莲花清肝汤加减辅助TACE治疗原发性肝癌肝热血瘀证的临床研究OA

Objective:To explore the clinical efficacy of modified Lianhua Qinggan Tang in assisting hepatic artery chemoembolization(TACE)for the treatment of primary liver cancer(PLC)of liver blood stasis type.Methods:121 patients with advanced PLC admitted to our hospital from January 2020 to June 2022 were selected.They were divided into two groups by random number table method,and both groups were given routine liver protection and antiviral treatment.Sixty patients in the control group were treated with TACE,and 61 patients in the observation group were treated with Lianhua Qinggan Tang combined with TACE.Both groups were treated for 12 weeks,and were followed up for 2 years after the first TACE.The efficacy and side effects of the two groups were evaluated.Before and after treatment,Traditional Chinese medicine(TCM)syndrome score,serum alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate antigen-125(CA-125),serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),prothrombin time(PT),prothrombin activity(PTA)and survival during follow-up were observed.Results:There was no significant difference in the objective remission rate between the two groups of PLC(P＞0.05),and the disease control rate in the observation group was higher than that in the control group(P＜0.05).The TCM syndrome score,serum AFP,CA125 and CEA levels in the observation group were(10.4±1.6)points,(518.3±88.0)μg/L,(17.8±4.5)kU/L and(27.2±9.3)kU/L,respectively,which were lower than those in the control group[(13.1±1.3)points,(830.5±92.5)μg/L,(23.4±4.2)kU/L,(35.4±10.2)kU/L,P＜0.05].The serum levels of ALT,AST,and TBiL in the observation group were(40.7±5.2)μmol/L,(48.5±9.3)U/L,and(18.2±2.5)U/L,respectively,which were lower than those in the control group[(52.2±6.5)μmol/L,(56.3±10.2)U/L,and(22.6±3.1)U/L,P＜0.05].The PT of the observation group was(12.4±1.8)s lower than that of the control group[(17.3±1.8)s,P＜0.05],and the PTA was(86.1±7.2)％higher than that of the control group[(71.5±8.6)％,P＜0.05].There was no significant difference in the incidence of toxic side effects between the two groups during treatment(P＞0.05).During the postoperative follow-up period,the cumulative survival rate of the observation group was higher than that of the control group(P＜0.05).Conclusion:Lianhua Qinggan Tang,with modifications,can assist TACE in the treatment of advanced liver hot blood stasis type PLC by reducing the TCM syndrome score and tumor marker levels in patients,improving liver function and coagulation function,effectively increasing disease control rate,improving patient survival rate,and not increasing toxic side effects.