Abstract
The combination of Traditional Chinese Medicine and Interventional Radiology has an excellent clinical effect. This paper reviews the principles and methods of the combined application of Traditional Chinese Medicine and Interventional Radiology, aiming to promote the complementary and coordinated development of Traditional Chinese Medicine and Interventional Radiology.
Keywords: Interventional medicine, Traditional Chinese medicine
Traditional Chinese medicine (TCM) is a treasure of Chinese civilization.1 TCM should adhere to integrity, innovate, inherit and develop, and complement and coordinate with modern medicine.2,3 Interventional radiology is a new discipline, which has been widely used in various disciplines of clinical medicine, called interventional medicine.4,5
The combination of TCM and interventional radiology has been developed for decades. In the 1990s, there were literature reports on the combination of TCM and interventional therapy.6,7 The combination of TCM and interventional technology can achieve the combination of whole and local, macro and micro in the process of diagnosis and treatment, and learn from each other's strongths to make up for their weaknesses .8,9 TCM Intervention means the combination or integration of TCM and intervention, which has become an important part of multidisciplinary team.10, 11, 12 The combination or integration of TCM and intervention mainly includes the following ways.
1. Combination of TCM and interventional medicine
The combined application of TCM and interventional diagnosis and treatment technology in the diagnosis and treatment of a disease can improve the curative effects, reduce the side effects and achieve synergy or auxiliary effects. TCM, including prescriptions and proprietary Chinese medicines, can not only correct side effects of interventional therapy, but also accelerate recovery and improve quality of life. TCM combined with Interventional Medicine has accumulated rich experience in the treatment of liver cancer.13, 14, 15, 16, 17 TCM can regulate immune responses, reduce liver function damage caused by interventional therapy, improve gastrointestinal function, reduce bone marrow suppression, relieve postoperative pain, improve interventional efficacy and reduce toxic and side effects. Kanglaite injection combined with TACE in the treatment of primary liver cancer has achieved satisfactory clinical results.18 The author used the modified Qingfei Xiaoji decoction combined with paclitaxel cisplatin bronchial artery infusion chemotherapy in the treatment of lung cancer, and obtained satisfactory clinical effect, which improved the quality of life and long-term survival of patients.19 Yiqi Huoxue Decoction can assist modern medicine in improving clinical efficacy, reducing the incidence of adverse events and stent restenosis in patients with ischemic encephalopathy after PCI.20 Oral administration of TCM and enema combined with interventional fallopian tube recanalization have achieved good effect on fallopian tube obstruction.21 Acupuncture, massage and application can significantly improve the quality of life related to interventional therapy, such as pain, vomiting and intractable hiccup, without side effects of related drugs.22,23
2. TCMs as the drug of interventional medicine
2.1Chinese patent medicines used for arterial infusion in the treatment of tumor hydroxycamptothecin, elemene emulsion and brucea javanica oil emulsion have been used in the treatment of tumor by arterial infusion in clinic
These drugs are safe and feasible in the treatment of primary liver cancer by hepatic arterial infusion. They can control liver cancer in cooperation with TACE, enhance immunity, reduce side effects, improve quality of life and improve prognosis.24, 25, 26
2.2 Chinese patent medicine used for adjuvant treatment of malignant hydrops
Aidi combined with cisplatin directly perfused into the thoracic cavity, and achieved satisfactory effect on malignant pleural effusion.27
2.3 TCMs for intratumoral injection
Hydroxycamptothecin and norcantharidin for intratumoral injection can directly inhibit the proliferation of tumor cells, promote the generation of immune active substances, and enhance the body's immunity.28,29
2.4 TCMs as interventional medicine embolic agent
Bletilla striata, Brucea javanica oil emulsion, elemene emulsion and zedoary turmeric oil have been used as drug carriers and embolic agents for tumor treatment. Feng Gensheng et al. compared with gelatin sponge, studied Bletilla striata as an embolic agent for the treatment of liver cancer and prostate cancer, and believed that Bletilla striata is an ideal peripheral vascular embolic agent30,31 with the following functionalities:"carrier, conductor, embolization and self-anti-tumor” et al. Unfortunately it has not been widely applied. Similar to Brucea javanica oil emulsion, elemene emulsion and zedoary turmeric oil as oily TCM embolic agents have been proved to have immune enhancement, anti-inflammatory, anti-virus, promoting mucosal repair and other effects, no obvious damage to liver function, no bone marrow suppression, and the effect of increasing white blood cells.32 These advantages make it possible for them to partially or completely replace modern medicine as ideal embolic agents for tumor interventional therapy.
2.5 Local treatment of ischemic diseases with TCM
In addition to the systematic treatment of cardiovascular and cerebrovascular diseases and peripheral vascular diseases with TCM for activating blood circulation and removing blood stasis, regional arterial infusion of TCMs combined with thrombolysis and vasodilation has also achieved good results in the treatment of avascular necrosis of the femoral head.33
In short, the combination or integration of Interventional Medicine and TCM has penetrated into many aspects of clinical practice. With the continuous accumulation and summary of clinical practice, their combination or integration will be more and more popular and recognized. At present, while continuing to summarize the role and value of TCM in interventional diagnosis and treatment, we should vigorously explore how to better integrate TCM with interventional technology, including more research on dosage forms of TCM suitable for interventional treatment, embolic agents of TCMs, tumor intervention of TCMs, anticoagulation, thrombolysis, etc. To clarify the mechanism of action of Chinese herbal medicine, to clarify the dialectical classification and treatment of diseases, and to develop objective indicators for efficacy evaluation.34 Development of TCM technology, such as acupuncture, massage, application, rehabilitation and interventional therapy technology integration development, common or phased treatment of a disease. The combination or integration of TCM and interventional medicine has bright prospects and is worth exploring.
Declaration of competing interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgements
This work is supported by the special medical innovation research project of ”scientific and technological innovation action plan” of Shanghai Science and Technology Commission (20Y11913900).
Footnotes
Supplementary data to this article can be found online at https://doi.org/10.1016/j.jimed.2021.07.002.
Contributor Information
Yujin Liu, Email: liuyujin@shyueyanghospital.com.
Yongde Cheng, Email: yongdech@163.com.
Authors' contributions
Yujin Liu wrote the manuscript. Yongde Cheng edited and proofread this manuscript and revised the manuscript. All authors read and approved the final manuscript.
Appendix A. Supplementary data
The following is the Supplementary data to this article:
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