Research Progress on Liuwei Dihuang Decoction Combined with Sijunzi Decoction plus Endocrine Therapy for Prostate Cancer with Spleen Kidney Insufficiency Syndrome

Abstract

Prostate cancer (PCa) is a common malignant tumor that seriously endangers the health of middle aged and elderly men worldwide. In recent years, the incidence and mortality of prostate cancer in China have increased remarkably. Most patients are diagnosed at advanced stages and lose the opportunity for radical treatment. Androgen deprivation therapy (ADT) serves as the standard foundational therapy for metastatic hormone sensitive prostate cancer (mHSPC). While ADT brings survival benefits, it is accompanied by risks of progression to castration resistant prostate cancer (CRPC) and a series of severe adverse events that impair patients’ quality of life. Traditional Chinese medicine (TCM) exhibits unique advantages in the treatment of prostate cancer, especially in strengthening body resistance, attenuating toxic effects and enhancing therapeutic efficacy. Under the background of ADT, spleen kidney insufficiency has become a common TCM syndrome among patients with hormone sensitive prostate cancer receiving ADT. Liuwei Dihuang Decoction (LDD) and Sijunzi Decoction (SJD) are classical prescriptions for nourishing kidney yin and tonifying qi to invigorate the spleen, respectively. The combination of the two prescriptions conforms to the therapeutic principle of simultaneous tonification of the spleen and kidney. This review systematically sorts out current status and challenges of western medical treatment for prostate cancer, TCM understanding of its etiology and pathogenesis, as well as research advances in clinical application and underlying mechanisms of LDD and SJD in prostate cancer management. Furthermore, it demonstrates the theoretical basis, clinical potential and research value of LDD combined with SJD plus ADT for prostate cancer with spleen kidney insufficiency syndrome.