CN115429848A - Application of traditional Chinese medicine composition in preparation of medicine for treating osteoporosis - Google Patents

Application of traditional Chinese medicine composition in preparation of medicine for treating osteoporosis Download PDF

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CN115429848A
CN115429848A CN202111397663.8A CN202111397663A CN115429848A CN 115429848 A CN115429848 A CN 115429848A CN 202111397663 A CN202111397663 A CN 202111397663A CN 115429848 A CN115429848 A CN 115429848A
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root
ginseng
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孙成磊
潘丽红
李涛
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Shandong New Time Pharmaceutical Co Ltd
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Abstract

The invention belongs to the technical field of traditional Chinese medicines, and particularly relates to a ginseng root-strengthening traditional Chinese medicine composition prepared from ginseng, rehmannia glutinosa, poria cocos, moutan bark, prepared rehmannia root, dogwood, chinese yam, rhizoma alismatis, radix asparagi and radix ophiopogonis, and application of the ginseng root-strengthening traditional Chinese medicine composition combined with zoledronic acid in preparation of a medicine for treating lung cancer bone metastasis with osteoporosis.

Description

Application of traditional Chinese medicine composition in preparation of medicine for treating osteoporosis
Technical Field
The invention belongs to the technical field of traditional Chinese medicines, and particularly relates to application of ginseng root-strengthening oral liquid and zoledronic acid in lung cancer bone metastasis with osteoporosis.
Background
In recent years, the incidence and mortality of lung cancer have rapidly increased, and the lung cancer has become one of the most common malignant tumors. The highly metastatic character of lung cancer is one of the leading causes of poor treatment and death. The most common sites of metastasis for lung cancer are brain metastases and bone metastases. In advanced lung cancer, bone metastasis is predominant, and the metastatic sites are usually found in the spine, the bones of the limbs, the ilium, etc. The radiotherapy and chemotherapy and the like have adverse effects on bone metabolism, so that the loss of bone components is increased, osteoporosis is caused, the osteoporosis has high morbidity in elderly patients, the osteoporosis and bone metastasis mutually affect, clinical symptoms are aggravated, and the life quality of the patients is seriously affected. The clinical manifestations of lung cancer bone metastasis and osteoporosis are related to bone events such as dysfunction, pathological fracture, severe bone pain, spinal cord compression of vertebral body metastasis, hypercalcemia and the like. Bone metastasis prognosis is poor, so early detection of treatment is extremely important.
The current major therapies include chemoradiotherapy, radionuclides, bisphosphonates, analgesics, etc. Zoledronic acid (Zoledronic acid) is a latest generation of diphosphate type medicine, and has good prevention and treatment effects on malignant tumor bone metastasis and osteoporosis. The zoledronic acid can selectively inhibit osteoclast activity and bone destruction, induce apoptosis of various tumor cells, and reduce bone destruction, absorption and pathological fracture incidence; and can reduce the release of inflammatory mediators and pain factors such as prostaglandin, lactic acid and the like, relieve pain, and have the advantages of improving the survival rate and the life quality of patients and the like. Zoledronic acid combined with radiotherapy is a main therapy for lung cancer bone metastasis, and is widely used for preventing and treating various clinical bone metastasis tumors. However, the medicine has great medicine taking problems because the medicine is very poor in absorption and stimulates the esophagus, so that the medicine taking requirements are quite strict and accurate, and side effects are great.
Clinical research shows that the clinical curative effect of treating the lung cancer bone metastasis by combining traditional Chinese medicine and western medicine is more obvious than that of treating the bone metastasis by using simple western medicine. The ginseng root-strengthening oral liquid is prepared from ginseng, rehmannia root, poria cocos, moutan bark, prepared rehmannia root, dogwood fruit, chinese yam, rhizoma alismatis, asparagus and radix ophiopogonis, has the effects of nourishing yin and tonifying qi, and strengthening the body resistance and reinforcing primordial qi, and is mainly used for treating yin deficiency and qi weakness, consumptive cough, palpitation and short breath, bone steaming and tidal fever, waist soreness and tinnitus, spermatorrhea and night sweat, and dry stool. The applicant finds that the ginseng root-strengthening oral liquid and the zoledronic acid have better treatment effects in the bone metastasis of lung cancer and osteoporosis clinically, and the efficacy of the ginseng root-strengthening oral liquid is not reported in the previous literature.
Disclosure of Invention
The inventor finds that the traditional Chinese medicine product can prevent and treat the lung cancer bone metastasis with osteoporosis by combining with zoledronic acid on the basis of clinical use feedback of 'ginseng root-strengthening oral liquid'.
The invention aims to provide a ginseng root-strengthening traditional Chinese medicine composition, and an application of the ginseng root-strengthening traditional Chinese medicine composition in preparation of a combined medicine for preventing and/or treating lung cancer bone metastasis with osteoporosis.
The ginseng root-strengthening traditional Chinese medicine composition is used for preparing a medicine for preventing and/or treating lung cancer bone metastasis in combination with zoledronic acid.
The lung cancer bone metastasis with osteoporosis is also accompanied by at least one symptom of functional disorder, pathological fracture, severe bone pain, spinal cord compression of vertebral body metastasis or hypercalcemia.
The ginseng root-strengthening traditional Chinese medicine composition is prepared from ginseng, rehmannia root, poria cocos, moutan bark, prepared rehmannia root, dogwood, chinese yam, rhizoma alismatis, asparagus cochinchinensis and radix ophiopogonis. The traditional Chinese medicine composition is prepared from the following medicinal materials in parts by weight: 60-90 parts of ginseng, 130-170 parts of rehmannia root, 130-170 parts of tuckahoe, 130-170 parts of tree peony bark, 130-170 parts of prepared rehmannia root, 130-170 parts of dogwood, 280-320 parts of Chinese yam, 130-170 parts of alisma orientale, 130-170 parts of asparagus and 130-170 parts of dwarf lilyturf tuber.
Further, the traditional Chinese medicine composition is prepared from the following medicinal materials in parts by weight: 70-80 parts of ginseng, 140-160 parts of rehmannia root, 140-160 parts of tuckahoe, 140-160 parts of tree peony bark, 140-160 parts of prepared rehmannia root, 140-160 parts of dogwood, 290-310 parts of Chinese yam, 140-160 parts of rhizoma alismatis, 140-160 parts of radix asparagi and 140-160 parts of radix ophiopogonis.
The ginseng root-strengthening oral liquid and zoledronic acid medicine can prevent or treat lung cancer bone metastasis with osteoporosis, and is also accompanied with at least one of the following symptoms: functional disorder, pathological fracture, severe bone pain, spinal cord compression of vertebral body metastasis or hypercalcemia.
The administration mode of the traditional Chinese medicine composition comprises preventive intervention administration or therapeutic administration.
The ginseng traditional Chinese medicine composition for consolidating the constitution also contains one or more pharmaceutically acceptable pharmaceutic adjuvants.
The traditional Chinese medicine composition can be prepared into an acceptable preparation form by directly adding pharmaceutically acceptable auxiliary materials through a conventional process.
The ginseng root-strengthening traditional Chinese medicine composition is processed into capsules, tablets, granules, powder, syrup, pills or oral liquid by the prior art.
Wherein, the clinically acceptable dosage forms comprise capsules, tablets, granules, pills or oral liquid.
Preferably, the clinically acceptable dosage form is an oral liquid.
Further preferably, the oral liquid is ginseng solid oral liquid.
Compared with the prior art, the invention has the following remarkable advantages:
the invention discloses a new application of a traditional Chinese medicine composition, namely ginseng root-strengthening oral liquid, in combination with zoledronic acid in preventing and treating lung cancer bone metastasis with osteoporosis for the first time. According to the invention, a lung cancer bone metastasis model is successfully established, and the combination of the ginseng root-strengthening oral liquid and the zoledronic acid can reduce the molding success rate of lung cancer bone metastasis and prevent the generation of the lung cancer bone metastasis with osteoporosis; the weight of the mice in the ginseng root-strengthening oral liquid and zoledronic acid group is maintained stably in the experimental process, and the vital signs are normal; enzyme-linked immunosorbent assay (ELISA) is used for detecting the serum type I collagen amino terminal peptide (NTX) level of each group of tumor-bearing nude mice, and the ginseng root-strengthening oral liquid and zoledronic acid group obviously reduce the serum NTX level (p is less than 0.05), which shows that the ginseng root-strengthening oral liquid and zoledronic acid can effectively inhibit the activity of osteolytic cells and reduce the damage of bone metastasis to bone quality.
Mice with successful lung cancer bone metastasis molding have a clinically common osteoporosis symptom. By carrying out bone density measurement on mice successfully molded before and after molding, the inventor finds that the zoledronic acid and ginseng root-strengthening oral liquid has significant difference compared with a control group when being used together, significantly improves the symptoms of lung cancer bone metastasis with osteoporosis, further improves the symptoms of lung cancer bone metastasis with osteoporosis compared with zoledronic acid, and plays a role in synergy; the microscopic CT analysis is carried out on the microstructure of the distal metaphyseal spongy bone of the femur, and the zoledronic acid and ginseng solid oral liquid further inhibits the reduction of the metaphyseal bone mass and the number of bone trabeculae of the femur, reduces the space between the bone trabeculae and can effectively improve the symptoms of bone metastasis of lung cancer with osteoporosis.
The ginseng root-strengthening oral liquid combined with zoledronic acid can effectively relieve the symptoms of lung cancer bone metastasis with osteoporosis, relieve pain, promote bone reconstruction, reduce the incidence rate of pathological fracture and inhibit a new bone metastasis, is safe and reliable in clinical application, good in patient tolerance and few in side effect, and is worthy of clinical use and popularization.
Detailed Description
The advantageous effects of the present invention will now be further described by the following examples, which should be understood as being for illustrative purposes only and not limiting the scope of the present invention, and that changes and modifications apparent to those of ordinary skill in the art in light of the present invention are also included within the scope of the present invention.
Example 1
Experimental animals: immunodeficient mice SCID mice (NIH-BNX mice), 70 mice, 8-10 weeks old, weighing 22 + -2 grams, were bred under SPF environment.
Tumor cell culture: preparing single cell suspension from human lung adenocarcinomse:Sub>A bone metastasis cell strain SPC-A-IBM in exponential growth phase. The single cell suspension is subjected to primary culture and then further amplified. The culture conditions were DMEM medium. Cell culture environment 37 deg.C, 5% 2 . Metastatic tumor model: the prepared cell suspension was inoculated into the left ventricle of 60 NIH-BNX mice (containing about 0.8X 10 viable cell count) at 0.2mL per cell 6 And (II) making into a lung cancer bone metastasis model.
Grouping and processing: according to the weight, 10 NIH-BNX mice are randomly selected as a normal control group without any treatment, the remaining 60 mice are prepared into a metastatic tumor model, the metastatic tumor model is randomly divided into 3 groups, each group is 20, and each mouse in the group is numbered by a toe-cutting method and is respectively 1-20. Dosing began on day 8 post-inoculation and was continued for a total of 5 weeks. The mice were weighed twice a week, observed for general conditions, sacrificed if they were imminent, and sacrificed at week 8.
Zoledronic acid group: zoledronic acid 0.2mg/kg2 times/w.times.5 w was administered by subcutaneous injection.
Zoledronic acid + ginseng solid oral liquid group: zoledronic acid 0.2mg/kg2 times/w is multiplied by 5w for subcutaneous injection administration, and ginseng solid oral liquid 3.6mL/kg for intragastric administration.
Control group: normal saline solution is injected in equal volume for administration.
Normal group: metastatic tumor modeling was not performed and saline was administered by equal volume injection.
Statistical treatment: all data were analyzed by SPSS16.0 for data processing and results
Figure BDA0003370810660000031
And (4) showing.
Evaluation indexes and results:
(I) evaluation index of bone metastasis
(1) Body weights were weighed and recorded twice weekly from the first drug injection to week 8 in the tumor cell inoculated murine model.
TABLE 1 weight change for each group
Figure BDA0003370810660000041
P <0.05 compared to control group
After inoculation of the tumor cells, mice in the control group began to experience wasting. By the 7 th week, the weight of the zoledronic acid group is remarkably different from that of the control group (p is less than 0.05), but the duration is short, the weight of mice in the zoledronic acid + ginseng root-fixing oral liquid group is remarkably different from that of the control group (p is less than 0.05) from the 4 th week and lasts until the 8 th week, which shows that the combined use of the zoledronic acid and the ginseng root-fixing oral liquid can maintain the weight of the mice at a certain level.
(2) Mice were sacrificed for pronucleus scanning by intravenous injection of 148MBq from the mouse tail 99 Mice were sacrificed by exsanguination after 5-6 hours and ECT scan with SPECTE. Matrix 256 × 256, zoom3.2, ims:0.1 mm. Times.2 cm. And observing the number of the bone metastasis mice by taking the nuclide concentration or deletion part as a bone metastasis positive part.
TABLE 2 number of tumor-bearing mice positive for each nuclide scan group
Figure BDA0003370810660000042
The bone metastasis of tumor-bearing mice is scanned by nuclides, and the number of the bone metastases in the control group is 16 at most, accounting for 80%. The number of mice with bone metastasis in the zoledronic acid group, the zoledronic acid group and the ginseng root-strengthening oral liquid group is 8 and 6 respectively, and results show that the zoledronic acid can prevent the bone metastasis to a certain extent, and the combined medication of the zoledronic acid and the ginseng root-strengthening oral liquid group has a synergistic effect on reducing the bone metastasis of lung cancer.
(3) Serum is reserved when the mice are sacrificed, the level of serum type I collagen amino-terminal peptide (NTX) of each group of tumor-bearing nude mice is detected by an enzyme-linked immunosorbent assay (ELISA), and the specific operation method is as provided in the NTX kit instruction provided by Haiyuan medical instrument company Limited.
TABLE 3 serum NTX levels in groups of tumor-bearing mice
Group of Number of tests (n) Mean value (nM)
Zoledronic acid group 8 9.867±3.493
Zoledronic acid and ginseng oral liquid group for strengthening body resistance 6 7.391±4.291*
Control group 16 13.759±4.892
Compared with the control group, the compound of the formula, * p<0.05
the type I collagen amino-terminal peptide (NTX) is a bone metastasis marker representing the activity of osteolytic cells, the serum NTX level of each group of tumor-bearing mice is shown in table 3, and the zoledronic acid and ginseng solid oral liquid group obviously reduces the serum NTX level (p is less than 0.05), which indicates that the ginseng solid oral liquid and the zoledronic acid can effectively inhibit the activity of the osteolytic cells and reduce the damage of bone metastasis to bone quality. (II) evaluation index of osteoporosis after bone metastasis
And (3) measuring the osteoporosis degree related indexes of 60 modeling experiment mice, and selecting the data of mice with successful lung cancer bone metastasis according to the nuclide scanning condition after the measurement is finished, and finishing the data as follows.
(1) Bone Density (BMD) determination
Before molding, 60 mice divided into 3 groups were anesthetized with pentobarbital sodium in the abdominal cavity, and the supine position was examined for bone density by using a dual-energy X-ray bone densitometer, wherein the examination time was before molding (0 week), in the middle stage of drug intervention (4 weeks), and after sacrifice (8 weeks).
TABLE 4 comparison of Whole body BMD for each group
Figure BDA0003370810660000051
P <0.05, P <0.01, compared to control group
The bone density of the lung cancer bone metastasis mice in the control group continuously decreases along with the time; the bone density of mice administered with zoledronic acid decreased with time, and at week 8, the zoledronic acid group was significantly different from the control group (P < 0.05); the bone density of mice administered with the zoledronic acid + ginseng solid oral solution decreases less with time, and is significantly different from the control group at week 4 (P < 0.05) and significantly different from the control group at week 8 (P < 0.01). The experimental result shows that the zoledronic acid and the ginseng root-strengthening oral liquid have a synergistic effect and can obviously improve the symptoms of lung cancer bone metastasis with osteoporosis.
(2) The microstructure of the distal metaphyseal cancellous bone of the femur was analyzed by micro-CT. And 2-dimensional scanning is adopted to scan the cross section with the thickness of 9.43 mu m at the position 1.06mm below the far epiphyseal cartilage line of the femur, and the structure of the spongy bone is quantitatively analyzed, wherein the content comprises the bone mass/tissue mass of the spongy bone, the number of trabeculae and the distance between the trabeculae.
TABLE 5 comparison of distal femur spongy bone in groups of mice
Group of n Bone mass/tissue mass (%) Number of trabeculae (n/mm) Bone trabecula spacing (mm)
Zoledronic acid group 8 14.6±0.9*# 2.7±0.3*# 0.34±0.04 *#
Zoledronic acid and ginseng oral liquid group for strengthening body resistance 6 16.3±1.1** 3.7±0.3** 0.29±0.02**
Control group 16 8.7±1.4## 1.8±0.4## 0.49±0.07##
Normal group 10 17.2±0.7** 3.8±0.3** 0.27±0.05**
Comparing with control group * P<0.05, ** P<0.01; comparison with Normal group # P<0.05, ## P<0.01
Compared with the normal group, the bone mass and the number of trabeculae at the metaphysis of the femur of the control group are obviously reduced, and the spacing between the trabeculae is obviously increased; the zoledronic acid group inhibited the decrease in the amount of metaphyseal bone and number of trabeculae of the femur and maintained the trabecular spacing; the zoledronic acid and ginseng root-strengthening oral liquid group further inhibits the reduction of the metaphyseal bone mass of femoral bones and the number of bone trabeculae, reduces the spacing between the bone trabeculae, has no significance (P is more than 0.05) compared with the normal group, shows that the zoledronic acid and ginseng root-strengthening oral liquid have obvious combined effect and has synergistic effect on improving the symptoms of lung cancer bone metastasis and osteoporosis.

Claims (10)

1. Application of ginseng root-strengthening traditional Chinese medicine composition in preparing medicines for preventing and/or treating lung cancer bone metastasis with osteoporosis.
2. The use of claim 1, wherein the ginseng root-securing traditional Chinese medicine composition is used for preparing a medicine for preventing and/or treating lung cancer bone metastasis with osteoporosis in combination with zoledronic acid.
3. The use of claim 1, wherein the ginseng root-strengthening traditional Chinese medicine composition is used for preparing a medicine for preventing and/or treating lung cancer bone metastasis in combination with zoledronic acid.
4. The use of claim 2, wherein the lung cancer bone metastasis with osteoporosis is further accompanied by at least one symptom of a functional disorder, pathological fracture, severe bone pain, spinal cord compression of vertebral body metastasis, or hypercalcemia.
5. The use of claim 1, 2, 3 or 4, wherein the ginseng root-strengthening Chinese medicinal composition is prepared from ginseng, rehmannia glutinosa, poria cocos, moutan bark, prepared rehmannia root, cornus officinalis, chinese yam, alisma orientale, asparagus, and ophiopogon root.
6. The use of claim 5, wherein the ginseng root-strengthening traditional Chinese medicine composition is prepared from the following medicinal materials in parts by weight: 60-90 parts of ginseng, 130-170 parts of rehmannia root, 130-170 parts of tuckahoe, 130-170 parts of tree peony bark, 130-170 parts of prepared rehmannia root, 130-170 parts of dogwood, 280-320 parts of Chinese yam, 130-170 parts of rhizoma alismatis, 130-170 parts of asparagus and 130-170 parts of radix ophiopogonis.
7. The use of claim 5, wherein the Chinese medicinal composition is prepared from the following medicinal materials in parts by weight: 70-80 parts of ginseng, 140-160 parts of rehmannia root, 140-160 parts of tuckahoe, 140-160 parts of tree peony bark, 140-160 parts of prepared rehmannia root, 140-160 parts of dogwood, 290-310 parts of Chinese yam, 140-160 parts of rhizoma alismatis, 140-160 parts of radix asparagi and 140-160 parts of radix ophiopogonis.
8. The use of claim 5, wherein the ginseng root-strengthening traditional Chinese medicine composition further comprises one or more pharmaceutically acceptable pharmaceutical excipients.
9. The use of claim 5, wherein the ginseng root-strengthening traditional Chinese medicine composition is processed into capsules, tablets, granules, powder, syrup, pills or oral liquid by the prior art.
10. The use of claim 9, wherein the ginseng root-securing traditional Chinese medicine composition is a ginseng root-securing oral liquid.
CN202111397663.8A 2020-11-27 2021-11-24 Application of traditional Chinese medicine composition in preparation of medicine for treating osteoporosis Pending CN115429848A (en)

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