Chi Zhang1, Wei Guo2, Xiaohui Yao3, Jiangnan Xia4, Zexin Zhang5, Jing Li6, Hanrui Chen7, Lizhu Lin8. 1. The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, 510006, China. Electronic address: 940399721@qq.com. 2. The First Hospital Affiliated of Guangzhou University of Chinese Medicine, Guangzhou, 510006, China. Electronic address: 844608579@qq.com. 3. The School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China. Electronic address: 20193101008@stu.gzucm.edu.cn. 4. The School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China. Electronic address: 154281558@qq.com. 5. The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, 510006, China. Electronic address: 13724057703@163.com. 6. The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, 510006, China. Electronic address: lilee2711@sina.com. 7. The First Hospital Affiliated of Guangzhou University of Chinese Medicine, Guangzhou, 510006, China. Electronic address: wang15244616809@126.com. 8. The First Hospital Affiliated of Guangzhou University of Chinese Medicine, Guangzhou, 510006, China. Electronic address: Lizhulin903@139.com.
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE: In China, Traditional Chinese medicine (TCM) is often used as the main therapy for cancer-related fatigue (CRF). However, there is limited evidence to prove its therapeutic effect and mechanism. AIM OF THE STUDY: We aimed to provide a basis for the therapeutic effect of TCM for CRF. MATERIALS AND METHODS: We performed a meta-analysis to investigate the efficacy of TCM treatment for CRF. Through frequency statistics and association rule mining, we screened the core Chinese medicine components, Astragalus mongholicus Bunge., root (Radix astragali, Huangqi) and Atractylodes macrocephala Koidz., rhizome (Rhizoma atractylodis macrocephalae, Baizhu). We then used animal experiments to verify the effectiveness of these two TCMs and changes in related indicators in mice. Relevant molecular mechanisms were explored through network pharmacological analysis. RESULTS: Twenty-four randomised control trials (RCTs) involving 1865 patients were included in the meta-analysis. TCM produced more positive effects on CRF than standard therapy alone. Radix astragali and Rhizoma atractylodis macrocephalae, as the core drug pair for the treatment of CRF, enhanced the physical fitness of mice; reduced abdominal circumference, level of inflammatory factors, and tumour weight; and increased body weight and blood sugar. Network pharmacology analysis showed that the mechanism of action of Radix astragali and Rhizoma atractylodis macrocephalae on CRF mainly involved compounds, such as quercetin, kaempferol and luteolin, acting through multiple targets, such as Protein kinase B α (AKT1), Tumour necrosis factor (TNF), and Interleukin-6 (IL-6). These molecules regulate cytokines, cancer signalling, and metabolic pathways and confer an anti-CRF effect. CONCLUSIONS: TCM may be a promising therapy to relieve CRF in cancer patients. Our research may provide a reference for the clinical application of TCM for treating CRF.
ETHNOPHARMACOLOGICAL RELEVANCE: In China, Traditional Chinese medicine (TCM) is often used as the main therapy for cancer-related fatigue (CRF). However, there is limited evidence to prove its therapeutic effect and mechanism. AIM OF THE STUDY: We aimed to provide a basis for the therapeutic effect of TCM for CRF. MATERIALS AND METHODS: We performed a meta-analysis to investigate the efficacy of TCM treatment for CRF. Through frequency statistics and association rule mining, we screened the core Chinese medicine components, Astragalus mongholicus Bunge., root (Radix astragali, Huangqi) and Atractylodes macrocephala Koidz., rhizome (Rhizoma atractylodis macrocephalae, Baizhu). We then used animal experiments to verify the effectiveness of these two TCMs and changes in related indicators in mice. Relevant molecular mechanisms were explored through network pharmacological analysis. RESULTS: Twenty-four randomised control trials (RCTs) involving 1865 patients were included in the meta-analysis. TCM produced more positive effects on CRF than standard therapy alone. Radix astragali and Rhizoma atractylodis macrocephalae, as the core drug pair for the treatment of CRF, enhanced the physical fitness of mice; reduced abdominal circumference, level of inflammatory factors, and tumour weight; and increased body weight and blood sugar. Network pharmacology analysis showed that the mechanism of action of Radix astragali and Rhizoma atractylodis macrocephalae on CRF mainly involved compounds, such as quercetin, kaempferol and luteolin, acting through multiple targets, such as Protein kinase B α (AKT1), Tumour necrosis factor (TNF), and Interleukin-6 (IL-6). These molecules regulate cytokines, cancer signalling, and metabolic pathways and confer an anti-CRF effect. CONCLUSIONS: TCM may be a promising therapy to relieve CRF in cancer patients. Our research may provide a reference for the clinical application of TCM for treating CRF.