to prevent postoperative recurrence and metastasis of GC. Taking the main therapeutic principles of "nourishing Qi and warming Yang, strengthening Zhengqi, and detoxifying" can aid in preventing the recurrence and metastasis of GC in patients during the watchful waiting period after surgery and adjuvant chemotherapy. This approach aims to enhance the quality of life of patients. However, high-quality evidence to support this hypothesis is lacking. This study will aim to investigate the efficacy and safety of YWJP to prevent and treat postoperative metastasis and GC recurrence. Methods The study will be a multicenter, randomized, double-blind, placebo-parallel-controlled clinical trial. A total of 212 patients who completed adjuvant chemotherapy within 8 months of radical gastrectomy will be enrolled. Patients in the intervention group will receive the YWJP, whereas those in the control group will receive a placebo. The main outcome was the disease-free survival (DFS) rate 2 years after surgery. The secondary outcomes included DFS time, overall survival, annual cumulative recurrence and rate of metastasis after 1-3 years, cumulative annual survival after 1-3 years, fat distribution-related indicators, tumor markers, peripheral blood inflammatory indicators, prognostic nutritional index, symptoms and quality of life evaluation, medication compliance, and adverse reaction rate. Discussion There is a lack of effective therapy after the completion of adjuvant therapy during the postoperative period of watchful waiting. This study will be the first randomized clinical trial to evaluate whether complementary and alternative medical interventions can effectively prevent recurrence and metastasis during the watchful waiting period after GC surgery and to provide evidence for surveillance treatment management after GC surgery. Clinical trial registration ClinicalTrials.gov, identifier NCT05229809.
Immunotherapy is a novel treatment approach for malignant tumors, which has opened a new journey of anti-tumor therapy. Although some patients will show a positive response to immunotherapy, unfortunately, most patients and cancer types do not achieve an ideal response to immunotherapy. Therefore, it is urgent to search for the pathogenesis of sensitized immunotherapy. This review indicates that Fusobacterium nucleatum, Coprobacillus cateniformis, Akkermansia muciniphila, Bifidobacterium, among others, as well as intestinal microbial metabolites are closely associated with resistance to anti-tumor immunotherapy. While natural products of pectin, inulin, jujube, anthocyanins, ginseng polysaccharides, diosgenin, camu-camu, and Inonotus hispidus (Bull).Fr. P. Karst, Icariside I, Safflower yellow, Ganoderma lucidum, and Ginsenoside Rk3, and other Chinese native medicinal compound prescriptions to boost their efficacy of anti-tumor immunotherapy through the regulation of microbiota and microbiota metabolites. However, current research mainly focuses on intestinal, liver, and lung cancer. In the future, natural products could be a viable option for treating malignant tumors, such as pancreatic, esophageal, and gastric malignancies, via sensitizing immunotherapy. Besides, the application characteristics of different types, sources and efficacy of natural products in different immune resistance scenarios also need to be further clarified through the development of future immunotherapy-related studies.
Background Studies from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021 can guide screening and prevention strategies for tracheal, bronchus, and lung (TBL) cancer. We aim to provide global, regional, and national estimates of the TBL cancer burden and its attributable risk from 1990 to 2021, including during the coronavirus disease 2019 (COVID-19) pandemic. Methods Incidence, age-standardised incidence rate (ASIR), deaths, age-standardised mortality rate (ASMR), disability-adjusted life years (DALYs), age-standardised rate of DALYs (ASDR), and the burden due to risk factors associated with TBL cancer were analysed from 1990 to 2021. Trends in ASIR, ASMR, and ASDR of TBL cancer during the COVID-19 pandemic (2019-2021) - 2021) were also determined. All statistical analyses were performed using Join-point software (version 4.9.1.0). Findings Between 1990 and 2021, the global incidence, deaths, and DALYs of TBL cancer to varying degrees. However, the ASIR (Average Annual Percent Change [AAPC], - 0.3 [-0.4 - 0.4 to-0.2]), - 0.2]), ASMR (AAPC, - 0.5 [-0.7 - 0.7 to-0.4]), - 0.4]), and ASDR (AAPC, - 0.9 [-1.0 - 1.0 to - 0.7]) all showed a decreasing trend. However, the ASIR, ASMR, and ASDR of TBL cancer in males all showed a decreasing trend from 1990 to 2021. In contrast, the ASIR and ASMR of TBL cancer in females showed an increasing trend, while the ASDR showed a relatively stable trend. During the COVID-19 pandemic, the trends for ASIR, ASMR, and ASDR remained stable across both sexes combined, females, males, fi ve socio-demographic index (SDI) quintiles, and the 21 GBD regions. In 2021, smoking was a major risk factor for TBL cancer DALYs, but the attributable ASDR for smoking decreased from 1990 to 2021 in both sexes combined, as well as individually for males and females. Conversely, the attributable ASDR for secondhand smoke, high fasting plasma glucose and occupational exposure factors increased primarily among females. Furthermore, the attributable ASDR for ambient particulate matter pollution, household air pollution from solid fuels, and low-fruit - fruit diets increased primarily in regions with lower SDI quintiles from 1990 to 2021. Interpretation The burden attributable to TBL cancer has increased in some populations from 1990 to 2021, highlighting the importance of implementing targeted measures to mitigate this trend. No significant fi cant change in the burden of TBL cancer was observed during the COVID-19 pandemic; however, post-COVID-19 rates still require further observation.
e24054 Background: Cancerous pain (CP) is a troublesome symptom which can not be adequately controlled. It is reported by several clinical studies that Huachansu can help to relieve CP. However, its mechanism is unclear. In this study, we try to use network pharmacology to explore the underlying mechanism of Huachansu capsule (a capsule form of Huachansu) in the treatment of CP. Methods: Firstly, we collected Huachansu capsule’s active compounds from the literature. And then DrugBank and SwissTargetPrediction were used to obtain the drug targets. Genecards, OMIM, Drugbank, CTD, TTD and DisGeNET were used to gather CP-related genes. Cytoscape 3.7.2 was applied to construct the PPI network. The candidate genes were screened according to betweenness centrality (BC), closeness centrality (CC), degree centrality (DC) and local average connectivity (LAC). A PPI enrichment analysis was performed by MCODE. GO and KEGG analysis were carried out by Metascape. Results: In this study, we collected 11 active compounds and 235 CP-related targets of Huachansu capsule. Go analysis showed that the main related-biological functions included immune response, cytokine-mediated signaling, hypoxia. The main related-KEGG pathways included MAPK, AMPK, mTOR, erbB, Chemokine, TNF, HIF-1, toll-like receptor, PI3K-Akt, cAMP and NF-Kappa B signaling pathway. Conclusions: This study provides a systematic view of the polypharmacological characteristics of Huachansu capsule for pain treatment. Nevertheless, it still need to be verified by in vitro or in vivo studies.
Anthracycline (ANT)-induced cardiotoxicity (AIC) is a particularly prominent form of cancer therapy-related cardiovascular toxicity leading to the limitations of ANTs in clinical practice. Even though AIC has drawn particular attention, the best way to treat it is remaining unclear. Updates to AIC therapy have been made possible by recent developments in research on the underlying processes of AIC. We review the current molecular pathways leading to AIC: 1) oxidative stress (OS) including enzymatic-induced and other mechanisms; 2) topoisomerase; 3) inflammatory response; 4) cardiac progenitor cell damage; 5) epigenetic changes; 6) renin-angiotensin-aldosterone system (RAAS) dysregulation. And we systematically discuss current prevention and treatment strategies and novel pathogenesis-based therapies for AIC: 1) dose reduction and change; 2) altering drug delivery methods; 3) antioxidants, dexrezosen, statina, RAAS inhibitors, and hypoglycemic drugs; 4) miRNA, natural phytochemicals, mesenchymal stem cells, and cardiac progenitor cells. We also offer a fresh perspective on the management of AIC by outlining the current dilemmas and challenges associated with its prevention and treatment.
Cancer and cardiovascular diseases are major contributors to global morbidity and mortality, and their seemingly separate pathologies are intricately intertwined. In the context of cancer, the cardiovascular disease encompasses not only the side effects arising from anti-tumor treatments but also the metabolic shifts induced by oncological conditions. A growing body of research indicates that lipid metabolic reprogramming serves as a distinctive hallmark of tumors. Furthermore, anomalies in lipid metabolism play a significant role in the development of cardiovascular disease. This study delves into the cardiac implications of lipid metabolic reprogramming within the cancer context, closely examining abnormalities in lipid metabolism present in tumors, cardiac tissue, and immune cells within the microenvironment. Additionally, we examined risk factors such as obesity and anti-tumor therapy. Despite progress, a gap remains in the availability of drugs targeting lipid metabolism modulation for treating tumors and mitigating cardiac risk, with limited advancement seen in prior studies. Here, we present a review of previous research on natural drugs that exhibit both shared and distinct therapeutic effects on tumors and cardiac health by modulating lipid metabolism. Our aim is to provide insights for potential drug development.
Cancer has become one of the most important causes of human death. In particular, the 5 year survival rate of patients with digestive tract cancer is low. Although chemotherapy drugs have a certain efficacy, they are highly toxic and prone to chemotherapy resistance. With the advancement of antitumor research, many natural drugs have gradually entered basic clinical research. They have low toxicity, few adverse reactions, and play an important synergistic role in the combined targeted therapy of radiotherapy and chemotherapy. A large number of studies have shown that the active components of Paris polyphylla (PPA), a common natural medicinal plant, can play an antitumor role in a variety of digestive tract cancers. In this paper, the main components of PPA such as polyphyllin, C 21 steroids, sterols, and flavonoids, amongst others, are introduced, and the mechanisms of action and research progress of PPA and its active components in the treatment of various digestive tract cancers are reviewed and summarized. The main components of PPA have been thoroughly explored to provide more detailed references and innovative ideas for the further development and utilization of similar natural antitumor drugs.
ETHNOPHARMACOLOGICAL RELEVANCE:Kanglaite injection (KLTi), a Chinese herbal medicine, is used as an adjuvant treatment for non-small-cell lung cancer (NSCLC).AIMS OF THE STUDY:To provide an evidence-based endorsement for the clinical application and selection of KLTi by evaluating the reporting quality, methodological quality, risk of bias, and evidence quality of systemic reviews (SRs).MATERIALS AND METHODS:SRs of KLTi adjuvant therapy of NSCLC were searched by using 12 databases, consulting experts, and retrieving relevant conference papers until 2022.03.24. The treatment group received KLTi in combination with other therapies, regardless of dosage, duration, or the therapy combined. Network meta-analyses and SRs using repeated data were excluded. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines 2009, A MeaSurement Tool to Assess systematic Reviews, Risk of Bias in Systematic Review, and the Grading of Recommendations Assessment, Development and Evaluation were used to assess the quality of reports, methodological quality, risk of bias, and level of evidence; R was used for visual analysis of the relevant contents.RESULTS:Twenty SRs (13 Chinese and 7 English articles), all authored by Chinese authors as the first author, were included. The reporting information of most included studies was relatively complete (21-27 points), accounting for three-fourths of the total literature. The quality of the methods used in all studies was critically low. The risk of bias was mostly high. Results of the evidence summary showed that among the "moderate" evidence, KLTi combined with chemotherapy had benefits of 9.7-16.4% for objective response rate (ORR) (11 SRs), 8.1-14% for disease control rate (four SRs), and 20.1-28.6% for quality of life (12 SRs) compared with those of chemotherapy alone. The incidence of gastrointestinal symptoms (five SRs) was reduced by 11.5%-23.2%, while that of leukopenia (four SRs) improved by 19.5-29.2%. Combined radiotherapy and targeted therapy had benefits of 25.9% and 16.8%, respectively, in ORR and 31.3% and 22.8%, respectively, in quality of life (the quality of evidence was "low"). The results depicted that treatment with two courses of KLTi produce the best results.CONCLUSION:Our results suggest that KLTi, whether combined with chemotherapy, radiotherapy, or targeted therapy, has an effect on ORR and quality of life and induces adverse reactions, such as leukopenia, nausea, and vomiting. It may improve patient survival; however, the impact of its low-grade quality on the immune function remains undetermined. Owing to the low reporting quality and methodological quality and high risk of bias of the SRs and the included studies, clinical application of KLTi remains unelucidated; higher-quality SRs and randomized controlled trials are necessary in the future.
恶性淋巴瘤发病机制复杂,是临床防治中的难题.本文基于"阳虚痰凝"理论,依据三焦与淋巴组织在位置及生理功能上的相关性,以阳虚导致三焦疏泄失常,凝痰成核为主要病机,提出防治恶性淋巴瘤应重视机体阴阳的动态变化情况,在疾病初起之时以温阳化气行水为主,进展期重视祛瘀排毒消积,后期则主扶阳益阴培本,进而达到恢复三焦正常疏泄功能、化痰消瘤的最终目的,为探求更高效安全的中西医结合治疗方案提供新的思路.
Radiation enteritis is a common intestinal complication arising from abdominal and pelvic malignancies after radiation therapy, which is currently poorly treated by western medicine and greatly affects the quality of life of patients.In this paper, based on the theory of “Zangfu extraordinary connection”,from the perspective of yin and yang properties, generation-inhibition of five elements, and meridian circulation, and in accordance with the western medicine “liver-intestine axis” theory, we clarify the pathological mechanism basis that liver and large intestine are connected with each other in terms of qi and blood, disease transmission and mutual treatment.Moreover, according to the symptoms of radiation enteritis in different periods, we summarized the pathological characteristics of acute radiation enteritis with damp-heat, chronic radiation enteritis with blood deficiency and loss of qi harmony throughout.Therefore, we propose that the treatment should be combined with the patient’s symptoms, the application of liver regulating methods such as clearing heat and dampness, benefiting yin and nourishing blood, regulating qi and relieving depression.If the liver has not been affected, it should be settled first.Since it has been affected, then it should restore its function of lifting and draining, moistening and retaining, thus helping the intestinal bowels to restore its function of purging and excreting, promoting the healing of the disease, in order to supplement and enlighten the subsequent Chinese medicine treatment of radiation enteritis.
BackgroundThe question of whether flexible sigmoidoscopy (FS) for colorectal cancer (CRC) affects incidence or mortality remains unclear. In this study, we conducted a meta-analysis and systematic review to explore this issue.MethodsA systematic search of PubMed, EMBASE, and ClinicalTrials.gov was performed for cohort studies (CS), case–control studies, and randomized controlled trials (RCTs) of people who underwent FS and reported mortality or incidence of CRC until 11 December 2022. Relative risk (RR) was applied as an estimate of the effect of interest. To combine the RRs and 95% confidence intervals, a random-effects model was used. The quality of the included studies and evidence was assessed by the Newcastle-Ottawa quality assessment scale, the Jadad scale, and the “Grading of Recommendations Assessment, Development and Evaluation System.”ResultsThere were a total of six RCTs and one CS, comprising 702,275 individuals. FS was found to be associated with a 26% RR reduction in CRC incidence (RR, 0.74; 95% CI, 0.66–0.84) and a 30% RR reduction in CRC mortality (RR, 0.70; 95% CI, 0.58–0.85). In the incidence subgroup analysis, FS significantly reduced the incidence of CRC compared with non-screening, usual care, and fecal immunochemical testing. Significance was also shown in men, women, distal site, stages III–IV, ages 55–59, and age over 60. In terms of the mortality subgroup analysis, the results were roughly the same as those of incidence.ConclusionAccording to this study, FS might reduce the incidence and mortality of CRC. To confirm this finding, further prospective clinical studies should be conducted based on a larger-scale population.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023388925.
乳腺癌相关淋巴水肿(breast cancer related lymphedema,BCRL)是乳腺癌患者最常见的并发症之一,严重影响患者生活质量,可归属于中医"水肿"范畴.《素问·生气通天论篇》认为"因于气,为肿",水肿的发生与人体之气相关.故本文以此立论,结合乳腺癌患者素体肝郁,经手术、放化疗等现代医学治疗后正气受损,阳气不足,肿块虽除,气滞、瘀毒等有形实邪仍残存体内,阻碍阳气布运流行的特点,探讨从气致肿的机理,并以调和阳气为原则,提出益气温阳健脾、理气疏肝、祛邪化瘀以利水等治法,以期更好的指导临床用药.
肿瘤相关性失眠是与肿瘤发生发展及治疗相关的常见症状,且失眠对肿瘤演变具有负向推进作用.基于《黄帝内经》中营卫循行规律,提出以营卫昼夜"肌表-募原"循环阐释睡眠机理;并根据肿瘤相关性失眠不同表现将其分为寐质、寐时、寐期异常分别施以不同治法.其中入睡困难型寐时异常,核心病机为肝郁而失枢转之职,治以柔肝体、疏肝阴;早醒型寐时异常,核心病机为脾虚失摄,治以健脾疏肝并辅以分时施治;寐浅易醒型寐质异常,核心病机为肺魄不安,治以养血降肺;多梦型寐质异常,核心病机为痰瘀扰心,治以通达募原;主要表现为昼不精、夜不瞑的寐期异常,核心病机为肾阳内损,治以少火生阳.从营卫运行规律探讨肿瘤相关性失眠的病机及辨治,可进一步拓展该病的病机理论内涵与临证治疗思路.
Abstract Objective This study aimed to determine the optimal perioperative treatment regimen for locally resectable gastric cancer (GC). Methods A comprehensive literature search was conducted focusing on phase II/III randomized controlled trials (RCTs) assessing perioperative chemotherapy and chemoradiotherapy in locally resectable GC. The R0 resection rate, overall survival (OS), disease-free survival (DFS), and incidence of grade 3 or higher non-surgical adverse events (SAEs) associated with various perioperative regimens were analyzed. Bayesian network meta-analysis (NMA) was performed to compare the treatment regimens and rank their efficacy. Results A total of 30 RCTs involving 8346 patients were included in this study. Neoadjuvant XELOX plus neoadjuvant radiotherapy and neoadjuvant CF were found to significantly improve the R0 resection rate compared to surgery alone, and the former had the highest probability of being the most effective option in this context. Neoadjuvant plus adjuvant FLOT was associated with the highest probability of being the best regimen for OS. Due to limited data, no definitive ranking could be determined for DFS. Considering non-surgical SAEs, FLO emerged as the safest regimen. Conclusions This study provides valuable insights for clinicians in selecting perioperative treatment regimens for locally resectable GC. However, further studies are needed to validate these findings.
阳微阴弦是《金匮要略》对胸痹病因病机的阐释.在肿瘤的治疗过程中,化学治疗(简称"化疗")产生的心脏毒性可归属于中医学"胸痹"范畴,阳微阴弦对心脏毒性的发生、发展、转归及治疗有重要指导意义.肿瘤患者因病而虚、因药致虚的阳微之本是化疗心脏毒性发生的基本病机,痰浊、血瘀、药毒等阴弦标实是其发作或加重的病理基础.化疗期间,依据患者机体"阳气尚足—阳气渐虚—阳气衰败"及"阴弦不盛—阴弦渐盛—阳衰阴盛"等特点分析不同阶段心脏毒性的病机及临床特点,并以此提出以益气健脾防病生、祛痰化瘀阻其变、温阳利水培其本等治法分阶段论治,以期为中医药在化疗心脏毒性的防治中提供借鉴.
Epidermal growth factor receptor (EGFR) mutations are the most common oncogenic driver in non-small cell lung cancer (NSCLC). Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are widely used in the treatment of lung cancer, especially in the first-line treatment of advanced NSCLC, and EGFR-TKIs monotherapy has achieved better efficacy and tolerability compared with standard chemotherapy. However, acquired resistance to EGFR-TKIs and associated adverse events pose a significant obstacle to targeted lung cancer therapy. Therefore, there is an urgent need to seek effective interventions to overcome these limitations. Natural medicines have shown potential therapeutic advantages in reversing acquired resistance to EGFR-TKIs and reducing adverse events, bringing new options and directions for EGFR-TKIs combination therapy. In this paper, we systematically demonstrated the resistance mechanism of EGFR-TKIs, the clinical strategy of each generation of EGFR-TKIs in the synergistic treatment of NSCLC, the treatment-related adverse events of EGFR-TKIs, and the potential role of traditional Chinese medicine in overcoming the resistance and adverse reactions of EGFR-TKIs. Herbs and active compounds have the potential to act synergistically through multiple pathways and multiple mechanisms of overall regulation, combined with targeted therapy, and are expected to be an innovative model for NSCLC treatment.
基于"传舍"理论,阐述阳虚毒结作为核心病机在胃癌术后复发转移各个环节中的作用,并提出聚阳以遏易"传"之势防复发、护阳以安易"舍"之地防转移、温阳以阻"传舍"之途防浸淫、攻伐以清癌毒之邪除宿根的胃癌术后复发转移的防治思路.在防治胃癌术后复发转移的过程中,当以治阳为纲,灵活运用聚阳、护阳、温阳三法;佐以攻伐清除癌毒,辨证与辨病相结合;同时详辨机体虚实寒热变化,随证治之,以期为临床精准辨治胃癌术后复发转移提供借鉴.