Chinese herbal medicines of supplementing Qi and nourishing Yin combined with chemotherapy for non-small cell lung cancer: A meta-analysis and systematic review.

BACKGROUND: Non-small cell lung cancer (NSCLC) is one of the malignant tumors with the highest incidence and mortality. This meta-analysis aimed to explore the efficacy of the supplementing Qi and nourishing Yin method combined with chemotherapy for the treatment of NSCLC based on qualified randomized controlled trials. METHOD: PubMed, Cochrane, and Embase databases were searched by the index words to identify the eligible studies, and relevant literature sources were also searched. The latest research was performed in December 2017. Of the eligible studies, only those involving randomized controlled trials were included. Relative risks (RR) along with 95% confidence interval (95% CI) were used to analyze the main outcomes. RESULT: A total of 41 studies were involved in the meta-analysis with 1335 objects in the treatment group and 1272 objects in the control group. Compared with chemotherapy, supplementing Qi and nourishing Yin combined with chemotherapy significantly increased the effective rate (RR: 1.37, 95% CI: 1.24-1.51), increased the Karnofsky score (RR: 1.50, 95% CI: 1.39-1.61), and improved the TCM symptom (RR: 1.69, 95% CI: 1.55-1.85). CONCLUSION: These results demonstrated that supplementing Qi and nourishing Yin combined with chemotherapy would have better clinical efficacy in effective rate, the Karnofsky score, and TCM symptom. Most of the included studies had a low Jadad score; however, there is still a need for high-quality, larger-sample, multicentric, and long-term follow-up randomized controlled trials to confirm our conclusion.

Yangfei Kongliu Formula, a compound Chinese herbal medicine, combined with cisplatin, inhibits growth of lung cancer cells through transforming growth factor-ß1 signaling pathway.

OBJECTIVE: To investigate the tumor inhibition effect of Yangfei Kongliu Formula (YKF), a compound Chinese herbal medicine, combined with cisplatin (DDP) and its action mechanisms. METHODS: C57BL/6 mice with Lewis lung carcinoma were divided into six groups: control group (C), DDP group (2 mg/kg, DDP), low-dose YKF group (2.43 g/kg, L), high-dose YKF group (24.3 g/kg, H), low-dose YKF combined with DDP group (L + DDP) and high-dose YKF combined with DDP group (H + DDP). Transforming growth factor-ß1 (TGF-ß1), mothers against decapentaplegic homolog 3 (Smad3) and Smad7 levels were measured with quantitative real-time polymerase chain reaction (qPCR), Western blotting and immunohistochemistry. An enzyme-linked immunosorbent assay was used to analyze the expressions of interleukin-2 (IL-2) and tumor necrosis factor-α (TNF-α). RESULTS: YKF combined with DDP significantly inhibited the growth and metastasis of tumors relative to the control group, and YKF groups (P < 0.05). There was no significant difference between high-dose YKF group and low-dose YKF group (P > 0.05). We also found that the expression levels of TGF-ß1 and Smad3 were both significantly decreased by YKF relative to the control group (P < 0.05). Furthermore, after treatment with YKF combined with DDP, the expression levels of TGF-ß1 and Smad3 were decreased but the expression level of Smad7 was increased relative to the DDP group (P < 0.05). Compared to the DDP group, the combination of YKF and DDP enhanced the effect of tumor inhibition (P < 0.05), showing obvious synergy between YKF and DDP. Treatment with DDP or YKF decreased serum levels of IL-2 and TNF-α relative to the control group (P < 0.05). Furthermore, the expression levels of IL-2 and TNF-α were significantly decreased when treated with YKF in combination with DDP. Co-treatment with YKF and DDP significantly inhibited tumor growth, decreased the expressions of TGF-ß1, Smad3, IL-2 and TNF-α and increased the expression of Smad7; these differences were significant relative to both YKF groups and the control group (P < 0.05). CONCLUSION: YKF can inhibit tumor growth synergistically with DDP, mainly through the TGF-ß1 signaling pathway.