RESUMO
This paper discusses the theoretical basis of traditional Chinese medicine （TCM） for the treatment of cancer-related fatigue （CRF） based on the principle of treating overstrain with warming in the Huangdi's Internal Classic 《黄帝内经》 and the role of hypothalamic-pituitary-adrenal （HPA） axis dysregulation in CRF， aiming to provide new ideas for the clinical treatment of CRF. In the pulsatile regulation of the HPA axis， cortisol， which is synthesized and released by the adrenal cortex， plays an essential role in the life activities. The abnormal circadian rhythm and reduced serum level of cortisol are major factors leading to CRF. Therefore， increasing the serum level and stimulating the biological activity of cortisol and restoring the normal function of HPA axis are important targets for the treatment of CRF and also the key to the TCM treatment of this disease. According to the TCM principle of treating overstrain with warming， we interpreted the etiology and clinical manifestations of overstrain and further explored the causes of CRF. It is believed that the depletion of Qi and blood， Yin and Yang， and fluid in the kidney， spleen， and liver is the key of the disease， which results in symptoms such as fatigue. Further， we elaborated on the theoretical connotation of warming and summarized the two main treatment principles of tonifying with warm-natured herbs and relieving fever with sweet- and warm-natured herbs. According to the different characteristics of the organs affected by pathogen， we proposed the treatment method of warming kidney to cultivate essence， warming stomach and nourishing spleen to replenish Qi， nourishing liver and tonifying blood to promote Qi movement， and relieving fever with sweet- and warm-natured herbs to alleviate fatigue. The warming method can elevate the serum level and invigorate the biological functions of cortisol in CRF patients， which provides a new theoretical basis for alleviating the symptoms and improving the quality of life of cancer patients in clinical practice.
RESUMO
Ovarian cancer is a malignant tumor of female reproductive system with high morbidity and mortality. Currently， ovarian cancer patients are mainly treated by primary debulking surgery combined with taxotere/cyclophosphamide （TC） chemotherapy， with the five-year survival rate of 36%-46%. Chinese medicinal materials play a positive role in preventing the occurrence and development of ovarian cancer via multiple targets. The flavonoid monomers in representative Chinese herbal medicines， such as Epimedii Folium， Scutellariae Radix， Curcumae Longae Rhizoma， Ginkgo Folium， Bupleuri Radix， and Longicerae Japonicae Flos， have been proved to have significant anti-tumor activity and been widely used in the treatment of malignant tumors. We reviewed the relevant literature and summarized that flavonoid monomers can regulate multiple signaling pathways to inhibit cell proliferation， block tumor cell cycle， induce apoptosis and autophagy， reduce the ability of cell invasion and migration， inhibit tumor angiogenesis， and reverse platinum resistance， thereby inhibiting the occurrence and development of ovarian cancer. Such pathways include phosphatidylinositol 3- kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR） signaling pathway， Janus kinase （JAK）/signal transducer and activator of transcription 3 （STAT3） signaling pathway， mitogen-activated protein kinase （MAPK） signaling pathway， secreted glycoprotein （Wnt）/β-catenin signaling pathway， Notch signaling pathway， and nuclear factor kappaB （NF-κB） signaling pathway. By reviewing the regulatory effect of flavonoid monomers on the signaling pathways of ovarian cancer， we aim to provide a theoretical basis for the research on the roles of flavonoid monomers in inhibiting the occurrence and development of ovarian cancer.
RESUMO
Ovarian cancer is a malignant tumor of female reproductive system with high morbidity and mortality. Currently， ovarian cancer patients are mainly treated by primary debulking surgery combined with taxotere/cyclophosphamide （TC） chemotherapy， with the five-year survival rate of 36%-46%. Chinese medicinal materials play a positive role in preventing the occurrence and development of ovarian cancer via multiple targets. The flavonoid monomers in representative Chinese herbal medicines， such as Epimedii Folium， Scutellariae Radix， Curcumae Longae Rhizoma， Ginkgo Folium， Bupleuri Radix， and Longicerae Japonicae Flos， have been proved to have significant anti-tumor activity and been widely used in the treatment of malignant tumors. We reviewed the relevant literature and summarized that flavonoid monomers can regulate multiple signaling pathways to inhibit cell proliferation， block tumor cell cycle， induce apoptosis and autophagy， reduce the ability of cell invasion and migration， inhibit tumor angiogenesis， and reverse platinum resistance， thereby inhibiting the occurrence and development of ovarian cancer. Such pathways include phosphatidylinositol 3- kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR） signaling pathway， Janus kinase （JAK）/signal transducer and activator of transcription 3 （STAT3） signaling pathway， mitogen-activated protein kinase （MAPK） signaling pathway， secreted glycoprotein （Wnt）/β-catenin signaling pathway， Notch signaling pathway， and nuclear factor kappaB （NF-κB） signaling pathway. By reviewing the regulatory effect of flavonoid monomers on the signaling pathways of ovarian cancer， we aim to provide a theoretical basis for the research on the roles of flavonoid monomers in inhibiting the occurrence and development of ovarian cancer.