Effects of Jianpi Xiaoai Decoction Combined with FOLFIRI Regimen Chemotherapy in Treating Advanced Colon Cancer Patients with Spleen and Kidney Deficiency Syndrome and Its Impact on Serum FLI-1/Klotho Signaling Pathway
Objective To investigate the clinical effects of Jianpi Xiaoai Decoction combined with FOLFIRI regi-men as chemotherapy in treating advanced colorectal cancer patients with spleen and kidney deficiency syndrome and its influence on the serum Friend leukemia integration 1(FLI-1)/Klotho signal pathway.Methods 140 patients with advanced colon cancer admitted into the Third Department of Oncology,Shanghai Municipal Hospital of Traditional Chinese Medi-cine,from October 2019 to October 2021 were selected and randomly divided into a control group and an observation group,with 70 patients in each group.The control group was treated with FOLFIRI regimen chemotherapy,while the obser-vation group was treated with Jianpi Xiaoai decoction in addition to the FOLFIRI regimen.Each cycle lasted 14 days,and the treatment was administered for three cycles.The short-term efficacy,adverse reactions,symptom scores of spleen and kidney deficiency syndrome,quality of life[karnofsky performance status(KPS)and Quality of life(QOL)],serum tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen(CA)199,and cytokeratin19 fragment antigen 21-1(CY-FRA21-1)],angiogenic factors[vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF),and platelet-derived growth factor(PDGF)],FLI-1 and Klotho mRNA expression levels and progression-free survival(PFS)were observed and compared between the two groups.Results After treatment,the objective response rate in the ob-servation group was 42.86％(30/70)and the disease control rate was 81.43％(57/70),both significantly higher than those of the control group,which were 17.14％(12/70)and 51.43％(36/70),respectively,with statistical significance(P＜0.05).Traditional Chinese medicine(TCM)symptom scores in both groups were lower after treatment compared to be-fore treatment,with statistical significance(P＜0.05);the TCM symptom scores in the observation group were significantly lower than those of the control group,with statistical significance(P＜0.05).KPS and QOL scores in both groups were higher after treatment compared to before treatment,with statistical significance(P＜0.05);the scores of the observation group were significantly higher than those of the control group,with statistical significance(P＜0.05).Serum levels of CEA,CA199,and CYFRA21-1 in both groups were lower after treatment compared to before treatment,with statistical sig-nificance(P＜0.05);the CEA,CA199,and CYFRA21-1 levels of the observation group were significantly lower than those of the control group,with statistical significance(P＜0.05).Serum levels of VEGF,bFGF,and PDGF in both groups were lower after treatment compared to before treatment,with statistical significance(P＜0.05);the VEGF,bFGF,and PDGF levels of the observation group were significantly lower than those of the control group,with statistical significance(P＜0.05).FLI-1 and Klotho mRNA expression levels in serum in both groups were higher after treatment compared to be-fore treatment,with statistical significance(P＜0.05);the FLI-1 and Klotho mRNA expression levels of the observation group were significantly higher than those of the control group,with statistical significance(P＜0.05).During treatment,incidence rates of grade I-Ⅱ leukopenia,liver and kidney function damage,and nausea and vomiting were lower in the ob-servation group than in the control group,with statistical significance(P＜0.05);there were no significant differences in thrombocytopenia and neurotoxicity between the groups(P＞0.05).The median PFS in the observation group was 5.27 months,significantly longer than the control group's 3.20 months,with statistical significance(Log-rank=20.216,P＜0.05).Conclusion Jianpi Xiaoai Decoction combined with the FOLFIRI regimen chemotherapy can improve the short-term efficacy in treating advanced colorectal cancer,alleviate clinical symptoms,improve quality of life,lower tumor mark-ers levels,reduce tumor load,and prolong PFS.Its mechanism may be related to the inhibition of angiogenic factor expres-sion and the regulation of FLI-1/Klotho signaling pathway activation.
Jianpi Xiaoai DecoctionColon CancerSpleen and Kidney Deficiency SyndromeTumor LoadAngio-genic Factor
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