Sarcopenia is a progressive, generalized syndrome characterized by decreased skeletal muscle content and decreased function. Patients with malignant tumors can develop sarcopenia at different stages of progression, with an incidence of 32.05%~70.40%, and the prevalence varies according to tumor type, stage, and measurement method. Compared with other types of tumors, the incidence of sarcopenia in patients with digestive tract tumors is higher, 17%~78%. In this paper, the PI3K/AKT/mTOR pathway was used to explore the mechanism of Qi Strengthening Decoction in the intervention of sarcopenia in patients with advanced esophageal cancer, in order to provide a method for the clinical treatment of sarcopenia.

Jianhua Ke, Jin Zheng, Zhenping Ouyang. Research Progress of Traditional Chinese Medicine Formula Yiqi and Muscle Building Decoction and Carcinogenic Sarcopenia. Frontiers in Medical Science Research (2023) Vol. 5, Issue 5: 40-48. https://doi.org/10.25236/FMSR.2023.050507.

[1] Ma Dan, Yang Fan, Liao Zhuan, et al. Expert consensus opinion on early esophageal cancer screening and endoscopic diagnosis and treatment in China (Beijing, 2014)[J]. Chinese Journal of Practical Internal Medicine, 2015.

[2] Li Xiangyang, Li Fan, Zhang Shuze, et al. Research progress of tumor-associated sarcopenia [J]. Chinese Journal of Liberation Army Medicine, 2012,47(07):739-744.

[3] Haiducu C,Buzea A,Mireal E,et al. The prevalence and the impact of sarcopenia in digestive cancers. A systematic review[J]. Rom J Intern Med,2021,59(4):328-344. 

[4] Nakamura R,Inage Y,Tobita R,et al.Sarcopenia in resected NSCLC:effect on postoperative outcomes[J].J Thorac Oncol,2018,13(7):895-903. 22/116 

[5] Yoon HG, Oh D, Ahn YC,et al. Prognostic Impact of Sarcopenia and Skeletal Muscle Loss During Neoadjuvant Chemoradiotherapy in Esophageal Cancer[J]. Cancers (Basel). 2020 Apr 10;12(4):925. 

[6] Xia L, Zhao R, Wan Q, et al. Sarcopenia and adverse health-related outcomes: An umbrella review of meta-analyses of observational studies[J]. Cancer Med. 2020 Nov;9(21):7964-7978. 

[7] Rosa-Caldwell M E, FiX D K. Washington T A. et al. Muscle alterations in the development and progression of cancer-induced muscle atrophy: a Review[J].J APPL Physiol(1985).2020.128 (1):25-41. 

[8] Wang Chayi, Wang Qiang, Guo JW, et al. Aligilen improves tumor cachexia in mice [J]. Basic medicine and clinic 2016.36 (4) : 468-473.

[9] Wu Yanping, Wang Yang, Li Yali, et al. Oxidative stress and autophagy[J]. Chinese Journal of Animal Nutrition, 2016, 28(9):8.

[10] Enoki Y,Watanabe H, Arake R. et aL. Indoxyl sulfate potentiates skeletal muscle atrophy by inducing the oxidative stress-mediated expression of myostatin andatrogin-1 [J].SiReP. 2016. 6:32084. 

[11] Jun W. Curcuma longa L. Water Extract Improves Dexamethasone-Induced Sarcopenia by Modulating the Muscle-Related Gene and Oxidative Stress in Mice[J]. Antioxidants, 2021, 10.

[12] Antunes D, Padrão AI, Maciel E, et al. Molecular insights into mitochondrial dysfunction in cancer-related muscle wasting[J]. Biochim Biophys Acta, 2014, 1841(6): 896-905. 

[13] McCormick R, Vasilaki A. Age-related changes in skeletal muscle: Changes to life-style as a therapy [J]. Biogerontology, 2018, 19(6): 519-536. 

[14] Zhang Y, Wang X X. Mechanism of protein degradation in skeletal muscle with carcinomatous fluid [J]. Journal of Tumor Metabolism & Nutrition, 2020,7 (03) : 255-258.23/116. 

[15] Porporato PE. Understanding cachexia as a cancer metabolism syndrome[J]. Oncogenesis, 2016, 5(2): e200. 

[16] Hou YC, Wang CJ, Chao YJ, et al. Elevated serum interleukin-8 level correlates with cancer-related cachexia and sarcopenia: An indicator for pancreatic cancer outcomes[J]. J Clin Med, 2018, 7(12): 502. 

[17] Li Gen, Zhen Fuhang, Lv Wenhao, et al. Study on the pathogenesis of senile sarcopenia[J]. Journal of Brain and Neurological Diseases, 2019, 27(4):5. 

[18] Lee H, Heo Jw, Kim Ar, et al. Z-ajoene from Crushed Garlic Alleviates Cancer-Induced Skeletal Muscle Atrophy[J]. Nutrients. 2019;11(11):2724. 

[19] Cai Liya, Zhao Wenzhi, Yang Zhenpeng, et al. The pathogenesis of sarcopenia and the role of vitamin D and omega-3 fatty acid during tumor chemotherapy [J]. Chinese Journal of Advanced Medicine (Electronic Edition),20,12(01):13-19. 

[20] Chen JL, Colgan TD, Walton KL, et al. The TGF- β Signa lling Network in Muscle Development, Adaptation and Dise ases[J]. Adv Exp Med Biol, 2016, 900:97-131. 

[21] de Bree R, van Beers M A, Schaeffers A. Sarcopenia and its impact in head and neck cancer treatment[J]. Curr Opin Otolaryngol Head Neck Surg, 2022,30(2):87-93. 

[22] Jin S B, Tian Z B, Ding X L, et al. The Impact of Preoperative Sarcopenia on Survival Prognosis in Patients Receiving  Neoadjuvant Therapy for Esophageal Cancer: A Systematic Review and Meta-Analysis[J]. Front Oncol, 2021,11:619592. 

[23] Aoyama T, Nakazono M, Nagasawa S, et al. Clinical Impact of a Perioperative Exercise Program for Sarcopenia and  Overweight/Obesity Gastric Cancer[J]. In Vivo, 2021,35(2):707-712. 

[24] Trejo-Avila M, Bozada-Gutierrez K, Valenzuela-Salazar C, et al. Sarcopenia predicts worse postoperative outcomes and decreased survival rates in  patients with colorectal cancer: a systematic review and meta-analysis[J]. Int J Colorectal Dis, 2021,36(6):1077-1096. 

[25] Cancer Nutrition Committee of Chinese Anti-Cancer Association. Guidelines for diagnosis and treatment of tumor-associated sarcopenia [J]. Journal of Tumor Metabolism and Nutrition (Electronic Journal),2022,9(01):24-34. 

[26] Solheim T S, Laird B, Balstad T R, et al. A randomized phase II feasibility trial of a multimodal intervention for the  management of cachexia in lung and pancreatic cancer[J]. J Cachexia Sarcopenia Muscle, 2017,8(5):778-788.

[27] Yasuda M, Tanaka Y, Kume S, et al. Fatty acids are novel nutr ient factors to regulate mTORC1 lysosomal localization and apoptosis in podocytess[J]. Biochim Biophys Acta, 2014, 1842(7):1097-1108. 

[28] Smith GI, Atherton P, Reeds DN, et al. Omega-3 polyunsaturated fatty acids augment the muscle protein anabolic response to hyperinsulinaemia-hyperaminoacidaemia in healthy young and middle-aged men and womens[J]. Clin Sci (Lond), 2011, 121(6):267-278. 

[29] Shin SK, Kim JH, Lee JH, et al. Docosahexaenoic acid-mediated protein aggregates may reduce proteasome activity and delay myotube degradation during muscle atrophy in vitros[J]. Exp Mol Med, 2017, 49(1):e287. 

[30] Barber M D, Fearon K C, Tisdale M J, et al. Effect of a fish oil⁃ enriched nutritional supplement on metabolic mediators in patients with pancreatic cancer cachexia[J]. Nutr Cancer, 2001, 40(2):118⁃ 124. 

[31] Ryan A M, Reynolds J V, Healy L, et al. Enteral nutrition enriched with eicosapentaenoic acid (EPA) preserves lean body mass following esophageal cancer surgery: results of a dou⁃ ble⁃ blinded randomized controlled trial[J]. Ann Surg, 2009, 249(3):355⁃ 363. 

[32] Takayama K, Atagi S, Imamura F, et al. Quality of life and survival survey of cancer cachexia in advanced non-small cell lung cancer patients-Japan nutrition and QOL survey in patients with advanced non-small cell lung cancer study[J]. Support Care Cancer, 2016,24(8):3473-3480. 

[33] Liu Y Nan. Professor Heng Xianpei's experience in treating sarcosis [J]. Fujian Traditional Chinese Medicine, 2016,47 (4):53-54.

[34] Chen Jiamin, Zeng Yingping, Li Qiuhui, et al. Relationship between cardiopulmonary endurance, daily living activity ability and TCM syndrome type in elderly female patients with sarcopenia [J]. Beijing Traditional Chinese Medicine, 2018,37 (3):215-218.

[35] Wei Jing, Wei Kaishan, Luo Min, et al. Treatment of sarcopenia from "spleen"[J]. Clinical Journal of Traditional Chinese Medicine, 2019, 31(7):3. 

[36] Mao Zhizhi, Liu Xiaoting, Sun Xiaoting, et al. Liu Xiaoting uses the theory of "main spleen muscle limbs"to treat senilesarcopenia syndrome [J]. Liaoning Journal of Traditional Chinese Medicine, 2017, 44(7):1407-1409.

[37] Li Wei. Experimental study on the effect of medicated diet plus patch on antioxidant capacity and apoptosis of skeletal muscle in aging rats[D].Shenyang:Liao Ning University of Chinese Medicine,2017. 

[38] Zhang Shu,Yuan Ming,Wu Shiwen. Protective effect of Xuefu Zhuyu capsule on skeletal muscle atrophy under simulated weightlessness[J].Chinese Journal of Disaster Rescue Medicine, 2016, 4(11): 618-623.) 25/116 

[39] Wang Li,Zou Xi,Liu Shenlin . Clinical study of Xiangsha Liujun Tong plus minus combined with medroxyprogesterone in the treatment of tumor loss of appetite-cachexia syndrome[J]. Chinese Journal of Integrative Medicine,2018,38(8):927-931. 

[40] Xu Ling,Zhang Xuejin,Yang Guoliang . Effect of Four Gentlemen's Soup on Serum Cytokines in Cancerous Cachexia Mice [J]. Chinese Journal of Traditional Chinese Medicine,2015,33(4):907-910. 

[41] Chen J M, Yang T T, Cheng T S, et al. Modified Sjunzi decoction can alleviate cisplatin-induced toxicity and prolong the survival time of cachectic mice by recovering muscleatrophy [J]. JEthnopharmacol, 2019,233:47-55. 

[42] Hu Chenglin, Hu Lingjing, Ye Haiying, Et al. Effects of ginseng white surgery on TNF-α, TWEAK and Fn14 expression in patients with tumor cachexia[J].Journal of Chongqing Medical University, 2019, 44(07:950-953.

[43] Wu Yaosong, Jin Huabin, Chen Yulong, et al. Inhibitory effect of spleen and gastric methods on the growth of lung cancer cell line EC9706 transplanted tumor[J]. Chinese Journal of Traditional Chinese Medicine,2019,37(8):1836-1839. 

[44] Shang Yiwan, Meng Danhua, Luo Wenzhao, et al. Spleen and stomach method Liujunzi decoction enhances cisplatin by influencing cellular energy metabolism Inhibition of EC9706 activity [J]. Pharmacology and Clinical Journal of Traditional Chinese Materia Medica,2021,37(2):7-12.

[45] Lyu Cuitian,Dong Zhibin,Chen Yulong . Effect of Liujunzi decoction on immunomodulation of 4-nitroquinoline-1-oxide-induced lung cancer in mice[J]. Chinese Journal of Traditional Chinese Medicine, 2016, 31(7):2831-2834. 

[46] Zhang Yan, Sang Yaya, Peng Mengwei, et al. Mechanism of Liujunzi decoction regulating STAT3/ubiquitin proteasome pathway in preventing and treating muscle atrophy in lung cancer cachexia mice[J].Chinese Journal of Experimental Formulae,2022,8(05):8-15.

[47] Zhang Jingfang, Yang Xueqin, Zhang Xuefu. Anti-atherosclerotic effect of astragalus polysaccharides and its mechanism[J]. Chinese Journal of Arteriosclerosis, 2011, 19(3):1.

[48] Zheng Yongfeng, Wang Jiajing, Fu Chaomei, Wang Jianxin. Research Progress on Chemical Composition and Pharmacological Effects of Scutellaria baicalensis [J]. Chinese Patent Medicine, 2016, 38(1):7.

[49] Xu Xuejiao, Li Tianying, Li Xin, et al. Research Progress on Chemical Composition and Antidepressant Mechanism of Chaihu [J]. Chemical Engineer, 2022, 36(6):4.

[50] Lin Liya, Chen Suhong, Lv Guiyuan. Pharmacological study on qi and blood breaking, accumulation and pain relief in the operation of curcum[J]. International Journal of Chinese Medicine,

2008, 30(2):4.

[51] Wang Guomei. Modern Application of Traditional Chinese Medicine Wellingxian[J]. Journal of Medical Information, 2011, 24(023):586-586.

[52] Li Qiongge, Hu Dunmei, Ding Yufeng. Research Progress on Acute Chemical Components and Pharmacological Effects of Traditional Chinese Medicines[J]. Chinese Pharmacist, 2012, 15(2):3.

[53] Wang Ping, Wu Dongqing, Li Caixia. Study on antioxidant properties and bacteriostatic effects of ethanol extracts from cycloclave flowers [J]. Chinese Medical Theory and Practice, 2005.

[54] Gao Jiarong, Wu Jian, Han Yanquan. Study on cough and phlegm reduction effect of water extract and alcohol extract of spiral flower [J]. Anhui Medicine, 2013, 17(8):2.

[55] Feng Feng, Wang Xiaoning, Yan Cuimin. Study on chemical composition of citrus aurantium[J]. Asia-Pacific Journal of Traditional Medicine, 2012, 008(010):22-24.

[56] Ge Jianzhong. Overview of chemical composition and pharmacological effects of hawthorn in traditional Chinese medicine [J]. Frontiers of Medicine, 2017, 7(25):2.

[57] Wang Yaping. Progress in the pharmacology of angelica on blood and hematopoietic system[J]. Journal of Chongqing Medical University, 1988(3).

[58] Chen Qi, He Xiangyu, Zhou Manjia, et al. Research Progress on Chemical Composition, Pharmacological Effects and Clinical Application of White Peony [J]. Clinical Medical Research and Practice, 2021, 6(11):3.

[59] Sun Xiaoyuan, Yu Fan, Xiao Wei, et al. Research Progress on Modern Application of Mai Dong [J]. Modern Chinese Medicine, 2018, 20(11):6.

[60] Shi Lin, Wang Zhicheng, Feng Xuqiao. Research Progress on Chemical Composition and Pharmacological Effects of Schisandra [J]. Pharmaceutical Evaluation Research, 2011, 34(3):208-212.