| Objectivesrwe study the temporary therapy effect and side effect of advanced stage of hepatic carcinoma by using Hydroxycamptothecin combined Iodinated Oil injection by hepatic artery by retrospective.And observed the changes of TCM syndrome pre- and post- operation.Methods:54 advanced stage primary hepatic carcinoma patients were selected to the retrospective case control study. All patients were divided into treatment group and control group, then, we set two subgroup according to Hepatic function of Child-Pugh's gradersimple drug inpuse subgroup and incorporating Iodinated Oil embolism subgroup.30 patients in treatment group were treated by the method of injecting hydroxycamptothecin through hepatic artery. (19 of 30 patients combined with Iodinated Oil embolism). 24 patients in control group were treated by TACE with combined chemotherapeutics of Pirarubicin, Mitomycin, Carboplatin(9 of patents)and Iodinated Oil(15 of patents). All patients were received interventional therapy for 1-2 times in 2 months. Therapy effect and side effect of the two group was evaluated after treatment.We diagnosised each patients into 5 TCM syndromes according to the Principle of clinical research for new traditional herbs (1st issue. Ministry of health P. R. China. August, 1993). The 5 syndromes was asfollowed: splenic deficiency and stagnation of liver qi, qi stagnation and blood stasis, accumulated dampness-heat, accumulated dampness-static blood , yin deficiency of liver and kidney. The change of syndrome preoperation and postoperation were observed and analyzed, which aimed to study the effect of Hydroxycamptothecin on the change of TCM syndrome for liver cancer. Datas were statistics and analysis by using SPSS 11.0 software.Results: 1. evaluation on therapeutic effect: on size of tumor, there was no statistically significant difference on effective power and stable power between the treatment group and control group after treatment(P >0. 05). On AFP value .there was no statistically significant difference between the two groups after 1 month, 2 patients got a more than 50% decreased after operation in 21 patients in middling concentration AFP value(>300ug/L) before operation in control group,wich showed a 9.6% rate. And in treatment group , there was 3 in 26 patients , the rate was of 11. 5%. On QOL scale, patients with incorporating Iodinated Oil embolism of two groups, QOL scale was raised post-treatment. There was statistically significant difference after 1 and 3 months of treatment. On the contrary, QOL scale was descended of patients with simple drug inpuseof two groups, There was no statistically significant difference.2. evaluation on side effect after operation: there was no statistically significant difference on fever and hepatic region pain between the two group (P>0. 05) .There were 1 patient of bloody stools after operation in the treatment group. There was decrease in WBC, RBC, PLT in both two groups, especially in treatment group, and there was a great decrease in WBC, PLT which showed significant statistical difference,but not the same in RBC. On the damage of liver function, as the most sensitive target on acute damage of liver function , TBIL, ALT, AST showed similar change in thetwo therapy groups. But the increase of ALT and AST was lower in treatment group than control group, there was significant difference (P<0. 05) .On renal function, there were no obviously change on serum creatinine (Cr) and blood urea nitrogen (BUN) in treatment group after treatment, but control group showed an average raise of 39. 379 ± 6. 616(umol/L) on Cr and 2.3344 ± 0.4421 (mmol/L) on BUN, it was significant difference on T Test of P<0.01 between the two groups.3. evaluation on TCM syndrome: In treatment group , we found that patients of sthenia-syndrome(qi stagnation and blood stasis,accumulated dampness-heat, accumulated dampness-static blood) were decrease, and there was a raise in patients of asthenia-syndrome (splenic deficiency and stagnation of liver qi, , yin deficiency of liver and kidney) after treatment (P< 0.05). In control group, we found that patients of sthenia-syndrome (qi stagnation and blood stasis, accumulated dampness-heat, accumulated dampness-static blood) were raise, and there was a deplete in patients of asthenia-syndrome (splenic deficiency and stagnation of liver qi, , yin deficiency of liver and kidney) after treatment (P>0. 05) .Conclusions: hydroxycamptothecin has some antitumous effect, It has got the good effect using on interventional therapy on advanced stage of liver cancer similar to the classic TACE on temporary effect.It can improve the patients' QOL on those of Hepatic function of Child-Pugh of A and B than chemotherapeutis. It's was of less damage on liver and renal function, and was of more safe than chemotherapeutics. By the change on the TCM syndrome pre- and post- operation, it was improved that hydroxycamptothecin has the function of anticancer and removing stasis, promoting blood flow and detumescence, clearing away the heat-evil and expelling superficial evils. Because of our sample size was small, the...
|
PDF Full Text Request