Clinical Observation Of Chai Shao Tang Combined With Hepatic Artery Infusion Chemotherapy In The Treatment Of Hepatocellular Carcinoma Combined With Portal Vein Carcinoma Thrombosis

Objective: In this study,we observed the clinical study of Chai Shao Tang combined with hepatic artery infusion chemotherapy(HAIC)in the treatment of hepatocellular carcinoma combined with portal vein carcinoma thrombosis(PVTT),and initially evaluated the clinical efficacy of this protocol,and on the basis of this study,we refined the clinical formula of Chai Shao Tang to provide consideration and reference for the combination of Chinese and Western medicine in the treatment of liver tumor lesions.Methods: Cases were selected from patients who were hospitalized in the Department of Hepatology(Guangxi TCM Liver Disease Treatment Center)of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from August 2021 to August 2022 and met the diagnostic criteria of hepatocellular carcinoma combined with PVTT.A total of 68 patients were included according to the inclusion and exclusion criteria,and were divided into treatment and control groups using the random number table method,with 34 patients in each group.Patients in both groups were treated with hepatic artery infusion chemotherapy(FOLFOX regimen)and given routine symptomatic treatment after surgery,while the treatment group was treated with Chinese herbal medicine Chai Shao Tang on top of HAIC.Solid tumor efficacy,progression-free survival(PFS),the 6-month survival rate,adverse effects,TCM evidence score,tumor markers and vascular endothelial growth factor(VEGF)were evaluated in both groups and analyzed using statistical software.Results: 1.Baseline data: There was no statistically significant difference(P > 0.05)between the two groups of patients in terms of gender,age,history of hepatitis,Child-Pugh score,Traditional Chinese Medicine syndrome score,and AFP,AFP-L3,DCP levels before treatment.2.Tumor response: The treatment group had an objective response rate(ORR)of 37.5% and a disease control rate(DCR)of 84.37%,while the control group had an ORR of 25.8% and a DCR of 70.96%.Statistical analysis showed that there was no statistically significant difference in ORR between the two groups(P > 0.05),but the DCR was significantly higher in the treatment group than in the control group(P < 0.05).3.PFS: The median PFS was 228 d in the treatment group and 179 d in the control group.The median PFS was significantly longer in the treatment group than in the control group,and the difference was statistically significant by Log-Rank test(P<0.05).The 6-month survival rate of all patients was100%.4.Safety: the incidence of elevated transaminases,elevated bilirubin,leukopenia,thrombocytopenia,nausea and vomiting,abdominal pain,and fever was lower in the treatment group than in the control group(P < 0.05),and there was no statistical difference in the data between the two groups regarding allergic reactions(P > 0.05).No treatment-related deaths were observed.5.In terms of the total TCM syndrome score: the total TCM syndrome score in the treatment group was significantly lower than that in the control group after treatment(P < 0.05),and the TCM syndrome score in the treatment group decreased significantly compared with that before treatment(P < 0.05),while there was no significant decrease in the control group,and the difference was not statistically significant(P > 0.05);in terms of the TCM syndrome efficacy: the total effective rate in the treatment group was 84.37%;the total effective rate in the control group was 67.74%;the effective rate in the treatment group was better than that in the control group,and the difference was statistically significant(P < 0.05).The difference was statistically significant(P < 0.05).6.Tumor markers and vascular endothelial growth factor: tumor markers decreased significantly in both groups compared with those before treatment(P < 0.05);the difference between markers in the treatment group and the control group was not statistically significant(P > 0.05);VEGF expression decreased significantly in the treatment group compared with the control group,and the difference was statistically significant(P < 0.05),and decreased significantly in the treatment group compared with that before treatment(P <0.05).The difference between the treatment group and the control group was statistically significant(P < 0.05),while the change in the control group before and after treatment was not significant(P > 0.05).Conclusion(s): The combination of Xiao Chai Hu Tang(Minor Bupleurum Decoction)and Danggui Shaoyao San(Tangkuei and Peony Powder)with hepatic arterial infusion chemotherapy(HAIC)can prolong the progression-free survival of patients,improve their Traditional Chinese Medicine clinical symptoms,and reduce the incidence of adverse reactions after HAIC treatment,making it safe and effective.At the same time,it can downregulate the expression level of vascular endothelial growth factor(VEGF)and improve the tumor microenvironment.The application value of the combination of Xiao Chai Hu Tang and Danggui Shaoyao San with HAIC deserves promotion and further research.