Study on the mechanism of Fuzi Lizhong decoction (附子理中汤) in the treatment of colorectal cancer of spleen kidney Yang deficiency from the perspective of intestinal flora and hypoxia inducible factor-1α signalling pathway

doi:10.19852/j.cnki.jtcm.2025.04.013

Abstract

Abstract:

OBJECTIVE: To evaluate the effect of Fuzi Lizhong decoction (附子理中汤) on intestinal flora, serum inflammatory factors, and hypoxia inducible factor-1α (HIF-1α) in patients with colorectal cancer associated with spleen and kidney Yang deficiency.

METHODS: A total of 100 patients diagnosed with advanced colorectal cancer were randomly divided into two groups: a control group (CON, 50) and a Traditional Chinese Medicine (TCM) group (n = 50). The control group received treatment with the Capecitabine + Oxaliplatin (CAPEOX) regimen, while the TCM group received the same regimen along with Fuzi Lizhong decoction for six weeks. Changes in intestinal flora were assessed before and after six weeks in both groups. Serum markers, including HIF-1α, vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), were measured using enzyme-linked immunosorbent assay. Adverse reactions, clinical efficacy, and TCM syndrome efficacy were also monitored.

RESULTS: After six weeks, the levels of Lactobacillus and Bifidobacterium were significantly higher, while the levels of Enterobacter and Enterococcus were significantly lower in the TCM group compared to the control group (P < 0.05). Serum levels of HIF-1α, VEGF, IL-6, and TNF-α were also significantly reduced in the TCM group compared to the control group (P < 0.05). Additionally, the incidence of adverse reactions was lower, and the clinical efficacy was higher in the TCM group compared to the control group (P < 0.05).

CONCLUSION: Fuzi Lizhong decoction effectively improves intestinal microbiota composition, reduces inflammatory factors and HIF-1α expression, alleviates chemotherapy-related adverse reactions, enhances clinical efficacy, and may inhibit tumor growth in patients with colorectal cancer.

Key words: colorectal neoplasms, gastrointestinal microbiome, vascular endothelial growth factors, hypoxia-inducible factor 1, alpha subunit, interleukin-6, tumor necrosis factor-alpha, Fuzi Lizhong decoction

ZHANG Lina, LIN Xiu, ZHAO Xin, LI Wenjuan, ZHAO Ye. Study on the mechanism of Fuzi Lizhong decoction (附子理中汤) in the treatment of colorectal cancer of spleen kidney Yang deficiency from the perspective of intestinal flora and hypoxia inducible factor-1α signalling pathway[J]. Journal of Traditional Chinese Medicine, 2025, 45(4): 845-851.

Figures/Tables 2

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Group	n	Time	Lactobacillus	Bifidobacterium	Enterobacteria	Enterococcus
CON	50	Pre-treatment	7.1±0.4	7.9±0.5	7.8±0.5	8.2±0.5
CON	50	Post-treatment	8.9±0.8	7.2±0.5	7.4±0.5	7.9±0.4
TCM	50	Pre-treatment	7.8±0.4^a	7.1±0.5^a	7.7±0.6^a	8.4±0.4^a
TCM	50	Post-treatment	7.7±0.4^b	9.3±0.9^b	6.9±0.5^b	6.4±0.4^b

Group	n	Time	Lactobacillus	Bifidobacterium	Enterobacteria	Enterococcus
CON	50	Pre-treatment	7.1±0.4	7.9±0.5	7.8±0.5	8.2±0.5
CON	50	Post-treatment	8.9±0.8	7.2±0.5	7.4±0.5	7.9±0.4
TCM	50	Pre-treatment	7.8±0.4^a	7.1±0.5^a	7.7±0.6^a	8.4±0.4^a
TCM	50	Post-treatment	7.7±0.4^b	9.3±0.9^b	6.9±0.5^b	6.4±0.4^b

Group	n	Time	HIF-1α	VEGF (pg/mL)	IL-6	TNF-α (ng/mL)
CON	50	Pre-treatment	212±4	379±15	152±5	125±7
CON	50	Post-treatment	225±13	326±14	114±4	97±5
TCM	50	Pre-treatment	289±17^a	380±15^a	148±5^a	125±6^a
TCM	50	Post-treatment	128±8^b	266±11^b	97±2^b	82±3^b

Group	n	Time	HIF-1α	VEGF (pg/mL)	IL-6	TNF-α (ng/mL)
CON	50	Pre-treatment	212±4	379±15	152±5	125±7
CON	50	Post-treatment	225±13	326±14	114±4	97±5
TCM	50	Pre-treatment	289±17^a	380±15^a	148±5^a	125±6^a
TCM	50	Post-treatment	128±8^b	266±11^b	97±2^b	82±3^b

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