Hemostatic Effect of the Nhi Chi Thang in Patients with Cystitis Bleed after Radiotherapy of Cervical Cancer

Cervical cancer is one of the most common cancers in women,
especially in their 30 years of age and older...


Dosage
Take two sachets (1 herbal box) / day, after eating, divided into two morning-afternoon times

Study Design
Open clinical trial, comparing before-after treatment.

Sample Size
40 patients diagnosed with stage II -III cervical cancer received radiation treatment at National Hospital K and appeared bleeding cystitis at level 1, 2, 3 according to the classification of Radiotherapy Association American cancer [1,3].
Excluded from the research:

Discussion
Regarding the effect of the remedy "Nhi chi thang" on signs of  Comment: The difference of 24-hour urination in patients before and after treatment was statistically significant with p <0.05 and p <0.01. Comment: At the start of treatment (D0), 100% of the patients had blood in their urine, of which 11 patients (27.5%) had blood urination above 70% of the time per day.
After 28 days of treatment (D28), no patients had more than 70% of their urine peeing in 24 hours. 67.5% of patients urinate blood less than 50% of urination in 24 hours. 7 patients (17.5%) did not urinate blood (p <0.05 and p <0.01).
Regarding the number of times the urine saw blood, research results in Table 3 showed that, before taking the drug, there were 11 patients with blood urination on 70% of the time urinating in 24 hours; 16 patients urinated with blood urination between 50% and 70% of the time, and 13 patients with blood urination found less than 50% of the total time they urinated. At the end of treatment, seven patients no longer urinated blood, 27 patients urinated with blood less than 50% of the total time of urination, six patients with blood urination from 50% to 70% of times urinating (p<0.05).
Regarding the effect of reducing the level of bladder bleeding in patients with cystitis bleed after radiotherapy of cervical cancer according to Droller's standards: For normal people, when there is bleeding, the body's anticoagulant mechanism is activated to create blood clots in the veins that block the bleeding location so that blood does not flow out of the vessels. In patients with cervical cancer treated with radiation therapy, the radiation causes the vascular wall to become fibrous, when there is bleeding, this blood clot is unstable, easily sloughing due to bladder spasms. When large amounts of blood flow are not eliminated in time, they can collect to form larger blood clots, which can sometimes partially peel off, even plaque-causing patients to naturally urinate. Blood clot or urinary retention caused by blood clots that block the urinary tract. The greater the amount of blood in the urine, the greater the number of times the person urinates blood in the urine, the greater the degree of bleeding in the bladder and the longer the bleeding period, the more severe the degree of illness [7,11,12]. in combination with spleen qi deficiency, qi cannot control blood, cannot stores blood causing hematuria. In "Huyet Chung luan"

Volume 27-Issue 4
(Blood discussing symptoms), Duong Ton Hai wrote: "Blood was born in the fire heart but spilled down in the liver, Qi was born in the kidneys that came up to lung but manipulated by the spleen; two organs water -fire is belonging to prenatal, the pregnant woman then prenatal creating postnatal, so the two organs water -fire are waiting in the spleen. The nutritional qi gets into the spleen, spleen creates nutrients and brought up the fire heart, fire heart turned into fire, that is called blood. So cure blood must cure the spleen to master. The remedy "Nhi chi thang" has the effect of the spleen, thus strengthening the effect of the spleen system to regulate the spleen (which regulates the movement of blood) from which to stop the blood [4,13,14].  inflammation. , bleeding at different levels [7,12].
According to the concept of Traditional Medicine, cancer has the name "Nham Chung"; meaning rugged, jagged, hard as rocky mountains, described in ancient literature as "emerging like a mountain," "carved like a ravine," "jagged as a cliff," due to melancholy worry outrageous anger, willpower disorders spleen, gallbladder qi frustrated, stagnant blood qi that create disease [13,14]. The nutrition qi gets into the spleen. The spleen creates nutrients brought to the fire heart. The heart turns into fire, which is called blood. Should treat spleen blood to take control of the spleen". Thus, related to the pathology of blood here, there are organs of heart, liver, kidney, and spleen, in which the spleen plays an important role in regulating the function of the organs of heart, liver, kidney [3,13,14]. Effects of remedy "Nhi chi thang" on erythrocyte index in patients with cystitis bleed after radiotherapy of cervical cancer. The research results presented in Table 4 show that before treatment, 40% of patients had erythrocytes (+++);  At the end of the treatment, 2% of the patients had negative erythrocytes; 65% of patients have red blood cell (+); 20% of patients have red blood cells (++); Only 10% of patients have RBC (+++).
The difference in the number of red blood cells in the urine at the time before and after treatment was statistically significant with p <0.05.

Conclusion
Study on the hemostatic effect of the remedy "Nhi chi thang" on 40 patients with cystitis bleed grade 1, 2, 3 according to the classification of the American Association for Radiotherapy after radiotherapy of cervical cancer in the course of treatment orally, 400ml of "Nhi chi thang" is divided into two doses in the 28-day course of therapy. The results of the study showed that the remedy "Nhi chi thang" helps to improve bleeding cystitis: Reduces the number of blood urination in 24 hours. After the 28-day course of treatment, 34/40 patients with blood urination saw less than 50% of the total number of times they urinated in 24 hours and 0 patients with blood urination above 70% of the total number of times the urine saw blood in 24 hours. Reducing the amount of blood in the urine: No more patients urinate large blood clots after treatment, there are 28/70 patients microscopic hematuria, general but no blood clot, reaching the rate of 70%. Urine tests showed a decrease in the number of red blood cells in the urine (p<0.05).
We are reducing the degree of bladder damage on cystoscopy images according to the standards of the American Association for Radiotherapy.