Dong-Xue Sun, Zhu Yang, Feng-Xi Long, Ming-Zhu Li, Guo Chen, Dong-Xin Tang, 2,*

Miao medicine may serve as an essential adjuvant therapy in cancer treatment

Dong-Xue Sun1, Zhu Yang1, Feng-Xi Long1, Ming-Zhu Li1, Guo Chen1, Dong-Xin Tang1, 2,*

1Guizhou University of Traditional Chinese Medicine, Guiyang 550002, China.2First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, NO.71 Baoshan North Road, Yuyan District, Guiyang 550001, China.

The Miao people have formed a unique treatment method for diseases in the long-term survival and development process, which lead to the formation of Miao medicine. Miao medicine is a kind of regional ethnic medicine in traditional Chinese medicine. Many studies and clinical trials have proved that Miao medicine played an active role in the prevention, treatment, and rehabilitation of tumors, which may reduce the recurrence and metastasis rate after tumor surgery, and decrease the toxic and side effects caused by radiotherapy and chemotherapy. Furthermore, Miao medicine may improve immunity and prolong the overall survival of patients with tumor. All these indicate that Miao medicine may serve as an essential adjuvant therapy. This article describes the specific application of Miao medicine in clinical and provides a scientific basis of Miao medicine in the treatment of cancer. received surgery, Yiqi Fuzheng Miao medicine not only prevents tumor metastasis and recurrence, but also reduces postoperative adverse reactions, and promotes patient's recovery after surgery. Miao herbs such as Wochonggang (Baihua Sheshecao,) Jiawo Bianjiannao (Banzhilian,) and Kela (Banxia,) are most used in the clinic. According to pharmacological studies, Miao herb Wamangsai (Heiguteng,) may inhibit the proliferation lung cancer cells, the mechanism of action may be to regulate protein expression levels in p53 and NF-kB pathway through ubiquitin ligase. Furthermore, regulation of PI3K-Akt signaling pathway inhibits metastasis and recurrence of lung cancer[12]. Miao herb Buyouda (Shemei,) has the effect of inhibiting the proliferation of tumor cells, inhibiting tumor growth, and enhancing the immunity of the human body. Tenglong Buzhong decoction is consists of Tengligen (), Shemei (), Yiyiren (), Hujisheng (),., mainly through the activation of Caspase-3, 8 and 9 to promote colorectal cancer cells death, inhibiting VEGF expression and angiogenesis, and also prevents cancer cell metastasis and tumor recurrence after surgery by inhibiting ɑVβ3-FAK and HIF-1ɑ signaling pathways[13].

Miao medicine, Tumor, Combination therapy

Introduction

According to 2018 GLOBOCAN, the number of new cases of malignant tumors worldwide is about 18.08 million, and the number of deaths is about 9.56 million. China accounts for about 23.7% and 30% of the morbidity and mortality, which are significantly higher than the global average[1]. Malignant tumors in China rank second in the cause of death and ranking first in the cause of death in cities[2]. According to the latest data from the National Cancer Registry of China, the top 5 malignant tumors were lung cancer, stomach cancer, colorectal cancer, liver cancer, and breast cancer in China [3]. In 2014, the number of deaths caused by malignant tumors was about 2.296 million (884,000 females and 1.452 million males). The top 5 deaths were caused by lung cancer, liver cancer, stomach cancer, esophageal cancer, and colorectal cancer [3]. How to effectively prevent and treat cancer has become an urgent problem for the medical community. Although Western medicine has achieved remarkable effects in the treatment of tumors, there are still many problems, such as cancer-related pain, drug resistance, the toxicity of radiotherapy and chemotherapy,., still need to be resolved.

The Miao people have formed a unique treatment method for diseases in the long-term survival and development process. For example, in the winter, they drink “Jiu Jiang” (a Miao food, also known as liqueur), and in the summer, they take “Wu Ba” (a Miao food, also known as sour soup). The liqueur has the functions of keeping warm, promoting blood circulation, strengthening the body, and relieving collaterals. The sour soup has the effects of reducing heat, annealing, and heatstroke prevention. Furthermore, Miao medicine is an essential component of TCM [4]. Miao medicine may be a new way to treat tumors. Some studies have revealed that Miao medicine may have the function in preventing the occurrence, infiltration, and metastasis of malignant tumors, improving the efficacy and reducing toxic and side effects of chemoradiotherapy drugs, strengthening the immunity of the human body and reduce the incidence of complications. In this review, we will discuss the role of Miao medicine in cancer therapy.

The description of tumor and pathogenesis of tumor in Miao medicine

There is no accurate description of the tumor in the ancient books of Miao medicine. However, according to patients’ symptoms and signs, the tumor can be included in the category of "Gui Zheng" (a term to describe the tumor in Miao medicine. It is also named turtle disease because the shape of tumor is similar to turtles) [5]. According to the external form and softness of the mass, the "turtle disease" can be divided into the following types: gas turtle, stone turtle, blood turtle, female turtle, and male turtle. The term “male turtle” is similar to the tumor because the disease is difficult to treat, the disease period is short, and the location of the bump is difficult to move.

Miao medicine believes that "poison is the main cause of all diseases. Miao doctor thinks that the sources of "poison" are various, "poison" is distributed in different parts of the body, the toxic substances inside and outside the body coordinates with each other, and promotes and restricts each other [6]. If there is a problem in any process of the body that contacts, ingests, regulates, and discharges toxic substances, the balance will be damaged, and the tumor formed. "Male turtle" disease is composed of a variety of "poisons”, the accumulation of toxins will cause disturbance of metabolism in the body. As a result, the “Male turtle” disease appears, and the tumor gradually forms. So in Miao medicine, the primary method to treat a cancer is to eliminate the “poison” in the human body, and the “Nine methods of detoxification” (according to different kinds of poison, a total of nine methods are used in Miao medicine) [7].

Furthermore, Miao medicine treatment may not only have the function to kill tumor cells but not damage the immunity of the human body. Many of the drugs in “Zhonghua Bencao-Miaoyao volume” ("Chinese Herbal Medicine-Miao medicine volume", an ancient book of TCM), have anti-cancer and analgesic effects, for example, Jiajiangle (Baijiangcao,.), Jianvge (Weilingcai,), Rui-a Dupian (Yanjingdou,)., an extract of Weilingcai, may inhibit the proliferation of A375, LNCaP, and ACHN3 cells, and does not affect normal cell growth [8]. At the same time, the Miao doctor believes that the external treatment method also plays an essential role in tumor treatment, because the external treatment method may excrete toxins from the body. Scraping therapy refers to the treatment of selected acupuncture points (Yintang, Fengchi, Fengfu, Jizhui, Yangziwo,. (acupoints in TCM)), studies have shown that scraping therapy pain may increase the amount of endorphin in the blood, raise the pain threshold, and have analgesic and anti-inflammatory effects [9].

Miao medicine may reduce the recurrence and metastasis rate after tumor surgery

Although some of the tumors are mainly surgically resected, the tumor still has the possibility of metastasis and recurrence. Miao medicine combined with surgical treatment may reduce the recurrence and metastasis of tumors after surgery, prolong the overall survival time of patients with tumors, and improve the life quality of patients. Gangling (Shuizhi,) combined with surgery may effectively reduce tumor recurrence and metastasis. The primary mechanism is the anti-coagulant, improve tumor microenvironment, and inhibits tumor angiogenesis effects of Shuizhi [10]. Shuizhi has an anti-coagulant function and inhibits tumor metastasis by changing the tumor cell phenotype and neutrophil activity. For example, Shuizhi may inhibit the growth of malignant tumors by reducing the expression of p53, Ki267, and VEGF in mouse transplanted tumor cells [10]. Liu. [11] found that Shuizhi extract may interfere with the number of apoptotic cells, mainly by increasing the number of cells in G0/G1 phase, reducing the number of cells in S and G2/M phases, inhibiting DNA synthesis, and increasing NK cell activity.

Miao medicine may reduce the side effects of radiotherapy and chemotherapy

For patients with advanced tumors, radiotherapy, and chemotherapy may be the primary treatment method. The combination of Miao medicine with chemotherapy or radiotherapy may reduce the side effects and enhance the therapeutic effect of chemotherapy or radiotherapy. Clinical trials have shown that patients with advanced lung cancer (adenocarcinoma, squamous cell carcinoma) treated with Miao medicine combined with gemcitabine and cisplatin may suffer much lower side effects [14]. The extract of Banzhilian (D. Don) can be used to inhibit the growth and reproduction of malignant cells. When combined with chemotherapeutic drugs, it may accumulate drugs in the lesions, increase the efficacy of drugs, enhance the effect of chemotherapy, and alleviate the toxic effects of chemotherapy on normal tissue cells [12]. Ruiba (Xianhecao,Ldb.) may inhibit the proliferation of a variety of tumor cells, Combining Xianhecao with chemotherapy drugs may reduce the toxic effects of chemotherapeutic drugs. Besides, the extract of Xianhecao may arrest the cell cycle of gastric cancer cells, colon cancer cells, and other malignant tumors in the G0/G1 phase, preventing the transformation to the M + G2 phase, thus achieving the anti-tumor effect [15]. Moreover, Miao medicine may reverse chemotherapy resistance. For instance, ginseng isolates Rb1, Rh2 (monomers) may compete with anti-tumor drugs to bind P-GP (P-Glycoprotein), reducing drug efflux, and thus reverse the multidrug resistance of tumors [16]. Yan. have shown that Kushen () combined with cyclosporine A may reduce the expression of P-GP in the T24/ADM cell membrane and reverse the multidrug resistance [17]. Studies have shown that Chanchu () induces apoptosis of tumor cells, inhibits tumor cell proliferation, and enhances the immunity of the human body [18]. Jia-ouwu (Dangshen,) and Kai-ou (Huangjing,) have the effects of promoting the activity of hematopoietic stem cells, enhancing the immunity of the human body, and reducing side effects such as bone marrow suppression caused by radiotherapy and chemotherapy [19]. The extract of Miao medicine Ouhan Gama (Fengweicao,) may inhibit the growth and activity of tumors cells (sarcoma and liver cancer) by enhancing immunity [20]. These results indicate that the combination of Miao medicine with chemotherapy and radiotherapy drugs may reduce the side effects and enhance the efficacy of drug reactions chemotherapy and radiotherapy.

Miao medicine has apparent advantages in rehabilitation treatment

Cancer pain is one of the most painful symptoms encountered in patients with end-stage tumors, and about 70% of patients suffer from severe pain. The WHO recognizes that cancer pain is mainly controlled by the “three-step drug analgesic method”, but the treatment effect is not satisfaction [21]. According to the patient's physical condition, the principle of comprehensive treatment is applied, to continuously prevent cancer pain, control adverse drug reactions, and reduce the psychological burden. [22]. Miao doctors use fresh herb medicine and always have a single cube, which has significant advantages in intervening in cancer pain. "Male turtle" disease is based on the theory of "poison". Miao medicine has the functions of detoxification and attacking poison. The Journal of Modern Pharmacology has reported that Miao medicine has the effects of analgesia, anti-inflammatory, and inhibition of inflammatory factors expression, and as a result, Miao medicine may alleviate the symptoms of cancer pain [23]. For example, Gaba Haohu (Leigongteng,) has a good analgesic effect on cancer pain. Studies have shown that the extract of Leigongteng has a natural anti-cancer effect, and it is hopeful that it will become a low-toxic and highly effective anti-cancer medicine like paclitaxel [24]. Zhitongwei pills have a good analgesic effect on some patients with cancer pain [25]. Besides, Miao's unique technology called paper-fired moxibustion is a combination of anti-inflammatory and analgesic, which may significantly relieve pain [26].

Cancer-induced fatigue is common in cancer patients. Compared with normal fatigue, it has a long duration, a substantial degree, and cannot be relieved by rest. Miao medicine has achieved remarkable results in the treatment of cancer-induced fatigue [27]. Miao medicine belongs to the category of a chronic disease caused by unexplained or overworked [28]. According to the symptoms and signs, different patients may receive different treatment. Daji (Biejia,), Ji Jianuo (Yangquehue Gen,Kom), Douwobo (Digupi,), Douwogang (Sangye, Folium Mori),. may affect strengthen the immunity of the human body. Moreover, myelosuppression is the main side effect caused by radiotherapy and chemotherapy. Jia-ouwu (Dangshen,) and Kaiou (Huangjing,) have the effects of promoting hematopoietic stem cell hematopoiesis, enhancing immunity, and reducing side effects such as bone marrow suppression caused by radiotherapy and chemotherapy [29].

Discussion

Miao medicine has the advantage of reducing toxicity and increasing efficiency, delaying the disease cycle, and improving the life quality of patients with cancer, who received therapies like radiotherapy and chemotherapy. At present, the research on malignant tumors mainly focuses on autophagy, apoptosis, inflammatory microenvironment, signaling pathway, oxidative damage, immune regulation,. The anti-tumor mechanisms of some single drugs and compound drugs are summarized as follows (Table 1). However, there are many questions in a lot of clinical and experimental reports that are worth thinking. In the related research of malignant tumors, we usually choose single or double factor intervention, but the occurrence, infiltration, and metastasis of malignant tumors are the results of multi-factor interaction maintenance. Therefore, the study of the multi-factor, multi-signal, and multi-signal pathway is the main direction of our research. A great feature of Miao medicine is different from Western medicine is that different types of Miao medicine may work on the same target and signal pathway. In addition to the treatment of tumors or adjuvant therapy, Miao medicine may affect tumor-related complications, such as cancer-related fatigue, cancer pain, and bone marrow suppression. In addition to the traditional oral drugs, its external treatment of Miao medicine, for example, sputum acupuncture therapy, Miao nationality technology, paper-fired moxibustion, has a significant effect on the treatment of cancer pain. However, clinical and experimental evidence is still not insufficient to support the functions of Miao medicine.

Table 1 Anti-tumor neovascularization and related mechanisms of some Miao herbs

At present, Miao medicine research mainly focuses on the monomer of Miao herbs, but Miao medicine has synergistic and multi-target effects. It is more meaningful to study the multi-target and multi-channel mechanism of Miao medicine compound at the cellular level. However, many works of literature use medical animal experiments as observation indicators, and they all stay in the experimental stage. Without consulting medicine and clinical research, it is necessary to combine the ideas of transformational medicine, strengthen the relationship between basic research and clinical practice, and form a unified and standardized diagnosis and treatment standard.

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Miao medicine may serve as an adjuvant therapy in cancer treatment.

Miao medicine may reduce the recurrence and metastasis rate after tumor surgery.

Traditional Chinese medicine includes many kinds of regional ethnic medicine, such as Miao medicine. Miao medicine has unique insights in cancer treatment. Studies on Miao medicine is still insufficient, its unique treatment methods may bring new ideas to cancer treatment. The use of Miao medicine in treating cancer may require more experimental and clinical evidence

Submitted: 13 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.

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.