Clinical observation of Yifei Fuzheng Jiedu method for preventing and treating chemotherapy-induced myelosuppression in lung cancer patients and its mechanistic impact on the Wnt/β-catenin pathway
益肺扶正解毒法防治肺癌化疗骨髓抑制的临床观察及对Wnt/β-catenin 通路的机制影响

摘要

目的 本研究拟探讨益肺扶正解毒法对肺癌化疗相关骨髓抑制的干预效果，并重点研究其对WNT/β-catenin信号通路的影响。方法 采用随机对照试验设计，将60例接受化疗的肺癌患者随机分为两组，对照组30例仅接受常规支持治疗，治疗组30例在常规治疗基础上联合益肺扶正饮（治法为益肺扶正解毒法）。观察两组外周血象（白细胞、血小板、血红蛋白计数）变化，并在治疗期间动态观察两组治疗前后中医证候积分、功能状态（KPS）评分；借助采用流式细胞术动态检测外周血CD34⁺造血干细胞比例，同时通过荧光定量PCR动态检测血清中Wnt3a、c-Myc的mRNA表达水平。结果 与对照组相比，治疗组患者化疗后外周血象指标下降幅度更小（P<0.05），中医证候积分明显下降，KPS评分明显著提升（P<0.05）。机制分析显示，与对照组相比，治疗组干预14天后，Wnt3a、c-Myc mRNA表达及外周血CD34⁺细胞比例均接近正常水平，差异无统计学意义（P>0.05）。组内比较显示：治疗后7天，两组各指标均较治疗前明显改变（P<0.05）；治疗后14天，对照组各指标仍显著异于治疗前及治疗后7天（P<0.05），而治疗组各指标仅与治疗后7天存在显著差异（P<0.05），且两组各时间点比较差异均有统计学意义（P<0.05）。结论 益肺扶正解毒法能够缓解肺癌患者化疗后骨髓抑制程度，提高机体免疫力，改善生活质量，其作用机制可能与上调 Wnt3a、c-Myc 表达，提升外周血CD34+细胞比例有关。

Abstract

Objective This prospective randomized controlled trial was designed to explore the clinical efficacy and underlying mechanism of Yifei Fuzheng Jiedu Therapy in mitigating chemotherapy-induced myelosuppression in patients with lung cancer, focusing on its regulatory effects on key molecules within the Wnt/β-catenin signaling pathway.
Methods A randomized controlled trial was designed. Sixty chemotherapy-treated lung cancer patients were randomized into control (n=30) and treatment (n=30) groups. The control group received conventional supportive care only, while the treatment group was supplemented with Yifei Fuzheng Yin (therapeutic principle: YFJ therapy). Peripheral blood cell counts were evaluated pre- and post-treatment, and TCM syndrome scores and KPS scores were dynamically tracked. CD34+ hematopoietic stem cells were dynamically analyzed by flow cytometry, and Wnt3a/c-Myc mRNA expression was dynamically measured by qRT-PCR.
Results Compared with the control group, patients in the treatment group had a smaller decrease in peripheral blood indicators after chemotherapy (P<0.05), a significant reduction in TCM syndrome scores, and a marked improvement in KPS scores (P<0.05).Following 14 days of intervention, Wnt3a/c-Myc mRNA expression and CD34+ cell proportion in the treatment group returned to normal levels, with no inter-group difference (P>0.05).Intra-group analysis demonstrated significant changes in all indicators at 7 days post-treatment vs baseline in both groups (P<0.05). At 14 days, control group indicators still differed from baseline and 7-day values (P<0.05), whereas treatment group indicators differed in 7-day values (P<0.05). All inter-group comparisons at each time point were significant differences(P<0.05).
Conclusion   Our findings indicate that YFJ herapy mitigates chemotherapy-related myelosuppression, boosts immune function, and improves quality of life in lung cancer patients. Its mechanism could involve upregulating Wnt3a/c-Myc expression and increasing peripheral blood CD34+ cell proportion.