Clinical Application of Traditional Chinese Medicine in the Treatment of Ovarian Cancer

Jing LUO, Si LIN, Lingyu DENG, Huizhen QIN, Hua ZHU

Abstract Ovarian cancer is one of the most common gynecological malignancies and can occur at any time in a womans life. This paper analyzed the etiology and pathogenesis of ovarian cancer in traditional Chinese medicine， and simply sorted out the methods and means of oral administration and external application of traditional Chinese medicine in the treatment of ovarian cancer， hoping to provide new therapeutic ideas for the treatment of the disease.

Key words Chinese medicine; Ovarian cancer; Clinical application

Received： April 20， 2022  Accepted： June 27， 2022

Supported by Guangxi Science and Technology Base and Talent Project （GK AD21238031）; Guangxi Key Research and Development Program （GK AB21196016）; Collaborative Innovation Center of Zhuang and Yao Ethnic Medicine （GJKY[2013]20）; Guangxi Key Laboratory of Zhuang and Yao Ethnic Medicine （GKJZ[2014]32）; Guangxi Ethnic Medicine Resources and Application Research Center of Engineering （GFGGJH[2020]2605）; Guangxi Key Discipline： Zhuang Ethnic Medicine （GZXK-Z-20-64）; The Eighth Batch of Special Expert Projects of Guangxi Zhuang Autonomous Region （GRCTZ[2019]13）; National Natural Science Foundation of China （82060695）; Guangxi Zhuang Autonomous Region Philosophy and Social Science Planning Research Project （20BMZ005）; Foreign Expert Project of the Ministry of Science and Technology of the Peoples Republic of China （GXL20200233001）; Guangxi First-class Discipline of Traditional Chinese Medicine： Ethnic Medicine （GJKY[2018]12）.

Jing LUO （1998-）， female， P. R. China， master， devoted to research about identification of traditional chinese medicine （Zhuang and Yao ethic medicine）.

*Corresponding author. E-mail： zhuhuagx@163.com.

The incidence of ovarian cancer is about 5.37/100 000， second only to cervical cancer and endometrial cancer， ranking third in gynecological tumors， but the mortality rate ranks first in gynecological tumors[1]. Ovarian cancer can occur in women of any age， and it is generally asymptomatic in the early stage， so it is difficult to detect， and more than 70% are found in the advanced stage[2]. Traditional Chinese medicine treatment of ovarian cancer mainly uses the main prescriptions， and then dialectical treatment is carries out according to individual conditions， in addition to other nursing methods which actively intervene.

Etiology and Pathogenesis of Ovarian Cancer

From the perspective of etiology and pathogenesis of ovarian cancer， exogenous pathogenic toxins， eating disorders and emotional depression are the external causes， while the visceral yin and yang qi and blood disorders and the deficiency of vital qi are the internal causes of the disease. Due to the interaction of internal and external factors， phlegm-dampness， qi and blood stagnate in the Chong meridian， Ren meridian and uterus， accumulate over time and develop into cancer[3].

Ovarian cancer is a common gynecological disease， mainly manifested as abdominal distension， lower abdominal pain， menstrual disorders， dark purple complexion， mental fatigue， fatigue， loss of appetite， etc. The incidence of ovarian cancer is mostly related to the kidney， liver， and spleen， and the etiology and pathogenesis of ovarian cancer are mainly due to deficiency and evil. Due to the weakness of the bodys vital qi， blood stasis， toxins and phlegm stagnate in the abdomen， and lead to dystrophy of the uterus and imbalance of Chong and Ren， resulting in the disease[4]. Traditional Chinese medicine believes that the occurrence of ovarian cancer is mainly due to the lack of vital qi and the cohesion of evil spirits， and the pathogenesis belongs to asthenia in origin and asthenia in superficiality. Under normal circumstances， in the early stage of ovarian cancer， the main focus is on attacking evils and strengthening the vital qi， while the later treatment is mainly aimed at strengthening the vital qi and eliminating the pathogenic qi. Evil qi is mainly manifested as such two types as stagnation of qi and blood stasis and dampness and toxin accumulation， and deficiency of qi is mainly manifested as deficiency of both qi and yin[5].

Ovarian cancer does not have such a name in traditional Chinese medicine treatises， but belongs to the categories of "Shijia"， "Changqin"， "Jiju" and "Zhengjia" according to the symptoms and signs of ovarian cancer[6]. The methods of TCM treatment of ovarian cancer are mainly based on the corresponding dialectical demonstration of different main syndromes， in order to achieve a good therapeutic effect.

Oral Administration of Traditional Chinese Medicine in the Treatment of Ovarian Cancer

Guizhi Fuling Pills

Guizhi Fuling Pills comes from Synopsis of Golden Chamber： "When a woman has a history of Zheng disease， and shows the symptoms of cessation of menstruation for less than 3 months， as well as metrostaxis， and feel that there seems to be fetal movement on the numbilicus， in fact， it is not real fetal movement， but an accumulation of Zheng. When a woman feels fetal movement at 6 months of pregnancy， and was normal in menstruation in the three months before cessation of menstruation， and the uterus increases normally every month after conception， it is fetal pregnancy. When the menstrual flow is abnormal in the first three months， the menstruation stops in the next 3 months， the uterus does not increase normally every month， and the patient also suffers from metrostaxis， it is also seen that it is caused by the Zheng disease."[7] Ramulus Cinnamomi warms the meridians and clears the meridians to remove stasis; Persicae Semen， Cortex Moutan and Radix Paeoniae Alba promote blood circulation and remove blood stasis， and nourish blood to regenerate new blood; and Poria induces diuresis with to benefit blood vessels. The whole prescription is nourishing and mild， and has the effects of smoothing the nature of the liver， removing blood stasis and regenerating new ones， reconciling qi and blood， and relieving disease block[8].

Clinical studies have confirmed that modified Guizhi Fuling Pills in the treatment of ovarian cancer can improve the therapeutic effect and improve the quality of life of patients[9-10]. Guizhi Fuling Capsules in adjuvant treatment of ovarian cysts can significantly reduce the volume of cysts， improve the symptoms and hormone levels of patients， and achieve more significant and effective clinical effects[11]. Clinical studies have confirmed that modified Guizhi Fuling Pills in the treatment of ovarian cancer can improve the therapeutic effect and improve the quality of life of patients[9-10]. Guizhi Fuling Capsules in adjuvant treatment of ovarian cysts can significantly reduce the volume of cysts， improve the symptoms and hormone levels of patients， and achieve more significant and effective clinical effects[11]. Guizhi Fuling Pills may mediate progesterone/estrogen receptors through the PI3K-AKT signaling pathway， thereby significantly inhibiting the development of uterine fibroids[12]. Paclitaxel combined with carboplatin was used as the control group， and on this basis， Guizhi Fuling Pills were added as the study group. The results showed that the effective rate of tumor control in the study group was 54.39% higher than that in the control group （35.09%） （P<0.05）. The serum CA125 levels in both groups were significantly decreased， and the serum CA125 level in the study group was lower than those in the control group[13]. Adding Guizhi Fuling Pills to the treatment plan of cis-platinum and cyclophosphamide combined chemotherapy， it was found that the patients serum decreased after treatment， and the side effects were also significantly reduced. It can be considered that combining Guizhi Fuling Pills in the treatment of ovarian cancer can achieve better efficacy[14]. For Guizhi Fuling Pills and their compatible prescriptions， experimental and clinical studies on the treatment mechanism of tumors were conducted， and it was found that it could achieve anti-tumor effect by regulating immunity， endocrine and anti-inflammatory effect and inhibiting cell proliferation[15]. The advantage of this prescription is that it can limit the size of fibroids， restore serological indicators， improve chemotherapy sensitivity， enhance the bodys ability to resist tumors， and improve the quality of life of patients[16]. Guizhi Fuling Capsules plus Pheretima combined with TC in the treatment of ovarian patients with blood stasis type can better reduce the serum CA125 value， improve the quality of life， and will not cause adverse effects on white blood cells and liver and kidney functions[17].

Fang Qi Bie Yi Ling Decoction

Zhao Xianlong in the treatment of patients with intermediate and advanced ovarian cancer used Radix Astragali， Semen Coicis， Salviae Chinensis Herba， Herba Scutellariae Barbatae and Herba Hedyotidis Diffusae each 30 g， Folium et Ramulus Cephalotaxi， Eupolyphaga， stir-baked Carapax Triongcis with sand then treated with vinegar （decocted first）， Polyporus， Poria， Radix Codonopsis， Rhizoma Curcumae and Semen Plantaginis each 15 g， and Rhizoma Atractylodis Macrocephalae， Radix Angelicae Sinensis， Spica Prunellae and Radix Linderae each 12 g， Galli Gigerii Endothelium Corneum 10 g， Radix Glycyrrhizae Preparata 6 g， 1 dose daily， decocted in water， 30 doses for a course of treatment. It has the effects of invigorating qi and spleen， removing blood stasis， inducing diuresis and reducing edema， and clearing away heat and toxic material[18].

Longkui Danggui Sanleng Decoction

Herba Solani Nigri 30 g， Radix Angelicae Sinensis 12 g， Sparganii Rhizoma 10 g， Rhizoma Curcumae 10 g， Fructus Toosendan 10 g， Radix Linderae 10 g， Rhizoma Smilacis Glabrae 30 g， Radix Astragali 30 g， Pericarpium Arecae 10 g， Pangolin Scales 15 g and Eupolyphaga 9 g，  have the functions of regulating qi and promoting blood circulation， and removing stasis. The efficacy of eliminating symptoms[19]. Herba Solani Nigri， Eupolyphaga， Pericarpium Arecae and Pangolin Scales have the effects of clearing away heat and toxic materials， removing stasis and subsiding swelling; and Sparganii Rhizoma， Rhizoma Curcumae， Linderae Radix and Fructus Toosendan have the effects of stoping bleeding， helping digestion and harmonizing stomach， and breaking blood stasis to promote the circulation of qi. Longkui Danggui Sanleng Decoction can effectively improve the clinical efficacy of ovarian cancer， improve the immunity of patients， and reduce the inflammatory reaction and adverse reactions of chemotherapy[20].

External Use of Traditional Chinese Medicine in the Treatment of Ovarian Cancer

Pressing ear auricular points with beans

During chemotherapy， ovarian cancer patients suffer from anxiety and depression due to physical recovery， psychological and economic burden. Therefore， while treating the disease， effective intervention measures should be taken to improve patients mental health level， reduce the level of anxiety and depression， and thus improve patientss quality of life[21]. Ovarian cancer patients often experience depression along with their psychology. If patiens emotions are not relieved in time， their disease condition will be accelerated. Ear auricular points corresponding to the liver， gallbladder， heart， kidney， Shenmen， and subcortex can be selected to treat liver depression， chest pain， nausea and vomiting， palpitations， shortness of breath， and schizophrenia， and improve fatigue， pain， sleep disturbance， loss of appetite， low mood and other symptoms， so as to improve the quality of life of ovarian cancer patients[22].

Moxibustion

Cancer patients often experience cancer-related fatigue during treatment， which persists for a long time， seriously affecting the quality of life of patients. According to the different conditions of different patients， dialectically giving intervention can promote the recovery of patients and improve the quality of life of patients. Selecting corresponding acupoints for moxibustion， burning moxa sticks to generate heat and transferring it to the meridian system and mobilizing the bodys immune function can effectively relieve the fatigue symptoms of cancer patients， and it is economical， convenient， and easy for patients to accept[23]. Moxibustion on Qihai， Guanyuan and Zusanli acupoints can significantly reduce the degree of fatigue and improve the symptoms of qi deficiency[24]. Since the diagnosis of patients condition， through moxibustion at Shenque， Sanyinjiao and Zusanli every day， stepping on a pressure plate to stimulate the sole， and applying moisture exposed burn ointment （MEBO） to the punctured vein every day after chemotherapy was carried out， the patients not only did not have obvious bone marrow suppression and gastrointestinal symptoms， but also had a good mental state[25].

Conclusions

The early symptoms of ovarian cancer are not easy to detect， and most patients are already in the advanced stage when they are discovered， but ovarian cancer is not easy to cure， which is extremely challenging for both doctors and patients. Early diagnosis and treatment of ovarian cancer is extremely important to improve the survival rate of ovarian cancer patients[26]. As the traditional medicine of the Chinese nation， traditional Chinese medicine has accumulated many years of medical experience in the treatment of ovarian cancer. Learning the wisdom of the predecessors， in addition to adopting non-drug adjuvant treatment methods， it can effectively relieve patients negative emotions during the treatment process or patients fatigue state during the treatment process， improve patients physical and mental health， and improve patients quality of life. While summarizing the methods and means of treating ovarian cancer， it is also hoped that new breakthroughs can be made in the treatment plan in the future， and the quality of life of thousands of patients can be continuously improved.

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