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A series of clinical applications and mechanism exploration of the kidney-tonifying and marrow-nourishing method in treating tumor chemotherapy-induced leukopenia

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登记号:G20251406

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关键词: kidney tonic for marrow regeneration Tumor chemotherapy

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成果名称: A series of clinical applications and mechanism exploration of the kidney-tonifying and marrow-nourishing method in treating tumor chemotherapy-induced leukopenia
成果登记号: G20251406 学科分类:
绿色分类: 项目关键词: kidney tonic for marrow regeneration  Tumor   chemotherapy    
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Shanghai University of Traditional Chinese Medicine Affiliated Longhua Hospital

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国家/地区: Shanghai 知识产权: Invention patent, others
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This achievement belongs to the field of Traditional Chinese Medicine (TCM) Internal Medicine. Leukopenia is a common side effect of cancer chemotherapy, often leading to delays in treatment and subsequently affecting tumor therapy. In the 1980s, there were no effective therapeutic drugs available, and in the 1990s, the use of Colony-Stimulating Factors (CSFs) on one hand allowed for rapid recovery of white blood cells but also posed the risk of accelerated tumor growth. Xu Zhenye developed a clinical treatment method based on the 'Kidney Essence Nourishes Bone Marrow' theory from TCM classics such as the 'Inner Canon', combined with his own clinical experience, and achieved good clinical results. He also developed the corresponding medication, Shuanghuang Shengbai Granules, and conducted a series of clinical applications and mechanism discussions from four aspects: theory, clinic, foundation, and new drug research and development. Theory: Based on the theories of 'essence and blood share origin', 'qi essence shares origin', and 'kidneys govern bones and produce marrow' found in classic TCM texts such as the 'Inner Canon', combined with his own clinical experience, In 1987, the academic viewpoint of using kidney-tonifying and marrow-nourishing methods to treat tumor chemotherapy-induced leukopenia was first proposed domestically, and a specific treatment formula, Shuanghuang Shengbai Formula, was formulated. In 1996, it was made into an in-house preparation. Clinical: Randomized controlled studies were conducted on the efficacy of Shuanghuang Shengbai Granules compared with commonly used clinical drugs for bone marrow suppression, such as Qincao Discoloration Double Ester, GM-CSF, and Leucogen. A total of 567 patients were analyzed. The results showed that Shuanghuang Shengbai Granules have the following effects: (1) When used simultaneously with chemotherapy, it can reduce the incidence of leukopenia (23.9% vs. 62.74%); (2) After leukopenia occurs, its application can promote the recovery of white blood cells, with a significantly higher efficacy rate than Qincao Discoloration Double Ester (81.82% vs. 56.14%), and similar to that of GM-CSF (82% vs. 82%); (3) It can prevent and treat moderate to severe (III° and IV°) leukopenia during chemotherapy. 82% to 83%); ④ Can significantly improve clinical symptoms; ⑤ Lower cost, in line with the principles of pharmacoeconomics. This is the first time that traditional Chinese medicine granules have been used for an autologous crossover control study combined with granulocyte-macrophage colony-stimulating factor, comparing efficacy and treatment costs, and observing the treatment of grade III and IV leukopenia caused by chemotherapy with traditional Chinese medicine, breaking through the bottleneck that traditional Chinese medicine is only used for mild to moderate bone marrow suppression. Basis: The mechanism of action has been explored from multiple perspectives such as pathology, microenvironment, cytology, and molecular biology, finding that Shuanghuang Shengbai Granules have the following effects: ① Protecting and promoting the growth of bone marrow hematopoietic stem/progenitor cells; ② Promoting the differentiation of bone marrow hematopoietic cells; ③ Reducing the damage to the bone marrow hematopoietic microenvironment caused by chemotherapy; ④ Enhancing immune function; ⑤ Dual regulation of cell cycle (including stem cells); ⑥ Regulating cell cycle and proliferation-related factors CDK4, The expression of genes such as CDK6, CyclinD, WEGF, Wnt, Notch; ⑦ It can regulate the expression of microRNA in hematopoietic cells and tumor cells. For the first time in China, it was discovered that traditional Chinese medicine for kidney nourishment and marrow regeneration can promote the cell cycle progression of bone marrow cells while inhibiting the growth of tumor cells (including tumor stem cells). Its mechanism of action is related to regulating the CDK4/6-CyclinD signaling pathway and microRNA expression, further elucidating the mechanism of action of kidney nourishment and marrow regeneration methods, reflecting the advantages of traditional Chinese medicine's holistic concept and syndrome differentiation treatment. New drug: For the first time in China, an in-depth study was conducted on the empirical prescription and effective components of kidney nourishment and marrow regeneration. ① The Shuanghuang Shengbai oral liquid has applied for a new drug clinical research approval; ② An analysis study was conducted on the effective ingredients and components of Shuanghuang Shengbai granules, determining the main medicinal flavors as Astragalus membranaceus and Polygonatum odoratum. Further research has identified Astragalus polysaccharides and Polygonatum polysaccharides as the main components, and determined the optimal ratio. This project has obtained 2 invention patents, applied for 1 patent, won 2 awards, published 28 papers (including 2 SCI-indexed), with citations totaling 256 times, and produced 4 books. It has trained 15 master's degree holders, 5 doctoral candidates, 2 reserve experts at Shanghai University of Traditional Chinese Medicine, 1 leading talent in traditional Chinese medicine from Pudong New District, and 2 key talents among young and middle-aged professionals from Pudong New District. The achievements have been widely applied in multiple hospitals, signed 1 transfer and development contract, and submitted 1 application for a new clinical trial approval for traditional Chinese medicine.
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