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补肺通络解毒法对小鼠Lewis肺癌P53和C-myc蛋白分子表达的影响
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摘要
目的
     肺癌是当今各国最常见的恶性肿瘤。是目前对人类健康和生命威胁最大的常见病,发病率和死亡率在癌症中居首位。防治肺癌已成为人们迫切的愿望和国际医学界重点研究的课题。邱幸凡教授以其独特的理论见解和丰富的临床经验,提出肺癌发生机理为“肺虚络痹毒结”,其治疗方法为“补肺通络解毒”。本研究以中医基础理论为依据、结合现代中医学研究成果及我们的临床工作经验,深入探讨肺癌发生的中医机理,并通过实验研究观察补肺通络解毒方对小鼠Lewis肺癌生活质量、组织形态学、血液流变学、p53蛋白和c-myc蛋白的影响,探讨其作用机制,以指导临床治疗,改善患者生活质量,提高肺癌治愈率。
     理论探讨
     肺癌属于中医“肺积”、“息贲’”等疾病的范畴。《圣惠方》载有治疗息贲上气咳嗽、喘促咳嗽、结聚胀痛、腹胁胀痛、咳嗽见血、痰粘不利、坐卧不安、胸膈壅闷、食少乏力、咳嗽胸痛、呕吐痰涎、面黄体瘦等症状的方药,其所治之症类似于肺癌症状。进一步明确其发病机理,对应用中医药防治肺癌提供理论依据,具有一定的指导意义。故本文从整体观念和“肺虚络痹毒结”理论出发,结合现代中医学研究成果及我们在临床工作中治疗本病的体会,我们认为,肺癌患者,体内正邪相争的态势与病情起伏和预后呈正相关。而其中正气的强弱则是决定肺癌的发生、发展和预后的根本,扶正培本是中医治疗肺癌的重要法则;血气不足,则络脉无以充盈,血行不畅,肺气壅遏,肺失宣降,寒热痰瘀邪毒相裹痹窒肺络;因此在肺虚基础上,络脉痹阻促进了肺癌的形成;癌症是由于“毒根深藏”于体内造成的,此种毒非外感六淫之毒、虫兽之毒,亦异于疫疠毒气,它具有暴戾性、顽固性、多发性、内损性和依附性,发病凶险、怪异、难治。因此,癌毒的产生是肺癌形成的关键。综上所述,本病发病机理可归结为,肺气亏虚,体内外邪气入侵,肺气失调,凝痰、瘀血、热毒胶结于肺络变生癌毒,在此基础上,邱师提出治疗法则为“补肺通络解毒”。经过多年肺癌治疗的临床观察,依此法则加减,可取得较好疗效。
     实验研究
     方法
     建立Lewis肺癌荷瘤小鼠模型,观察补肺通络解毒方高、低二个剂量组和环磷酰胺组对肿瘤的抑制情况。通过观察各组小鼠饮食活动情况和毛发色泽变化及体重的改变,分析补肺通络解毒和环磷酰胺对荷瘤小鼠生存质量的影响;通过全自动血粘度仪检测血流变学指标,分析补肺通络解毒和环磷酰胺对荷瘤小鼠血流变学的影响;通过HE染色观察肺癌组织形态学变化、电镜观察肺癌组织超微结构,流式细胞仪检测荷瘤小鼠凋亡细胞及细胞周期阻滞,分析补肺通络解毒方和环磷酰胺对荷瘤小鼠凋亡周期的影响;通过应用免疫组化检测肺癌细胞p53和c-myc蛋白表达,分析补肺通络解毒方和环磷酰胺对肿瘤相关基因蛋白的影响。
     结果
     1.补肺通络解毒方高、低剂量组和环磷酰胺组的抑瘤率分别达21%35%和46.9%,高低剂量组之间有明显的量效关系,其中低剂量组较模型组有显著性差异(P<0.05);环磷酰胺组较模型组有非常显著性差异(P0.01)。
     2.恶性肿瘤和环磷酰胺化疗均可使小鼠饮食活动情况下降,毛发暗淡脱落,体重减轻,而补肺通络解毒方却可减轻肿瘤对机体的损伤。模型组、中药组之间鼠重比较没有统计学意义(P<0.05),而分别与环磷酰胺组比较均有非常显著性差异(P>0.01);模型组鼠重较正常组明显减轻,具显著性差异(P<0.05)。
     3.补肺通络解毒方低剂量组全血粘度、血浆粘度、红细胞压积、红细胞聚积指数与模型组比较均有非常显著性差异(P<0.01)。
     4.小鼠肺癌组织光、电镜下观察符合癌细胞病理改变,补肺通络解毒方高、低剂量组和环磷酰胺组治疗后均有明显改善。
     5.补肺通络解毒方高、低剂量组,G0/G1细胞比例明显高于模型组(P0.01),尤以补肺通络解毒方低剂量组上升明显。同时实验结果显示,补肺通络解毒方高、低剂量组及环磷酰胺组Lewis小鼠肺癌细胞凋亡率均高于模型组,有非常显著性差异(P0.01),其中补肺通络解毒方低剂量组凋亡率高于环磷酰胺组,有显著性差异(P0.05),而补肺通络解毒方高剂量组凋亡率低于环磷酰胺组,有显著性差异(P0.05)。
     6.小鼠Lewis肺癌组织中的p53蛋白表达明显高于正常组,补肺通络解毒方能降低其表达。
     7.小鼠Lewis肺癌组织中c-myc蛋白表达明显增多,治疗后其表达不同程度减少,以高剂量组明显。
     结论
     1.补肺通络解毒方各剂量组对小鼠Lewis肺癌均有抑瘤作用,呈现一定范围内剂量依赖效应。但补肺通络解毒方直接杀伤肿瘤细胞作用不及环磷酰胺。
     2.补肺通络解毒方低剂量组在减轻肿瘤对机体损害的同时,还能增加小鼠食欲,在一定程度上恢复小鼠活动机能,改善小鼠的生活质量。
     3.补肺通络解毒方低剂量组能显著改善荷瘤小鼠血流变指标,改善血流内环境,从而抑制肿瘤扩增及转移。
     4.从微观角度证实环磷酰胺组和中药组对癌细胞凋亡的成功调控,降低S期细胞比例,抑制其增殖周期,使肿瘤细胞阻滞于G0/G1期,不再进入有丝分裂,进而提高其凋亡率,从而达到抑制肿瘤的作用,其中以补肺通络解毒方低剂量组调控癌细胞凋亡作用最强。
     5.补肺通络解毒方高低剂量组和环磷酰胺组均具有一定的抗肿瘤作用,其机制可能与提高p53蛋白和抑制c-myc蛋白表达有关。
Objects
     Today,Lung cancer is the most common malignant tumor in the world. It is the most threatening diseases to human health and life as well as the leading cause of cancer death, the experimental study based on the theory of Traditional Chinese Medicine, combining Medern Traditional Chinese Medicine search results and our clinic experience, Discussion on the TCM mechanism of lung cancer. And The experimental study observed the effect of BTJ rule to quality of life, Hemorheology, histomorphology, c-myc Protein and p53 protein of Lewis lung cancer, exploring it's mechanisms, which is to guide the treatment.
     Theoretical viewpoints
     In this article,throngh discussing on the characteristic and function of the lung and the relations of lung cancer and the other four intenal organs, combining Modern TCM search results and our clinic experience,we think, the emphasis is on the weakness of lung-qi, pathogenic factor invade, lung-qi disorder, phlegm, blood stasis pyretic toxicity obstructed in Lung collaterals, then produced cancer poison, the basic rule is "bufeitongluojiedu"
     Experiental study
     Methodologys
     To establish lewis lung-cancer tumor-bearing mice model,we observde innibition ratio of high and low does of BTJ and CP. To analyze effect of BTJ and CP on improve tumor-bearing mice's quality life. We studied the effect of BTJ and CP on hemorheology of tumor-bearing mice by detecting peripheral blood. HE staining was used to observe the effect of BTJ and CP on the morphological and ultrastructural structure, flow cytometry test were used to explore the effect of BTJ and CP on cell apoptosis and the cell cycle block; immunohistochermical techniques were to detect the c-myc and p53 protein of lung cancer cell and analysised the effect of BTJ and CP on related tumor-produced gene protein.
     Results
     1. the inbibition ratio of high dose of BTJ is 35%, low is 21 %, CP is 46.9%. It has obvious dose-effect relationship between the BTJ. The inhibition ratio of high dose is obviously (P<0.05); The inhibition ratio of CP is obviously(P<0.01).
     2.Malignant tumor and CP both could low the food and activity of mice, its hair becam dull in colour and lose, lose weight, but BTJ can relieve the damage of Malignant tumor to body. The weight of mice between the modle group and CHM groups had no differences (P>0.05). but respectively comparing with CP group had obvious defferences (P<0.01). the weight of mice in modle group is obviously lower the normal (P<0.05).
     3. Blood viscosity (BV), plasma viscosity (PV), hematocrit (Hct),and red cell aggregation (RCA) of the high does of BTJ had obvious defferences with the molde group. (P<0.01).
     4. Lung cancer tissues of mice correspond with pathological change of cancer cell by light and electron microscopy respectively,which had obvious improvment in BTJ and CP.
     5. BTJ high dose、low dose were obviously higher than those of model group in the ratio of G0/G1cell (P<0.01), espescially BTJ low dose. meanswhile the experience showed that apoptosis rate of BTJ high dose、low dose and CP were obviously higher than those of model group(P<0.01), BTJ low dose were higher than CP in apoptosis rate(P <0.05), but BTJ high dose were lower than CP n apoptosis rate(P <0.05).
     6. Expressions of p53 protein in lung cancer tissues of Lweis mice were obviously higher than that in normal group, BTJ can lower the expressions.
     7. Expressions of c-myc protein in lung cancer tissues of Lweis mice were obviously higher. But the expressions lower of the high dose of BTJ is most obvious by treatment.
     Conclusions
     1. Both two doses of BTJ have inbititory action on lung cancer tumor-bearing mice. It has obviously dose-effect relationship. The dirct cytotoxic effect of BTJ on tumor cell inferior to CP.
     2. BTJH can relieve the damage of Malignant tumor to body. Meanwhile, it also can whet its appetite, restore its active function, improve its quality of life.
     3. BTJH can suppress amplification and metastsis of tumor by improving index of hemorheology.
     4. From microscopic angle we confirm the successful regulation of CP and BTJ to apoptosis, lower the proportion in S phase cell, inhibit growth,led to the lewis cell in G1 phase end, improve its apoptosis rate, then realize to inhibit cancer, in which BTJ low dose is most.
     5. BTJ and CP both have some Anti-tumor Effects, which mechanisms maybe have relations with improving the expressions of p53 and inhibiting c-myc protein in lung cancer tissues.
引文
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