Jia Wang, Zhu Yang, Feng-Xi Long, Jin-Lin Wu, Ting Yu, Dong-Xin Tang

The role of Fuzheng Peiben in clinical oncology

Jia Wang1, 3, Zhu Yang1, 3, Feng-Xi Long1, 3, Jin-Lin Wu1, 3, Ting Yu1, 3, Dong-Xin Tang2, 3,*

1Guizhou University of Traditional Chinese Medicine, Guiyang 550002, China.2First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang 550001, China.3Tumor Inheritance and Scientific and Technological Innovation Talents Base of Traditional Chinese Medicine in Guizhou Province, Guiyang 550001, China.

As one of the treating methods of traditional Chinese medicine (TCM), Fuzheng Peiben method plays an essential role in the treatment of malignant tumors. Combining Fuzheng Peiben treatment with surgery, radiotherapy, chemotherapy, or other Western medicine methods in treating tumor complications and advanced tumors may become a new method. This study aims to reveal the clinical significance of Fuzheng Peiben method in tumor treatment. It is found that Fuzheng Peiben treatment may promote postoperative rehabilitation, prevent postoperative complications, reduce the toxicity of radiotherapy and chemotherapy, improve the efficacy of radiotherapy and chemotherapy, improve the life quality patients with tumors, and inhibit tumor growth. This article will provide a clinical basis for the application of Fuzheng Peiben method in cancer therapy.

Malignant tumors, Fuzheng Peiben theory, Adjuvant therapy, Traditional Chinese medicine

Introduction

According to the 2016 National Cancer Registry, the incidence of malignant tumors in China reached 270.59/1000000, and the mortality rate reached 163.83/1000000 [1]. At present, the treatment of malignant tumors is mainly surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. Traditional Chinese medicine (TCM) treatment characterized by holistic concepts and syndrome differentiation is a unique treatment for malignant tumors in China, and its role in the prevention and treatment of malignant tumors has received more and more attention.

Fuzheng Peiben is a treating method in TCM, aims to improve immunity and disease resistance of the human body. For the treatment of tumors, Fuzheng Peiben method is to improve the "Xu" (description of a symptom in TCM) status of patients with cancer by supplementing and regulating the balance of Yin, Yang, Qi, and Xue (the description of pathogenesis in TCM) of human body, thereby preventing and treating cancer [2]. Some clinical studies reveal that the use of Fuzheng Peiben method may reduce postoperative rehabilitation of patients with malignant tumors or the adverse reactions of radiotherapy and chemotherapy, enhance the efficacy of radiotherapy and chemotherapy, improve overall survival of patients, and improve the immunity of patients. Its mechanism may be related to inhibiting tumor cell proliferation, promoting apoptosis, inhibiting angiogenesis, preventing metastasis, regulating the composition of immune cells, and reversing multidrug resistance [3, 4]. This article will review the role of Fuzheng Peiben theory in tumor adjuvant therapy.

Theoretical exploration of the principle of Fuzheng Peiben

The general principles of strengthening the body in TCM is to improve the deficiency states Qi, Xue, Yin and Yang (a vital force that forms parts of living entity in TCM) and enhance the immunity of the human body. The theory of Fuzheng Peiben to treat cancer is originally derived from the "Huangdi Neijing" (an ancient book of China), which believes that the cause of malignant tumors is the deficiency of Zheng Qi (a theory in TCM, which is alike with the immunity of human body). Therefore, supporting Zheng Qi may resist external evil. Later, Zhang Yuansu. further explored the "Bu" (a theory of TCM, which means to strengthen the immunity of human body) method for treating tumorsNow, Fuzheng Peiben method is widely used in modern medicine. Professor Hua. [5] believe that clinical treatment is based on Fuzheng Peiben method combined with the methods of “Removing dampness and phlegm, removing blood stasis and detoxifying” (treating methods in TCM, which means to promote blood flow and reduce tumor volume), and the curative effect is remarkable. Professor Sun [6] use Fuzheng Peiben as a guiding ideology to treat cancer, thereby enhancing the immunity of patients, improving the effectiveness of radiotherapy and chemotherapy, and reducing the side effects of radiotherapy and chemotherapy. Besides, modern research shows that Fuzheng Peiben has the effect of inducing tumor cell apoptosis, enhancing immunity, and inhibiting tumor cell proliferation [7].

Application of Fuzheng Peiben in the Treatment of Cancer

The combination of Fuzheng Peiben with surgery

Surgery is the primary treatment for malignant tumors, but postoperative complications and postoperative recurrence and metastasis remain a severe problem to affect the overall survival of patients with cancer. Studies have shown that Shiquan Dabu decoction may effectively ameliorate the clinical symptoms of patients with gastric cancer that received operation with Qi and Xue deficiency syndrome. The mechanisms may be related to increasing the levels of total protein, albumin, and hemoglobin [8]. The effective rate of Tiaogan Lipi Hewei decoction combined with acupuncture and domperidone in the treatment of postoperative gastroparesis syndrome in gastrointestinal cancer is about 95.24%, which is much higher than the effective rate of domperidone alone (75%) (< 0.05) [9]. The total effective rate of Hewei Huashi formula in the treatment of gastrointestinal dysfunction after surgery is 98% and is higher than that of omeprazole enteric-coated capsule (82%,< 0.05).

Furthermore, Hewei Huashi formula may affect the intestinal microenvironment of patients with gastrointestinal cancer [10]. Compared with the symptomatic treatment of Western medicine (antipyretic, antiemetic, analgesic, rehydration,.), the TCM may have apparent advantages in reducing fever and improving appetite and pain of patients with hepatocellular carcinoma (< 0.05) [11]. These studies indicate that Fuzheng Peiben may promote postoperative recovery and reduce postoperative complications.

Fuzheng Peiben prescription combined with radiotherapy and chemotherapy

Radiotherapy and chemotherapy are essential treatment methods for malignant tumors. Clinical practice has shown that it may effectively reduce the recurrence and metastasis of malignant tumors. However, the side effects of radiotherapy and chemotherapy also seriously affect the life quality of patients with cancer. Modern medical research proposes that Fuzheng Peiben may have the function to regulate tumor microenvironment and angiogenesis, and consider that it may resist tumor invasion and metastasis, which can provide a basis for the timing of clinical radiotherapy and chemotherapy [12]. Also, a study shows that the use of Shashen Maidong decoction after radiotherapy in patients with head and neck cancer may alleviate the symptoms of oral inflammation and dry pharynx [13]. The effective rate of Fuzheng Guben decoction combined with radiotherapy in the treatment of bone metastasis of cancer is 84%, which is higher than that of radiotherapy alone (56%,< 0.05), and the adverse reactions of radiotherapy could be partially alleviated [14]. The tumor inhibition rate of Fuzheng Peiben-based prescription combined with chemotherapy in the treatment of lung cancer is 56.7%, which was significantly higher than that of chemotherapy alone (23.3%) (< 0.05). Besides, Fuzheng Peiben prescription combined with chemotherapy may enhance the immune function of the human body and improve the life quality of patients with cancer [15]. The improvement rate of KPS in patients with gastric cancer treated with Yangzheng Xiaoji capsule combined with chemotherapy is better than that in the chemotherapy group (< 0.05), and the incidence of gastrointestinal adverse reactions was lower than that in the chemotherapy group only (< 0.05) [16]. The improvement rate of KPS score in patients with colorectal cancer treated with Fuzheng Peiben medicine is significantly higher than that in the chemotherapy group (< 0.05). The incidence of leukopenia (II-IV degree) and appetite are lower than that treated with chemotherapy alone (< 0.05) [17]. These studies demonstrate that Fuzheng Peiben, combined with radiotherapy and chemotherapy, may enhance the therapeutic effect and reduce the toxicity of radiotherapy and chemotherapy. However, the mechanism of Fuzheng Peiben herbs in enhancing treatment efficiency of radiotherapy and chemotherapy is not precise. Whether Fuzheng Peiben medicine is to change the chemotherapy drugs resistance of tumor cells or promote tissue repair requires further research.

Fuzheng Peben prescription combined with other treatments

At present, there are many ways in which modern medicine treats tumors, and targeted therapy and immunotherapy have developed rapidly. Compared with immunotherapy alone, Fuzheng Peiben decoction combined with immunotherapy significantly improved the overall survival of patients with cancer (< 0.05) [18]. Anti-cancer prescription 2 plus high intensity focused ultrasound in the treatment of primary hepatocellular carcinoma may ameliorate the symptoms of patients, reduce the volume of tumors, and improve the life quality of patients [19]. Compared with the targeted therapy alone, Fuzheng Peiben herbs combined with targeted therapy in the treatment of patients with hepatocellular carcinoma improved the ZPS score and FACT-G total score (< 0.05) [20].

Fuzheng Peiben prescription for treatment of tumor complications

Most patients with malignant tumors may develop complications, including cancer pain and cancer fatigue in the later stage. The treatment of Fuzheng Peiben medicine may alleviate the complications of patients and improve the life quality of patients. In one study, the treatment group was given Fuzheng Peiben medicine (Guipi decoction) and Western medicine symptomatic treatment, while the control group was only given Western medicine symptomatic treatment. Results showed that the total score of cancer-induced fatigue in the experimental group was much lower than that in the control group [21]. Similarly, Shuyu pills may also have the function to reduce cancer-induced fatigue [22]. Wannianqing capsule may enhance the anti-cancer pain effect of morphine sulfate controlled-release tablets (< 0.05) [23]. The study on the treatment of hepatocellular carcinoma pain showed that combination Fuzheng Jiedu Huayu decoction with epidural analgesia significantly promote the analgesic effect [24]. These studies may indicate that Fuzheng Peiben treatment may improve symptoms such as cancer fatigue and cancer pain in cancer patients. Modern medicine has limited treatment methods for cancer-related complications such as cancer pain, and Fuzheng Peiben medicine may be a new method for adjuvant treatment.

Fuzheng Peiben prescription for advanced tumor

For patients with advanced cancers, repeated treatment leads to reduced pH physical function and even cachexia, which makes patients unable to tolerate further surgery, radiotherapy, or chemotherapy. In China, TCM may play an anti-cancer role as an alternative treatment. A study of Zilongjin tablet in the treatment of advanced malignant tumors showed this kind of medicine might inhibit tumor growth [25]. Liujunzi decoction may enhance the efficiency of chemotherapy [26]. Shenqi Baizhu powder combines with nutritional support treatment significantly increase the KPS score of patients with advanced cancer [27]. In many cases, treatment methods for patients with advanced cancer are limited, Fuzheng Peiben medicine may have the effect of release cancer pain, enhance the immunity of the human body, and increase patient sensitivity to treatment like chemotherapy. Fuzheng Peiben treatment may serve as an essential adjacent treating method in patients with advanced cancer.

Discussion

According to the theories of TCM, the main causer of human cancer is the deficiency of Zheng Qi, and then the secondary cause is stagnation of pathogenic toxins. Fuzheng Peiben is one of the critical rules of TCM in the treatment of cancer. In clinical tumor treatment, Fuzheng Peiben may play an essential role in inhibiting tumor growth, reducing the side effects of treatment, improving patient immunity, and alleviating tumor-related complications. Studies have shown that Fuzheng Peiben treatment exerts anti-tumor effects by regulating the hypothalamic-pituitary-gonadal axis of the body [28]. It also protects malignant tumors by promoting immune function, protecting and improving hematopoietic function, inhibiting the growth of tumor cells, and controlling tumor cell infiltration and metastasis [29].

Fuzheng Peiben is not completely using nourishing herbs. In clinical application, we should pay attention to the point that the principle of Fuzheng Peiben should not be used singly. It is often combined with the principles of “Ruanjian Sanjie” (a treatment method in TCM), “Qingre Jiedu” (a treatment method in TCM). In short, Fuzheng Peiben has a high clinical application value, and its action law should be further explored to provide more therapeutic basis for tumor clinical work.

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Fuzheng Peiben method aims to strength the immunity of patients with cancer.

Fuzheng Peiben herbs may have the function of enhance the efficiency and reduce the toxicity of radiotherapy and chemotherapy.

Traditional Chinese medicine has a variety of treatment theories for tumor. The method Fuzheng Peiben may have the function of strengthening the immunity of the patient's and may become an important auxiliary theory for treating tumors.

14 August 2019,

*Correspondence: Dong-Xin Tang, First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, NO.71 Baoshan North Road, Yuyan District, Guiyang, Guizhou Province 550001, China. E-mail: tangdongxin@sina.com.

Submitted: 30 June 2019,

Online: 20 September 2019.

Competing interests: Authors declare that they have no competing interests.

Copyright: ?2019 TMR Publishing Group Limited. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License.