Literature Research on Drug Use Regulation of Miao Medicine in Suppression of Gastric Cancer

Hui-Li Shui, Zhu Yang, Feng-Xi Long, Wen-Qi Huang, Bing Yang, Zhen Zhang, Dong-Xin Tang,

1 Guiyang College of Traditional Chinese Medicine, Guiyang, 550002, Guizhou, China.

2 The Key Laboratory of Treatment on Chronic Pain by Miao Medicine Governed by The State Administration of Traditional Chinese Medicine, Guiyang, 550002, Guizhou, China.

Abstract Objective: To investigate the rule of medication used by Miao medicine to inhibit gastric cancer.Methods: Taking the coil named Miao Medicine of Chinese Materia Medica as data source, formulating "drug name" + "gastric cancer" or "drug name" + "stomach tumor"as the key words to search papers in China Knowledge Network, Weipu Chinese database,Wanfang database to gather drugs that have the effect of inhibiting gastric cancer, this paper made statistical analysis from the views of Wu Xing, Zou Guan, Ru Jia, Efficacy and Toxicity.Results: There are 81 kinds of drugs that suppress stomach cancer eligible for inclusion.And the Soil Xing medicines are the mainstay in the Wu Xing classification, accounted for 70.4%; the distribution of Zou Guan drugs are dominated by Middle and Interior Guan drugs which accounted for 87.7%; Every kinds of Jia group was involved in the distribution of Jiu Jia groups, but the Body Jia, abdomen Jia, Lung Jia and Cave Jia have the most frequent occurrences accounted for 66.9%; the efficacy distribution mainly includes antidote and tonification accounted for 71.6%; the toxicity distribution mostly is non-toxic drugs which is up to 70 kinds.Conclusion: Treating poison and tonifying body are mainly used in the treatment of gastric cancer in Miao medicine, with Middle and Interior Guan medicine, most of which are non-toxic drugs effective in disease location.

Keywords: Miao medicine; gastric cancer; medication rule; literature research

1 Introduction

According to the latest statistics of the National Cancer Center, the number of new cases of gastric cancer in China is nearly 410,000 every year, ranking the second place in the incidence of malignant tumors in China[1].Miao medicine, as a member of traditional Chinese medicine, has a long history. Since ancient times, it has been known as “Miao medical for a thousand years and Miao medicine for ten thousand years”,Miao medicine is unique in the prevention and treatment of many diseases.And Miao people live in mountainous areas with unique drug resources, a variety of anti-cancer drugs, and their ethnic characteristics are very distinct which is worth our in-depth exploration.

In Miao nationality medicine literature, gastric cancer belongs to Abdomen Jia disease in Jiu Jia classifications,closely related to “Male Turtle” symptoms, which is located in abdomen and its bag piece shaped like a turtle,round and angle, transfers rapidly from the Slow Meridian to Fast and Hot Meridian, causing Hui Qi hurt, and then up to a certain stage, makes people eat less, thinner and thinner, complexion pale, hair vellus withered, and pulse of Superior Horse, Inferior Horse and Five Finger quick and weak, or fast and subtle[2-3]. Its tendency is fierce,spreading quickly, which is similar to the symptoms of middle-late gastric cancer. Miao medicine believes that “poison is the cause of chaos, non-toxic can not cause diseases”, and “malignancy” is the root cause of gastric cancer, deficiency of Hui Qi in the body is the basic reason for the development of gastric cancer. So“malignancy” and the accumulation of pathological products of Qi, Blood and Water over time is the key to the generation of gastric cancer [4]. In treatment, Miao medicine makes attacking poison, supplementing body and repeling Qi as its therapeutic principle, always uses Tui Zhong San Jie Jian, Jiu Jia Nei Leng Wan, E Zao Juan Du Jian, Fu Hui Yi Xue Juan Du Jian, Xiao Zai Mian Yi Jian and so on to cure the treatment [5].

Based on the Miao Medicine volume of Chinese Materia Medica, this study sorted out and summarized the modern literature, and finally concluded and made statistical analysis of 81 kinds drugs that suppress gastric cancer in Miao medicine, to explore the drug regulation and in order to provide certain ideas for the clinical application of the Miao medicine in the treatment of gastric cancer and the development of new drugs.

2 Materials and methods

2.1 Data Sources

This study took 391 drugs in Miao Medicine volume of Chinese Materia Medica [6] compiled by the State Administration of Traditional Chinese Medicine as the data source. According to the drug screening criteria, this study made relevant research literature on Miao medicine inhibiting gastric cancer drugs published in June 2018 from the China knowledge network, Wipo Chinese database and Wanfang database.

2.2 Search Criteria

This study adopts the subject term retrieval method. It used “drug name” as the first search term and “stomach cancer” or “stomach tumor” as the second search term to search in Cnki firstly to get relevant information by reading the abstract or full text. If there is no result, in the case that the subject search term remains unchanged,the Chinese database of Wipo and Wanfang data are selected for the second and third retrieval successively,and the three databases are cross-searched to prevent the omission. Finally, relevant materials are obtained through the abstract or full-text reading.

2.3 Inclusion Criteria

(1) Miao medicine single drug effective components,extracts, water decoction in the treatment of gastric cancer clinical research and experimental research literature; (2)The design of the study program is reasonable, and drugs under study have a direct inhibitory effect on gastric cancer; (3) Literature title or key words contain “drug name” or “stomach cancer” or “stomach tumor”.

2.4 Exclusion Criteria

(1) Pure theoretical, empirical research literature; (2) The experimental scheme design is unreasonable or drugs in the compound preparation; (3) Take only one paper of the same research or repeated published literature.

2.5 Data Analysis

According to the search results, five kinds of original data of related drugs, including Wu Xing, Zou Guan,Ru Jia, Efficacy and Toxicity, were extracted from Miao Medicine volume of Chinese Materia Medica. And Microsoft Office Excel 2016 was used to build a database of Miao medicine drugs inhibiting gastric cancer, and relevant data was analyzed.

3 Results

Through literature collected, 81 kinds of Miao medicine drugs for inhibiting gastric cancer were sorted out.Miao medicine has a unique medical theory system [7].According to the source of drug growth properties, it is divided into five types: Soil Xing, Water Xing, Move Xing,Cave Xing and Mineral Xing; According to the theory of Zou Guan, drugs are divided into three parts: Exterior Guan, Middle Guan and Interior Guan; According to the Ru Jia theory, drugs are divided into nine groups, namely Body Jia, Abdomen Jia, Cave Jia, Lung Jia, Sex Jia, Brain Jia, Liver Jia, Heart Jia and Kidney Jia. According to the effect of drugs, drugs are divided into six categories,namely, Anti-poison drugs, Complementary drugs,Promote Qi and Blood Drugs, Tonify Spleen drugs and Intersecting Ring Drugs, Cure Wound drugs, and others;According to the classification of drug toxicity, it is divided into four categories: Non-toxic, Toxic, Mild Toxic and Strong Toxic drugs. Classification and extraction were carried out for 81 drugs that met the requirements by reading the Miao Medicine volume of Chinese Materia Medica. In the statistical process, the total number of Zou Guan and the total number of Ru Jia of Miao medicine inhibiting gastric cancer drugs were taken as the statistical base for statistical analysis, because each drug was not only put into one Guan, but also put into one Jia.The following is the frequency and proportion analysis of the final data to further explore the rule of drug law of Miao medicine in inhibiting hidden gastric cancer.

3.1 Collection of Drugs for Inhibiting Gastric Cancer in Miao Medicine

Most of the Miao medicine drugs for inhibiting gastric cancer were from plants, with a total of 71 kinds of drugs accounting for 87.7%; 7 kinds of animal species,accounting for 8.6%; 3 kinds of mineral species,accounting for 3.7%. See table 1 for details.

3.2 The Distribution of Wu Xing Drugs for Inhibiting Gastric Cancer in Miao Medicine

More than half of the drugs for inhibiting gastric cancer in Miao medicine were Soil Property drugs, up to 57 kinds, accounting for 70.4%, far higher than other four. See table 2 for details.

3.3 Zou Guan Distribution of Drugs for Inhibiting Gastric Cancer in Miao Medicine

The total number of Zou Guan drugs which can inhibiting gastric cancer in Miao medicine was 138 times.Reaching Middle Guan and Interior Guan drugs times in the distribution were the main ones, with the cumulative frequency of 121 times, accounting for 87.7%; The number of reaching Exterior Guan drugs was less, 17 times, accounting for 12.3%. See table 3 for details.

3.4 Distribution of Ru Jia Drugs for Inhibiting Gastric Cancer in Miao Medicine

The total number of Ru Jia drugs that can inhibiting gastric cancer in Miao medicine was 257 times, and all of the Nine Jia groups were involved, but the main Jia were Body Jia, Abdomen Jia, Lung Jia and Cave Jia, with the cumulative frequency of 172 times, accounting for 66.9%in total. See table 4 for details.

3.5 Distribution of Efficacy of Miao Medicine in Inhibiting Gastric Cancer Drugs

The most frequently used drugs for inhibiting gastric cancer in Miao medicine were 34 kinds of Anti-poison drugs, accounting for 42.0%, followed by 24 kinds of Complementary drugs, accounting for 29.6%. See table 5 for details.

3.6 Distribution of Toxicity of Drugs Inhibiting Gastric Cancer in Miao Medicine

70 kinds of non-toxic drugs, accounting for 86.4% in Miao medicine inhibits gastric cancer drugs; There were 7 kinds of Toxic drugs, 3 kinds of Mild Toxic drugs and 1 kind of Strong Toxic drugs, accounting for 8.7%, 3.7%and 1.2% respectively. See table 6 for details.

Table 1 Collection of Drugs for Inhibiting Gastric Cancer in Miao Medicine

Table 2 Statistics of Five Properties of Drugs for Inhibiting Gastric Cancer in Miao Medicine

Table 3 Statistics of Drugs Reaching Three Different Guan for Inhibiting Gastric Cancer in Miao Medicine

Table 4 Statistics of Drugs for Inhibiting Gastric Cancer in Miao Medicine

Table 5 Efficacy Statistics of Miao Medicine in Inhibiting Gastric Cancer Drugs

Table 6 Toxicity Statistics of Drugs for Inhibiting Gastric Cancer in Miao Medicine

4 Discussion

4.1 Analysis of Five Properties of Drugs Used to Inhibit Gastric Cancer in Miao Medicine

According to the statistical analysis of the Five Properties, most of the growth properties of drugs inhibiting gastric cancer in Miao medicine were derived from Soil drugs, accounting for 70.4% of the total frequency.Most of Soil medicine grows in the place such as soil slope, field, such as sarcandra, tall gastrodia tuber,corn silk and so on. As can be seen from table 1-2, the frequency of the Soil, Water and Sock drugs is the same as that of Botanical drugs, both of which are 71 kinds;the frequency of Move drugs is equal to that of Animal drugs, which is 7 kinds; and the frequency of Rock drugs is equal to that of Mineral drugs, which is 3 kinds.This has a certain relationship with the superior climatic environment, lush vegetation and the relatively rich plant medicinal materials resources in mountainous areas such as the Miaoling mountain range, the Damiao mountain range and the Wumeng mountain range where the Miao people live in concentrated communities. The relatively large distribution of the Soil medicines is closely related to the majority of plant medicines in the species distribution. This may provide certain reference for the development source of medicine for treating gastric cancer of Miao nationality.

4.2 Analysis on Zou Guan Drug Use for Inhibiting Gastric Cancer in Miao Medicine

According to the statistical analysis of Zou Guan drugs,the main drugs for inhibiting gastric cancer in Miao medicine are going through the Middle and Interior Guan, accounting for 87.7% in total.In medicine of Miao nationality, Zou Guan theory is an overview of the tendency of action after drugs enter the body. Among the drugs for inhibiting gastric cancer in Miao medicine,Interior Guan drugs are the most frequently used, such as hedyotis, Chinese lobelia herb, and Chinese cinquefoil,etc. These drugs mainly act on internal organs and directly reach the disease location, accounting for 44.9%.Then there are Middle Guan drugs, such as common floweringqince fruit, root and vine of manyprickle acanthopanax, smoked plum and so on, which are mainly used in human fascia, muscle, blood, bone and other parts, accounting for 42.8%. In Miao medicine, gastric cancer is mostly treated with Middle and Interior Guan drugs with strong penetration, which is consistent with the understanding that gastric cancer is a deep disease in Miao medicine, and also reflecting the location of gastric cancer inside.

4.3 Analysis of Ru Jia Drug Use for Inhibiting Gastric Cancer in Miao Medicine

From the perspective of Ru Jia drugs statistical analysis,there are all of the Jiu Jia medical drugs for inhibiting gastric cancer in Miao medicine involved, but the Body Jia, Abdomen Jia, Lung Jia and Cave Jia drugs are the main ones, and the first one is Body Jia drugs, such as Groundsel, Sweet wormwood herb, Tibetan Hellebore and other drugs, which mainly affect bone, joint, flesh,fascia, membrane and skin parts, accounting for 18.6%.

The data reflects the treatment of gastric cancer through the Miao medicine cures the body mainly and pays attention to the overall recuperation. The second is Abdomen Jia drugs, such as medicinal evodia fruit, atrina glass, gypsum and other drugs, which are mainly acted on the oral cavity, Upper Delivery Ring, esophagus, stomach,large and small intestines, Lower Delivery Ring and other parts, accounting for 17.9%, which reflecting the fact that the Miao medical treatment focus on the treatment of the disease location, consistent with the Zou Guan drugs using Interior Guan drugs mainly. Lung Jia and Cave Jia were ranked the third, with a ratio of 15.2%.Lung Jia drugs have the function of regulating Qi and Blood. The Cave Jia drugs have the effect of regulating Qi movement, and it often regard Qi fluency as favorable trend and Qi stagnant as adverse trend, which reflects the emphasis on regulating Qi in the treatment of gastric cancer in the Miao medicine. Although the location of gastric cancer is in the Stomach Jia, it is also associated with the Body Jia, Lung Jia and Cave Jia, etc. Therefore,the treatment of gastric cancer in Miao medicine is centered on the treatment of abdomen, and considering the regulation of various Jia Groups.

4.4 Efficacy Analysis of Medicine for Inhibiting Gastric Cancer in Miao Medicine

According to the statistical analysis of efficacy, the main drugs used to inhibit gastric cancer in Miao medicine are antidote and complement drugs, accounting for 71.6% in total. First of all, the antidote accounts for 42%, because Miao medicine believes that “poison is the source of all kinds of diseases” and malignancy is the root of gastric cancer, then treatment should be based on the treatment of “poison”. Miao doctor according to the nature of the poison, the different parts of the infringement, choose different properties, different effects of the antidote to drive away the body poison, such as Gong Du drugs,Ke Du drugs, Bai Du drugs,Qing Du drugs,Gan Du drugs and so on. Among them, the most representative and most commonly used drugs is Gong Du drugs,such as toad, also known as frog, which has the effect of attacking and removing poison, activating Blood and Qi. Miao doctors cut open its living body, remove internal organs and apply them to the affected part, and let the blood drain to remove toxins in bodies during the drying process. This treatment is called toad-pulling poison method[8] in Miao medicine.Modern studies have shown that toad can effectively inhibit the proliferation of cancer cells and induce the apoptosis of cancer cells[9]. It has been processed and extracted into various preparations, such as Bufalin [10] and Chinese Toad Bufotoxin [11], which have obvious curative effect on gastric cancer.

Second, the tonics account for 29.6%. Miao medicine believes that the deficiency of Hui Qi is the basis of the formation of gastric cancer, and the treatment should use barbary wolfberry fruit, Chinese taxillus herb, dodder seed and other tonifying drugs to strengthen the body,restore the body creatures to remove poison out. The Miao nationality usually selects the tonic medicine with corresponding effect according to the deficiency and decline of Qi, Blood, Water and Fire, such as Qi and Blood tonic, Water tonic, Fire tonic and Leakage tonic.It is very similar to the use of Fostering Healthy Qi and Dispel ing Pathogenic Qi drugs, Tonifying Qi, Blood, Yin and Yang drugs in traditional Chinese medicine. Relevant studies have shown that such drugs can effectively regulate the body's immunity, induce differentiation of tumor cells, and promote apoptosis of tumor cells, etc.[12]. The above shows that Miao medicine is similar to the traditional Chinese medicine, emphasizing treatment based on syndrome differentiation, and selecting effective drugs according to clinical needs for syndrome differentiation and treatment.

4.5 Toxicity Analysis of Miao Medicine for Inhibiting Gastric Cancer

From the perspective of the statistical analysis of toxicity,Miao medicine uses toxic drugs for its heavy properties and strong efficacy to suppress gastric cancer, taking its toxic which can effectively remove the “malignancy” of the body to achieve the effect of treating poison with poison. Among the drugs for inhibiting gastric cancer in Miao medicine, such drugs with toxicity in narrow sense (including strong toxicity, toxicity and mild toxicity)accounting for 13.6%.Miao medicine thinks, although this kind of medicaments has toxicity, it is safe if you master their amounts properly. For example, the application of crossbow medicine in Miao medicine, it is a highly toxic medicine (like prepared common monkshood mother root, bee venom, pinellia ternata, etc.), primitively used to shoot large animals dying quickly, then improved to reduce toxic by adding honey, sugar and so on in it, used in the treatment which getting good results. Modern studies have shown that crossbow medicine is safe to use in a large dose, without skin allergy and irritation,and can be recommended for clinical use [13] . From the overall medication trend, non-toxic drugs are mostly used in Miao medicine to inhibit gastric cancer, accounting for 86.4%, which are in line with the principle of safe use of drugs.

5 Conclusion

Based on the analysis of the drugs for inhibiting gastric cancer in Miao medicine, it is preliminarily revealed that the treatment of gastric cancer in Miao medicine is mainly based on the treatment of antidote and complement, with the Middle and Interior Guan drugs reaching the disease location, and the non-toxic drugs being the majority. It is hoped that this study can provide a certain literature basis for the development and application of drugs for inhibiting gastric cancer in Miao medicine.

Funding:This research was supported by construction project of key research office of State Administration of Traditional Chinese Medicine:"key research office of treating chronic pain with Miao medicine", project document number :letter of State Administration of Traditional Chinese Medicine [2009] No. 95; Project of State Administration of Traditional Chinese Medicine:study on standards of Miao medicine diagnosis and treatment technology, project number: QZYFJS-2017-53; Project of State Administration of Traditional Chinese Medicine: classification and code of ethnic minority diseases and research on its formulation of clinical diagnosis and treatment terms, project number: GZY-FJS-2018-229. Project of Special Central Subsidy Fund for Public Health of the Project of State Administration of Traditional Chinese Medicine: construction of Miao medicine standardization base, project number: Qian finance society [2016] No. 117.