Combination of Chinese and Western medicine in the treatment of tumors has experienced more than 40 years of hard work. Combination of Chinese and Western medicine has made great progress in the recent efficacy of malignant tumors, prolonging the survival time of patients, and maintaining and improving the quality of life of cancer patients, showing the characteristics and advantages of Chinese medicine in the treatment of tumors. Looking back to the past and forward to the future, with the development of modern medical science, the research work of TCM and the combination of Chinese and Western medicine in the treatment of tumors has made great progress from clinical to basic, and will face unprecedented opportunities and challenges. The exploration of traditional Chinese medicine and the combination of Chinese and Western medicine in the prevention and treatment of tumors is a difficult task with a bright future. The combination of Chinese and Western medicine was born in the specific historical and cultural background of both Chinese medicine and Western medicine in China. It has created a new and important way for the development of medical science in China. As early as the 1950s and 1960s, the research of combined Chinese and Western medicine on tumor was in its initial stage, and the first generation of Western medical practitioners who took off to study Chinese medicine played an important and pioneering role in combining Chinese and Western medicine. In the 1970s, the research on the combination of Chinese and Western medicine was not extensive enough, and the progress was not great. The published literature was mainly based on single folk prescriptions and case reports, which were not too scientific, realistic and practical in the real sense. Since the 1980s, the research on the combination of Chinese and Western medicine in tumors has been very active, and a large number of papers have summarized the preventive and curative effects of Chinese medicine on the toxic side effects of Western medical treatments (surgery, radiotherapy, chemotherapy). The project. In clinical practice, the common side effects of radiation and chemotherapy include inflammatory reactions, digestive disorders, bone marrow suppression, and weakening of the body. According to the identification of Chinese medicine, the main reason is that the internal heat and toxicity of the organism is too strong after the invasion of external toxicity, resulting in the damage of fluid, disharmony of qi and blood, damage of qi and blood and the loss of liver and kidney, etc. The side reactions in radiotherapy are more manifested as the symptoms of heat and toxicity injuring yin, and the main treatment principle is to clear heat and detoxify, produce fluid and moisten dryness, and nourish liver and kidney. Cancer Hospital of Academy of Medical Sciences and Institute of Traditional Chinese Medicine clinically treated 102 cases of esophageal cancer with these treatments together with intracavitary radiation, none of them had side effects, while in the radiotherapy group alone, one-third of patients had local pain and even could not eat and drink. The First People’s Hospital of Fuzhou City used Fu Zheng Sheng Jin Tang (Dang Ginseng, Bai Zhu, Fu Ling, Sha Shen, Xuan Shen, Sheng Di, Yu Zhu, etc.) with radiotherapy to treat nasopharyngeal cancer not only to reduce the recent toxic side effects and the incidence of long-term sequelae, but also to improve the 5-year survival rate. The side effects of chemotherapy mainly manifested as damage to qi and blood. Beijing Hospital of Traditional Chinese Medicine used ascending blood soup (Astragalus, Radix et Rhizoma, Atractylodes Macrocephalae, Poria, Radix et Rhizoma Chicken, Radix et Rhizoma Chasteberry, Semen Cuscutae, etc.) to prevent and treat the toxic side effects caused by chemotherapy, which proved that the formula can reduce the gastrointestinal reactions caused by chemotherapy and protect and enhance the immune function of patients. In Hunan Cancer Hospital, 137 cases of postoperative breast cancer patients with stage II and III were treated with traditional Chinese medicine plus chemotherapy, and compared with 143 cases of postoperative patients with the same stage of single chemotherapy, it was found that the toxic side effects of patients in the traditional Chinese medicine plus chemotherapy group were significantly reduced compared with the control group, and their survival rate was also significantly higher than that of the single chemotherapy group. The completion rate of chemotherapy and radiotherapy plus traditional Chinese medicine was 70-90% in the chemotherapy and radiotherapy group, while the completion rate of chemotherapy and radiotherapy alone was 50-70%, and there was a statistical difference between the two groups. 2. Combination of Chinese medicine with surgery, radiotherapy and chemotherapy can improve the recent and long-term efficacy of tumor patients. There are abundant clinical research reports on the combination of Chinese and Western medicine to improve tumors such as gastric cancer, lung cancer, liver cancer, colorectal cancer, etc., which show the clinical treatment results of combining Chinese and Western medicine in tumors. Yu Guiqing et al. developed the combination of spleen and kidney tonics with chemotherapy to treat 303 patients with stage III gastric cancer after surgery, and achieved a 3-year survival rate of 77.31%, a 5-year survival rate of 53.40%, and a 10-year survival rate of 47.73% in addition to the recent efficacy and long-term follow-up. Qiu Jiaxin et al. used the spleen-strengthening method as the main treatment for postoperative advanced gastric cancer, and observed by prospective matching method. The results suggested that the survival rates at 1, 2 and 3 years were 82.44%, 62.49% and 37.12% in the herbal group, respectively, while the rates were 41.39%, 27.59% and 7.62% in the chemotherapy group, respectively. There were significant differences between the two groups. The prognosis of non-small cell lung cancer is poor. Liu Jiaxiang et al. treated 304 cases of advanced primary lung cancer with the method of nourishing yin, increasing fluids and benefiting qi and warming yang, and conducted a controlled study with chemotherapy. The survival rates at 1, 3, and 5 years after treatment were 60.94%, 31.36%, and 24.22% in the Chinese medicine group and 36.67%, 24.56%, and 0% in the chemotherapy group, respectively. The median survival period was 417 days in the Chinese medicine group and 265 days in the chemotherapy group, with significant differences. The median survival period was 417 days in the herbal group and 265 days in the chemotherapy group. Yu Erxin of Shanghai Cancer Hospital applied the combination of Chinese and Western medicine in the treatment of primary liver cancer. From the perspective of Chinese medicine, it is believed that middle and late stage liver cancer often manifests as spleen deficiency and qi stagnation, so the method of strengthening the spleen and regulating qi is used, and Xiang Sha Liu Jun Plus Decrease is applied. In the treatment of 228 cases of primary liver cancer (intermediate stage) with Chinese medicine plus radiotherapy, the 5-year survival rate was 42.97%, with a median survival of 53.4 months. In contrast, the 5-year survival rate of the control group was 14.4%, and the median survival was only 11.1 months. As for the combined Chinese and Western medicine treatment of colorectal cancer, it has been widely used in clinical practice and has achieved better results. Pan Mingji et al. used Fu Zheng Jian Spleen (Ginseng, Atractylodes, Ling, Cao, Shu Di, Shou Wu, Astragalus, Fructus Lycii, Lady’s Mantle, Sha Shen, Mai Dong, Chicken Blood Vine, Gorgonzola, Shan Yao) with chemotherapy; Fu Zheng Yang Yin Tang (Ginseng, Atractylodes, Ling, Cao, Mai Dong, Sha Shen, Yu Zhu, Serpentine, Dan Shen) with radiotherapy in 260 cases of medium to late stage colorectal cancer after surgery. The results were stage II (36 cases), stage III (155 cases) and stage IV (69 cases), whose 5-year survival rates were 85.5%, 56.12% and 21.73%, respectively, with a mean of 52.78%, and the above efficacy was better than that reported by single Western medical treatment in China. (1) Research on the essence of “evidence” of tumor “evidence” is a unique concept in the academic thought of Chinese medicine, it is a diagnosis result derived from the synthesis of various symptoms through four diagnoses under the guidance of Chinese medicine theory, and is a reflection of the essence of the disease at a certain stage. It is a reflection of the essence of a certain stage of the disease, which reflects the main lesions of that stage with a set of related symptoms, revealing the cause, location, nature and potential of the disease in TCM and providing a basis for treatment. One of the advances in the treatment of tumors by combining Chinese and Western medicine is the creation of certain animal models that conform to the basic theories of TCM regarding certain “evidence”, and the exploration of their pathological and physiological changes and the effects of TCM on these changes according to modern scientific methods. Yu Ersin et al. found that the tumor growth of spleen-deficient animals has certain specificity, and a series of changes in metabolism, blood viscosity and immune function have occurred in the body after tumor-bearing, which can slow down the tumor growth, reduce the appearance of malignant mass and prolong the survival period when using Chinese herbs for strengthening spleen and benefiting qi. (2) Research on TCM tumor treatment rules a. Fu Zheng Pei Ben Method: The research on applying Fu Zheng Pei Ben prescriptions as immune regulation can be said to have the most content, the longest time, the most in-depth work and convincing results. Medical Academy of Sciences Cancer Hospital, Institute of Traditional Chinese Medicine, etc. on some tonic herbs Astragalus, chasteberry, ginseng and Poria polysaccharide, poria polysaccharide, as well as the tonic Chinese Yi Qi Tang, six-flavored Dihuang Tang, etc. have done a large number of experiments, proved to promote the immune function of experimental animals, on the activation of T cells, improve the reticuloendothelial cells and macrophage viability have different degrees of effect. To improve the hematopoietic function of bone marrow and regulate endocrine also has a good effect. b. Nourishing Yin and generating fluid method: Shanghai University of Traditional Chinese Medicine made a nourishing Yin combination with Sha Shen, Tian Dong, Xuan Shen and Huang Jing, etc. Through the experimental observation of Lewis lung cancer model in mice, it showed that the nourishing Yin combination had the effect of prolonging the survival period of tumor-bearing mice and activating the splenocytes of tumor-bearing mice. The observation of spleen cytology and its ultrastructure by light and electron microscopy showed that the immunologically active cells in the spleen of lotus mice had a certain protective and stimulating effect, and also had a stimulating effect on macrophages. c. Heat-clearing and detoxification method: Research data confirmed that many heat-clearing and detoxifying drugs have anti-cancer effects. Such as lobelia, snake berry, white ying and other extracts on mouse liver cancer (H22) ascites cancer cell proliferation has a significant inhibitory effect, while the activity of phosphodiesterase on the surface of the cancer cell membrane was observed to be significantly reduced. Other experiments such as buttercup extracts were found to cause acute necrosis of cancer cells, indicating that the action link of purgative and detoxifying drugs is not consistent. d, blood circulation and blood stasis method: from the microcirculation, blood rheology, tissue metabolism and other aspects of the nature of “blood stasis” and the mechanism of blood stasis treatment of tumors, the main points are as follows: ① direct action on cancer cells. ②Improve the function of vascular endothelial cells, reduce platelet adhesion and aggregation, reduce fibrinogen content and increase fibrin dissolution. ③Improve microcirculation and the hypercoagulable state of the body in order to facilitate the reduction of tumor metastasis. ④Decrease the number of fibroblasts and the ability to secrete collagen, and reduce the side effects such as tissue fibrosis and vascular occlusion caused by radiotherapy. (3) anti-tumor herbal screening and its research results China’s anti-tumor screening of more than 3,000 kinds of herbal medicines, more than 400 compounds, found that more than 150 kinds of Chinese medicine, more than 30 compounds have anti-cancer effects, involving the family of plants, including the family of legumes, lilies, buttercups, Tennantaceae, Umbelliferae, Labiatae, Cucurbitaceae, Euphorbiaceae and ginger; from which some anti-cancer active ingredients have been isolated. Some have been used in clinical trials. From the perspective of combining Chinese and Western medicine, the research of anti-tumor herbal medicine mainly revolves around the following five aspects: (1) searching from the vast medical books of our predecessors (e.g. Zanthoxylum and its derivatives, Toadstool and various preparations); (2) searching from folk prescriptions (e.g. Curcuma oil of Curcuma longa and its components); (3) providing clues from Chinese medicine clinics (e.g. Angelica rebaudiana pills to Qing Dai and Indigo red); (4) experimental screening and borrowing from foreign discoveries (e.g., hippophae and hippophaeine, Cephalotaxus vulgaris and trichothecene, paclitaxel and paclitaxel); (5) exploring from plant relatives (e.g., Cichorium spp. and colchicine). In today’s rapid development of molecular biology and bioengineering, some drug research experts are heading back to the avenue of nature, and China has achieved a number of research results with international level in this regard. A, from plant cytotoxic drugs: (1) Qing Dai → Indocyanine (2) horse rushes → horse rushes (3) winter clover → winter clingin (4) Cephalotaxin → trichothecene (5) hippophae → hippophaeine (6) yew → paclitaxel B, with biological response regulator-like effect of Chinese medicine: ginseng, boswellic acid, poria, poria polysaccharide, shiitake mushroom polysaccharide, yunzhi polysaccharide, Cordyceps sinensis, acanthopanax, chasteberry, coix seeds → conlet. (4) Research on the mechanism of anti-tumor effect of Chinese medicine a. Regulation of body immune function Modern research has concluded that the effect of Fu Zheng Chinese medicine is multifaceted, and regulation of immune function is one of the important aspects. For example, Huang Qi, Ginseng and Ligustrum have regulatory effects on NK cells and T cells. Domestic scholars have applied modern immune indexes to observe the dynamic changes during the treatment of more than 500 cases receiving Fu Zheng Chinese medicine, indicating that Fu Zheng Chinese medicine has certain enhancement effects on cellular immune function and inhibits T8 (Ts) cells in T cell subpopulation. And it can protect and promote the synergistic effect of hematopoietic stem cells and interleukin II. b. Induction of apoptosis Cell regulation, also known as programmed cell death, is an active cell suicide process under genetic control. When the genes that induce apoptosis are inactivated and mutated or genes that inhibit apoptosis are overexpressed, tumor cells escape apoptosis and metastasis occurs through some pathway. Therefore, inhibition of tumor growth and metastasis through induction of apoptosis has received increasing attention. Elemicin, the active ingredient extracted from the Chinese medicine Curcuma longa, plays its role in inhibiting cancer cell development and metastasis by inhibiting DNA, RNA and protein synthesis in tumor cells and inducing differentiation and apoptosis in lung cancer cells. Then, the active ingredient of ginseng, ginsenoside Rg3, inhibits neovascularization of tumors by inhibiting the production of b-FGF. c. Anti-tumor cell metastasis The most important feature of malignant tumors is the aggressiveness and metastasis of tumors. The metastasis of tumor is a very complicated multi-step process, and there is a lack of practical and effective prevention and treatment measures in the medical field today, so the research on the application of Chinese medicine against tumor cell metastasis has also received attention. For example, studies on the genetic level by means of molecular biology, studies on DNA, platelet adhesion factor and endothelial cell adhesion factor by flow cytometry, studies on metastasis and protease degradation, and studies on metastasis and tumor neovascularization; the results have initially suggested that Chinese medicine has a multi-site and multi-target role in inhibiting tumor metastasis. The mechanism of ginsenoside Rg3 inhibition of tumor neovascularization is through the inhibition of b-FGF production, and it was observed in the TACE experiment that the MVD vessel count in the Chinese medicine Bletilla microsphere embolization group was significantly lower than that in the control group, and the mechanism was the inhibition of tumor vascular endothelial growth factor binding to its receptor. Relevant blood-activating and stasis-transforming drugs have a certain role in anti-tumor therapy, such as Yujin, Chuanxiong, Danshen, leech and the compound preparation Aidi injection also have anti-new blood vessel formation effects, and their exact molecular biological mechanisms are yet to be studied in more depth. d. Reversal of tumor multidrug resistance The multidrug resistance of tumor cells is the main reason for the failure of tumor chemotherapy. It is customary to refer to drugs that can reverse multidrug resistance as multidrug resistance reversal agents (MDR) or chemotherapy sensitizers (CS). Recent studies have shown that some natural drugs have multidrug resistance reversal effects at low concentrations of some Hu saponins, Lei Gong Gong Glucoside, Zhe Bei Bei Bei Alkaloids, Powder Pregnancy Alkaloids, Qian Jin Tang Alkaloids and other related studies provide a scientific basis for the anti-multidrug resistance effects of Chinese medicine. On the basis of reviewing the achievements and experiences of combined Chinese and Western medicine tumor research for more than 40 years and combining the achievements and development trend of modern tumor research, we believe that combined Chinese and Western medicine tumor research has great potential. 1. Large sample research confirms the exact efficacy of Chinese medicine in the treatment of tumors. In the past, the clinical research results obtained in the study of Chinese medicine for tumor treatment were based on a small number of observed cases, so we cannot easily draw conclusions about the efficacy of Chinese medicine for cancer treatment, and further verification and confirmation are needed on the basis of expanded observed cases. Only under the strict diagnostic criteria can the research conclusions be scientific, comparable and feasible for clinical application. 3.Large-scale collaborative research The best way to clarify the clinical efficacy is to establish the clinical treatment plan and improve the clinical efficacy of tumor combining Chinese and Western medicine, with randomized, open, multi-center and large-scale collaboration as the subject characteristics, and to organize the units with experience in tumor treatment combining Chinese and Western medicine for collaborative research. 4. The influence of Chinese medicine on the survival quality of tumor patients The application of Chinese medicine to improve the quality of life of tumor patients is the main direction to bring into play the advantages of Chinese and Western medicine in tumor treatment, and is also in line with the trend of international anti-tumor treatment research. By applying the accepted quantitative standards about quality of life and through a large number of case observations, the research data obtained will provide a scientific basis for the objective evaluation of the efficacy of Chinese and Western medicine in the treatment of tumors. 5.Research and development of effective anti-tumor Chinese medicine preparations How to improve the dosage form on the basis of effective clinical observation and further improve the anti-tumor efficacy of Chinese medicine preparations? This is a question worthy of our consideration. The reason why a formula or a drug can achieve curative effect is that there must be one or several active ingredients that play a major role. It is of great significance to improve the anti-tumor efficacy of traditional Chinese medicine by determining the active ingredients in a scientific way, studying the distribution and metabolic law of drugs in the body, and clarifying their effective dose and chemical properties. In the past, it was thought that only the study of compound prescriptions had the characteristics of TCM, and once the study of TCM monomers was out of the scope of TCM, we think this kind of thinking is worth discussing, in any case, the clinical efficacy of tumors should be taken as the premise, and the purpose is to improve the anti-tumor efficacy of combined Chinese and Western medicine, and such research should likewise attract sufficient attention. For example, the extraction and application of indigo red, Conlet, and the active ingredients of Chinese medicine have not only improved the efficacy but also avoided the waste of medicinal materials in the process of medication, and such research ideas are worthy of our reference. 6. Pay attention to the regulation of the internal environment of the patient’s organism, and achieve the balance of the internal environment through comprehensive treatment. Tumor patients can be roughly divided into two categories, one is patients who have hope to be cured through comprehensive treatment, and the other is patients who are difficult to be cured by the current medical level, for the former we may adopt more aggressive treatment to obtain satisfactory clinical effect of removing tumor cells from the body in the short term, while for the latter we try to prolong life on the basis of improving symptoms. However, regardless of the purpose of treatment, we are faced with the problem of analyzing the strength of the patient’s positive and evil forces and the trade-off between the emphasis on helping positive and eliminating evil. The purpose of using Chinese medicine is to improve the internal environment of the body, so that it can be transformed in a direction unfavorable to tumor recurrence and metastasis. For example, some scholars in China have conducted a more in-depth study on the patterns of patients in the middle and late stages and pointed out that the evidence of Qi deficiency and blood stasis in cancer is an important cause of tumor recurrence and metastasis, that is to say, the Qi deficiency and blood stasis in cancer patients is a kind of internal environment which is favorable to tumor recurrence and metastasis. The internal environment of the body. We found that the method can not only improve the macroscopic symptoms of Qi deficiency and Blood stasis, but also microscopically improve the hypercoagulable state of blood and immunosuppressive state, which are closely related to tumor recurrence and metastasis; the TCM evidence of cancer patients often reflects the nature, location and degree of environmental disorders in the body. Accurate identification and reasonable prescriptions are essential. Professor Schipper, an internationally renowned Canadian oncologist, has put forward a new understanding of the concept of tumor, arguing that the regulation and information transmission between cells are disrupted, but not lost, when suffering from tumor, and that carcinogenesis is the result of a few genes and environmental changes. The carcinogenic process is characterized by deregulation rather than full autonomy, and the oncogenic effect is a continuum of reversal possibilities. The treatment of tumors guided by this new concept believes that excessive killing of cancer cells may impair the normal responsiveness of the body, disrupt the balance of the body’s internal environment, and worsen and disrupt the imbalanced regulatory role of the body, which is most important for cancer treatment. This concept also provides new research ideas for recognizing the clinical phenomenon of recurrence and metastasis after Western medical treatment but still cannot avoid it, especially for the efficacy characteristics of Chinese medicine treatment with tumor survival. Development trend 1. Application of evidence-based medical concepts and methods to promote the standardization of clinical decision-making in TCM and TCM oncology. Clinical efficacy is the basic criterion for measuring all treatments, and efficacy is also the vitality for the survival and development of TCM and TCM tumor treatment. TCM tumor treatment is people-oriented, highlighting evidence-based treatment and forming significant characteristics of “individualized treatment”. The evaluation of treatment response is not limited to the change of certain biological indicators, but also pays more attention to the coordination and balance between human and nature, which is consistent with the concept of evidence-based medicine. At present, the problems in the quality of clinical research on TCM tumors are that the evaluation standards of therapeutic efficacy are not uniform, and there is a lack of rigorous and reasonable design and strict evidence-based norms. There is a lack of evaluation system for clinical adverse reactions and clinical efficacy. Therefore, applying the concept and evaluation method of evidence-based medicine, adopting randomized and double-blind method for professional design, studying the distribution pattern of TCM tumor evidence, evaluating the effectiveness of existing treatment protocols, and promoting the standardization of clinical evidence and efficacy evaluation system and scientific decision-making of TCM, TCM and TCM tumor clinics are beneficial and will probably have far-reaching effects. 2. To bring into play the advantages of TCM, TCM and TCM combination in comprehensive tumor treatment. The occurrence and development of tumor, invasion and metastasis is an extremely complex biological process with multiple factors, multiple links and steps. Modern clinical treatment of tumor has entered the era of comprehensive treatment. The significant feature of Chinese medicine in the treatment of tumor is to improve the symptoms, stabilize the tumor, improve the quality of life and achieve “survival with tumor”. Therefore, Chinese medicine has obvious advantages in the comprehensive treatment of middle and late stage tumors. Through years of clinical practice, Chinese scholars have reached a clear consensus on the combination of Chinese and Western medicine in the treatment of tumors, and have gradually formed the basic model of the combination of Chinese and Western medicine in the treatment of tumors, i.e., the combination of disease identification and evidence identification; the combination of helping the positive and eliminating the evil; the combination of overall treatment and local treatment. 3. It is the direction of tumor clinical research to pay attention to the improvement of tumor patients’ quality of life and survival. Improving the quality of life and survival of tumor patients is the main direction to bring into play the advantages of Chinese medicine and the combination of Chinese and Western medicine in tumor treatment. The classical method of tumor efficacy evaluation is to take the change of tumor as the only standard to measure the efficacy, and the efficacy evaluation standard of solid tumor proposed by WHO has been used as the golden index for efficacy evaluation in clinical practice. However, the treatment of malignant tumors is still based on surgery, radiotherapy and chemotherapy, and there has not been any breakthrough in its efficacy. Nowadays, people have realized that malignant tumor is a genetic disease and a systemic disease, and many “early stage” cancer patients have subclinical metastases at the time of diagnosis. Therefore, in the field of surgical oncology treatment, people have changed the past practice of relying on extended radical surgery to improve the efficacy, and have noticed the need to consider the possible postoperative complications and the quality of postoperative survival of patients. For the more advanced patients who are inoperable, when choosing the measures of radiotherapy and chemotherapy treatment, they also realize to put the responsiveness of the organism in the first place and strive to improve the survival quality of the patients with the emphasis on improving the efficacy, and include the measurement of survival quality in the evaluation of the efficacy. At present, for most patients with advanced stage or recurrence, it is impossible to achieve the disappearance of tumor by any treatment. The biggest problem to be solved is how to reduce the pain, improve the quality of survival, prolong the survival period, and achieve the purpose of “survival with tumor” by stabilizing the tumor and improving the symptoms. V. Conclusion Combination of traditional Chinese and Western medicine in the treatment of tumor is a treatment method with Chinese characteristics. A large number of clinical observations have shown that the organic combination of two medical theories and treatment methods, which complement each other and give full play to the strengths of both, can achieve better efficacy than Chinese medicine or Western medicine alone in improving tumor efficacy, prolonging patients’ survival and maintaining and improving the quality of cancer patients’ survival. Therefore, in further exploring and studying the combination of Chinese medicine and Western medicine in the treatment of tumors, it is necessary to start from a holistic concept, and at the same time make comprehensive consideration according to the specific conditions such as lesion location, cancer cell type, TNM stage and patient’s general condition, so as to develop the best comprehensive treatment plan for various tumors and create a new situation in tumor treatment.