Effect of cinobufotalin combined therapy on cancer pain in patients with advanced non-squamous non-small cell lung cancer with Qi-Yin deficiency

doi:10.3969/j.issn.1004-583X.2024.12.007

Abstract

Abstract:

Objective To investigate the effect of cinobufotalin combined therapy on the control of cancer pain in advanced non-squamous non-small cell lung cancer (NSCLC) with Qi-yin deficiency and its underlying mechanism. Methods A total of 76 NSCLC patients with Qi-Yin deficiency treated from May 2020 to October 2022 were recruited. They were assigned into the treatment group ( $n$ =38) and control group( $n$ =38) by random number table method. All patients were given conventional chemotherapy and analgesia treatment, and those in the treatment group were additionally given oral cinobufotalin capsules. After two months of treatment, the effect of cancer pain control, serum inflammatory factors (interleukin-6 [IL-6], interleukin-10 [IL-10], tumor necrosis factor-α [TNF-α], interferon-γ [INF-γ]), pain transmitters (5-hydroxytryptamine [5-HT), substance P [SP], neuropeptide Y [NPY], and β-endorphin [β-EP]) were compared between the two groups. Results During the experiment, 1 case dropped out the treatment group and 2 cases dropped out the control group. Finally, 73 cases were enrolled, involving 37 cases in the treatment group and 36 cases in the control group. The Numerical Rating Scale (NRS) score of the treatment group was significantly lower than that of the control group (P<0.05), and the effective rate was significantly higher (94.59% vs 77.78%, χ²=4.365, P<0.05). Serum IL-6, TNF-α and INF-γ contents in the treatment group were significantly lower than those of the control group, and IL-10 level was significantly higher (P<0.05). Serum 5-HT, SP and NPY in the treatment group were significantly lower than those of the control group, but β-EP was significantly higher (P<0.05). Conclusion Cinobufotalin combined therapy can alleviate cancer pain of advanced NSCLS with Qi-yin deficiency and improve the pain control effect via the antagonistic inflammatory response and regulation of pain neurotransmitters.

Key words: carcinoma, non-small-cell lung, cinobufotalin, cancerous pain, inflammatory factors, pain transmitter

CLC Number:

R730.26

Liu Yunfei, Chen Taoli, Wang Yanpeng, Sui Junzhao, Wang Qichuan. Effect of cinobufotalin combined therapy on cancer pain in patients with advanced non-squamous non-small cell lung cancer with Qi-Yin deficiency[J]. Clinical Focus, 2024, 39(12): 1101-1105.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.12.007

https://huicui.hebmu.edu.cn/EN/Y2024/V39/I12/1101

Figures/Tables 4

Tab.1 Baseline data between the two groups

组别	例数	性别[例(%)]		年龄 (岁)	病程 (月)	TNM分期[例(%)]
组别	例数	男	女	年龄 (岁)	病程 (月)	Ⅲ期	Ⅳ期
治疗组	37	21(56.76)	16(43.24)	57.63±7.12	14.05±2.12	22(59.46)	15(40.54)
对照组	36	24(66.67)	12(33.33)	55.78±7.35	13.46±2.25	25(69.44)	11(30.56)
统计值		χ²=0.758		$t$ =1.092	$t$ =1.153	χ²=0.793
P值		0.384		0.278	0.253	0.373

Tab.1 Baseline data between the two groups

组别	例数	性别[例(%)]		年龄 (岁)	病程 (月)	TNM分期[例(%)]
组别	例数	男	女	年龄 (岁)	病程 (月)	Ⅲ期	Ⅳ期
治疗组	37	21(56.76)	16(43.24)	57.63±7.12	14.05±2.12	22(59.46)	15(40.54)
对照组	36	24(66.67)	12(33.33)	55.78±7.35	13.46±2.25	25(69.44)	11(30.56)
统计值		χ²=0.758		$t$ =1.092	$t$ =1.153	χ²=0.793
P值		0.384		0.278	0.253	0.373

Tab.2 Analgesic effect between the two groups

组别	例数	NRS评分		镇痛效果
组别	例数	治疗前	治疗后	显效	有效	无效	有效率
治疗组	37	7.02±1.23	2.05±0.53^*	24(64.86)	11(29.73)	2(5.41)	35(94.59)
对照组	36	6.78±1.14	2.86±0.57^*	16(44.44)	12(33.33)	8(22.22)	28(77.78)
统计值		$t$ =0.864	$t$ =6.290	$Z$ =5.231		χ²=4.365
P值		0.391	0.000	0.073		0.037

Tab.2 Analgesic effect between the two groups

组别	例数	NRS评分		镇痛效果
组别	例数	治疗前	治疗后	显效	有效	无效	有效率
治疗组	37	7.02±1.23	2.05±0.53^*	24(64.86)	11(29.73)	2(5.41)	35(94.59)
对照组	36	6.78±1.14	2.86±0.57^*	16(44.44)	12(33.33)	8(22.22)	28(77.78)
统计值		$t$ =0.864	$t$ =6.290	$Z$ =5.231		χ²=4.365
P值		0.391	0.000	0.073		0.037

Tab.3 Serum inflammatory factor levels of the two groups before and after treatment

组别	例数	IL-6(ng/L)		IL-10(ng/L)		TNF-α(μg/L)		INF-γ(ng/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	37	36.23±5.44	23.15±4.12^*	105.34±20.24	197.45±12.15^*	7.06±1.01	2.85±0.64^*	58.45±6.12	36.38±5.43^*
对照组	36	35.08±5.56	28.23±4.52^*	105.36±13.12	134.24±22.45^*	6.84±1.23	3.41±0.68^*	57.12±6.45	43.24±7.12^*
$t$ 值		0.893	5.021	0.005	15.017	0.836	3.624	0.904	4.637
P值		0.375	0.000	0.996	0.000	0.406	0.001	0.369	0.000

Tab.3 Serum inflammatory factor levels of the two groups before and after treatment

组别	例数	IL-6(ng/L)		IL-10(ng/L)		TNF-α(μg/L)		INF-γ(ng/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	37	36.23±5.44	23.15±4.12^*	105.34±20.24	197.45±12.15^*	7.06±1.01	2.85±0.64^*	58.45±6.12	36.38±5.43^*
对照组	36	35.08±5.56	28.23±4.52^*	105.36±13.12	134.24±22.45^*	6.84±1.23	3.41±0.68^*	57.12±6.45	43.24±7.12^*
$t$ 值		0.893	5.021	0.005	15.017	0.836	3.624	0.904	4.637
P值		0.375	0.000	0.996	0.000	0.406	0.001	0.369	0.000

Tab.4 Serum pain transmitter content of the two groups before and after treatment

组别	例数	5-HT(ng/L)		SP(μg/mL)		NPY(μg/L)		β-EP(ng/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	37	208.42±30.1	124.36±15.24^*	545.36±67.25	254.45±42.36^*	224.12±30.15	136.24±20.36^*	108.25±15.12	232.41±35.24^*
对照组	36	201.35±32.32	162.14±18.21^*	528.42±62.16	314.25±45.34^*	213.56±31.45	162.14±22.15^*	112.45±16.12	186.24±33.54^*
$t$ 值		0.967	9.623	1.117	5.285	1.465	5.204	1.149	5.731
P值		0.337	0.000	0.268	0.000	0.147	0.000	0.255	0.000

Tab.4 Serum pain transmitter content of the two groups before and after treatment

组别	例数	5-HT(ng/L)		SP(μg/mL)		NPY(μg/L)		β-EP(ng/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	37	208.42±30.1	124.36±15.24^*	545.36±67.25	254.45±42.36^*	224.12±30.15	136.24±20.36^*	108.25±15.12	232.41±35.24^*
对照组	36	201.35±32.32	162.14±18.21^*	528.42±62.16	314.25±45.34^*	213.56±31.45	162.14±22.15^*	112.45±16.12	186.24±33.54^*
$t$ 值		0.967	9.623	1.117	5.285	1.465	5.204	1.149	5.731
P值		0.337	0.000	0.268	0.000	0.147	0.000	0.255	0.000

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