Chinese herbal decoction based on syndrome differentiation as maintenance therapy in patients with extensive-stage small-cell lung cancer: an exploratory and small prospective cohort study.

Objective. To investigate the treatment effect and treatment length of Chinese herbal decoction (CHD) as maintenance therapy on patients with extensive-stage small-cell lung cancer (ES-SCLC) and to reflect the real syndrome differentiation (Bian Zheng) practices of traditional Chinese medicine (TCM). Patients and Methods. Different CHDs were prescribed for each patient based on syndrome differentiation. The length of CHD treatment was divided into two phases for analyzing progression-free survival (PFS) and postprogression survival (PPS). Results. Three hundred and fifty-seven CHDs were prescribed based on syndrome differentiation during the study period. Median PFS was significantly longer in patients who received CHD >3 months than patients who received CHD ≤3 months in the first phase (8.7 months versus 4.5 months; hazard ratio (HR), 0.52; 95% confidence interval (CI), 0.41-0.99; P = 0.0009). Median PPS was significantly longer in patients who received CHD >7 months than patients who received CHD ≤7 months in the second phase (11.7 months versus 5.1 months; HR, 2.32; 95% CI, 1.90-2.74; P = 0.002). Conclusion. CHD could improve PFS and PPS, which are closely related to treatment time and deepness of response of first-line therapy. In addition, CHD could improve body function and keep patients in a relatively stable state.

[Study on percutaneous absorption of xiaozheng zhitong cataplasm].

OBJECTIVE: To study the transdermal behavior of Xiaozheng Zhitong cataplasm in rats. METHOD: With tetrahydropalmatine as the index, the Franz diffusion cell method was adopted for the experiment. Sample content was determined with HPLC. RESULT: The transdermal permeability and the transmission rate of tetrahydropalmatine accumulated for 24 h were 20.20% and 0.744 1 microg x cm(-2) x h(-1), respectively. CONCLUSION: The transdermal behaviors of Xiaozheng Zhitong cataplasm were ideal in conformity with the zero order kinetic model.

[Discussion on six errors of formulas corresponding to syndromes in using the classic formulas].

The theory of formulas corresponding to syndromes is one of the characteristics of Treatise on Cold Damage and Miscellaneous Diseases (Shanghan Zabing Lun) and one of the main principles in applying classic prescriptions. It is important to take effect by following the principle of formulas corresponding to syndromes. However, some medical practitioners always feel that the actual clinical effect is far less than expected. Six errors in the use of classic prescriptions as well as the theory of formulas corresponding to syndromes are the most important causes to be considered, i.e. paying attention only to the local syndromes while neglecting the whole, paying attention only to formulas corresponding to syndromes while neglecting the pathogenesis, paying attention only to syndromes while neglecting the pulse diagnosis, paying attention only to unilateral prescription but neglecting the combined prescriptions, paying attention only to classic prescriptions while neglecting the modern formulas, and paying attention only to the formulas but neglecting the drug dosage. Therefore, not only the patients' clinical syndromes, but also the combination of main syndrome and pathogenesis simultaneously is necessary in the clinical applications of classic prescriptions and the theory of prescription corresponding to syndrome. In addition, comprehensive syndrome differentiation, modern formulas, current prescriptions, combined prescriptions, and drug dosage all contribute to avoid clinical errors and improve clinical effects.

Alleviation of cancerous pain by external compress with Xiaozheng Zhitong Paste.

OBJECTIVE: To observe the clinical effectiveness of a topical application of Xiaozheng Zhitong: Paste (, XZP) in alleviating the cancerous pain of patients with middle/late stage cancer METHODS: By: adopting a random number table, 124 patients enrolled were randomized into the treatment group (64 patients) and the control group (60 patients). In addition to the basic therapy [including the three-ladder (3L) analgesia] used in both groups, topical application of XZP was given to patients in the treatment group for pain alleviation. The analgesic efficacy was recorded in terms of pain intensity, analgesia initiating time and sustaining time, and the optimal analgesic effect revealing time. Meanwhile, the quality of life (QOL) and adverse reactions that occurred in patients were recorded as well. RESULTS: The total effective rate in the treatment group was: 84.38% (54/64), and in the control group it was 88.33% (53/60), showing no significant difference between them (P>0.05), but the analgesia initiating time and the optimal analgesia effect revealing time in the treatment group were significantly shorter (both P<0.01). Moreover, XZP was better in improving patients' QOL, showing more significant improvements in the treatment group than those in the control group in aspects of mental condition, walking capacity, working capacity, social acceptability, sleep and joy of living (P<0.05 or P<0.01). Lower incidence of adverse reactions, such as nausea, vomiting, mouth dryness, dizziness, etc., especially constipation, was noted in the treatment group (P<0.05 or P<0.01). CONCLUSION: Applying an external compress: of XZP showed a synergistic action with 3L analgesia for shortening the initiating time and the optimal effect revealing time, and could evidently enhance patients' QOL with fewer adverse reactions.

[Clinical randomized controlled study on acupuncture for treatment of peripheral neuropathy induced by chemotherapeutic drugs].

OBJECTIVE: To seek the effective treatment for peripheral neuropathy induced by chemotherapeutic drugs. METHODS: Sixty-four cases of peripheral neuropathy induced by Paclitaxel or Oxaliplatin were randomly divided into an acupuncture group and a medication group, 32 cases in each group. The acupuncture group was treated with therapeutic principle of dredging meridians and collaterals, tonifying qi and eliminating blood stasis, supplementing liver and kidney, nourishing blood and tendon. Hegu (LI 4), Taichong (LR 3), Zusanli (ST 36), Qihai (CV 6) and Quchi (LI 11) etc. were selected. The medication group was treated with intramuscular injection of Cobamamide. The neurotoxicity of two groups was compared with questionnaire of peripheral neuropathy induced by chemotherapeutic drugs before and after treatment. RESULTS: The total effective rate for sensory nerve disorder of acupuncture group was 66.7% (20/30), which was superior to that of 40.0% (12/30) in medication group (P < 0.05). CONCLUSION: Acupuncture is more effective than Cobamamide for treatment of peripheral neuropathy induced by chemotherapeutic drugs, especially for moderate and severe sensory nerve disorder induced by paclitaxel.