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赵容,李静,严涵,黄祎.柴胡化积方对原发性肝癌TACE术后综合征外周血炎症因子及bFGF、MMP-9、VEGF水平的影响[J].湖南中医药大学学报,2023,43(12):2328-2334[点击复制] |
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| 柴胡化积方对原发性肝癌TACE术后综合征外周血炎症因子及bFGF、MMP-9、VEGF水平的影响 |
| 赵容,李静,严涵,黄祎 |
| (湖南中医药大学, 湖南 长沙 410208;重庆合川区中医院, 重庆 401520;重庆市江津区第一人民医院, 重庆 402260;重庆市中医院, 重庆 400021) |
| 摘要: |
| 目的 观察柴胡化积方对原发性肝癌（primary hepatic carcinoma，PHC）经导管动脉化疗栓塞（transcatheter arterial chemoembolization，TACE）术后综合征的外周血炎症因子及碱性成纤维细胞生长因子（basic fibroblast growth factor，bFGF）、基质金属蛋白酶-9（matrix metalloproteinase-9，MMP-9）、血管内皮生长因子（vascular endothelial growth factor，VEGF）的影响。方法 选择来自重庆市中医院肝病科的105例原发性肝癌TACE术后综合征患者为手术组，根据随机数字表法将其分为对照组和观察组，对照组53例（后脱落3例）仅接受西医基础治疗，观察组52例（后脱落2例）在对照组基础上加用柴胡化积方口服治疗，每天1剂，分早晚温服。两组连续治疗7 d。同时纳入20名健康志愿者作为健康组。采用ELISA法检测并比较健康组、对照组、观察组的血清C反应蛋白（C-reactive protein，CRP）、白细胞介素-12（interleukin-12，IL-12）、bFGF、MMP-9、VEGF水平；比较观察组和对照组治疗前后中医证候评分、临床疗效；分层比较观察组相同PHC分期治疗前后bFGF、IL-12、MMP-9、VEGF水平；分层比较手术组相同PHC分期治疗后bFGF、IL-12、MMP-9、VEGF水平；比较治疗过程中对照组、观察组的安全性。结果 与对照组比较，观察组除胁痛证候外，其余各项中医证候评分及总分均降低（P<0.05）；与治疗前比较，观察组、对照组治疗后的中医证候各项评分及总分均降低（P<0.05）。与对照组比较，观察组临床总有效率较高（P<0.05）。与健康组比较，观察组、对照组术前第2天CRP水平升高（P<0.05）；与术后第1天比较，对照组、观察组术后第7、28天CRP水平下降（P<0.05）。与健康组比较，观察组、对照组术前第2天外周血bFGF、IL-12、MMP-9、VEGF水平升高（P<0.05）；与对照组比较，观察组术后第7、28天外周血IL-12、MMP-9、VEGF水平下降（P<0.05）；与术后第1天比较，对照组、观察组术后第7、28天外周血bFGF、IL-12、MMP-9、VEGF水平下降（P<0.05）。与对照组比较，观察组Ⅰb、Ⅱa、Ⅲa患者术后第7天外周血IL-12、MMP-9、VEGF水平下降（P<0.05），观察组Ⅱb患者术后第7天外周血IL-12、MMP-9水平下降（P<0.05）；与术后第1天比较，观察组Ⅰb、Ⅱa、Ⅱb患者术后第7天外周血IL-12、MMP-9水平下降（P<0.05），Ⅲa患者术后第7天外周血b FGF、IL-12、MMP-9、VEGF水平下降（P<0.05）。治疗过程中两组未出现不良反应。治疗过程中检测患者血常规、肝功能、肾功能未见明显异常。结论 柴胡化积方可以改善原发性肝癌TACE术后综合征患者临床表现、降低外周血bFGF、IL-12、MMP-9、VEGF水平。 |
| 关键词: 原发性肝癌 经导管动脉化疗栓塞术 栓塞综合征 柴胡化积方 炎症因子 |
| DOI：10.3969/j.issn.1674-070X.2023.12.028 |
| 投稿时间：2023-07-14 |
| 基金项目:重庆市科卫联合中医药技术创新与应用发展项目（2021ZY024085）。 |
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| Effects of Chaihu Huaji Formula on peripheral blood inflammatory factors and bFGF, MMP9, and VEGF levels of post-TACE syndrome in PHC patients |
| ZHAO Rong,LI Jing,YAN Han,HUANG Yi |
| (Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;Chongqing Hechuan Chinese Medicine Hospital, Chongqing 401520, China;The First People's Hospital of Jiangjin District of Chongqing, Chongqing 402260, China;Chongqing Hospital of Chinese Medicine, Chongqing 400021, China) |
| Abstract: |
| Objective To observe the effects of Chaihu Huaji Formula(CHHJF) on peripheral blood inflammatory factors, basic fibroblast growth factor(bFGF), matrix metalloproteinase-9(MMP-9), and vascular endothelial growth factor(VEGF) in patients with primary hepatic carcinoma(PHC) after transcatheter arterial chemoembolization(TACE).Methods A total of 105 PHC patients with post-TACE syndrome from the Department of Hepatology of Chongqing Hospital of Chinese Medicine were selected as surgery group. According to the random number table method, they were divided into control group and observation group. The control group, consisting of 53 cases(three cases dropped out later), received only basic treatment with western medicine, while 52 cases in the observation group(two cases dropped out later) were treated with CHHJF on the basis of control group, one dose daily, administered by dissolving it in water, taken in two portions in the morning and in the evening respectively. Both groups were treated continuously for seven days. Meanwhile, 20 healthy volunteers were included as the healthy group. ELISA was used to determine and compare the levels of serum C-reactive protein(CRP), interleukin-12(IL-12), bFGF, MMP-9, and VEGF in healthy group, control group, and observation group. The TCM pattern score and clinical efficacy were compared between the observation group and the control group before and after treatment. In addition, the levels of bFGF, IL-12, MMP-9, and VEGF were compared by stratification before and after treatment at the same PHC stage. Besides, stratified comparisons were made within the surgery group in terms of bFGF, IL-12, MMP-9, and VEGF levels after treatment at the same PHC stage. Furthermore, the safety of the control group and the observation group during the treatment were also compared.Results Compared with the control group, the observation group showed a decrease in the scores of various Chinese medicine patterns as well as the total score, except for the scores of hypochondriac pain pattern(P<0.05). Additionally, compared with those before treatment, the scores of various Chinese medicine patterns and the total score in the observation group decreased after treatment(P<0.05). Moreover, compared with the control group, the total effective rate of the observation group increased(P<0.05). Compared with the healthy group, the CRP level in the observation group and the control group increased on the second day before surgery(P<0.05), and compared with the first day after surgery, the CRP level in the observation group and the control group decreased on the 7th and 28th days after surgery(P<0.05). Besides, compared with the healthy group, the levels of bFGF, IL-12, MMP-9, and VEGF in the peripheral blood of the observation group and the control group increased on the second day before surgery(P<0.05). Furthermore, compared with the control group, the levels of IL-12, MMP-9, and VEGF in the peripheral blood of the observation group decreased on the 7th and28th days after surgery(P<0.05). Compared with the first day after surgery, the levels of bFGF, IL-12, MMP-9, and VEGF in peripheral blood of the observation group and the control group decreased on the 7th and 28th day after surgery(P<0.05). Compared with the control group, the levels of IL-12, MMP-9, and VEGF in peripheral blood of Ⅰb, Ⅱa, and Ⅲa patients in the observation group decreased on the first day after surgery(P<0.05), and the levels of IL-12 and MMP-9 in peripheral blood of Ⅱb patients in the observation group decreased on the first day after surgery(P<0.05). Furthermore, the levels of IL-12 and MMP-9 in peripheral blood of Ⅰb, Ⅱa, and Ⅱb patients were lower than those before treatment on the first day after surgery(P<0.05), and the levels of bFGF, IL-12, MMP-9, and VEGF in peripheral blood of Ⅲa patients were lower than those before treatment on the first day after surgery(P<0.05). During the treatment, there were no adverse reactions in either group, and there was no obvious abnormality in blood routine, liver function, and renal function.Conclusion CHHJF can improve the TCM clinical manifestations of post-TACE syndrome in PHC patients, and reduce the levels of bFGF, IL-12, MMP-9, and VEGF in peripheral blood. |
| Key words: primary hepatic carcinoma transcatheter arterial chemoembolization embolism syndrome Chaihu Huaji Formula inflammatory factor |
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