| Background and ObjectiveMalignant ascites is defined as abnormal accumulation of fluid in the peritoneal cavity as a consequence of cancerl and presents a difficult clinical problem causing discomfort to many patients in the advanced stages of their disease.It occurs in association with a variety of cancer,especially ovary,stomach,and colon cancer,etc.Frequent troublesome symptoms of malignant ascites include distension, pain,dyspnea,loss of appetite,nausea,reduced mobility and problems with the body image,and the symptoms are uncontrol usually.The accretion rate of malignant ascites is 20 times of benign ascites(4～5ml/H).It's the final stage when malignant ascites ocuurs.So the inhibition of malignant ascites will result in a prolongation in the live time with a concomitant increase in life quality.Guided by the "tumor tan-zheng theories",traditional Chinese medicine(TCM) therapy obtains favourable effect in patients of advanced alimentary canal cancer.According to the theory,"tan-he"is the patho-fundation,"tan-zhuo" destroys "pi-wei",impact normal transmission of"jing-ye".We observed that the therapy with "xiao-tan li-shui theory" to those patients in malignant ascites is benificial.But some patients,such as in final stage or septatus ascites,have no effctive methods,because they can't eat anything including TCM medicinal broth or tolerant intraperitoneal chemotherapy(IPCT).Then it's essential remarkabely to find new therapy methods to these patients.Malignant ascites is in cases of disseminated intra-abdominal cancer-induced ascites.Its pathophysiology is caused by multiple factors.However,increased microvascular permeability of tumor vasculature is implicated as a main factor in the formation of malignant ascites along with lymphatic obstruction resulting from tumor invasion of open-ended diaphragmatic lymphatic channels.The roles of tumor-derived glycoprotein complexes,vascular endothelial growth factor(VEGF),matrix metalloproteinases(MMPs),heparinase(HPA) have been reported in the microvascular permeability process recent years.This experiment manufactues Xiaotan Lishui Tincture with the guideline of "tumor tan-zheng theories".We investigate the survival effect of the XLT on mice bearing Ehrlich ascites carcinoma(EAC) cell and its possible mechanism. MethodsMouse EAC model was established by intraperitoneal injection of 0.2 ml E2G8 ascitic cells(concentration 4×10~6/ml) and the animals were subsequently divided into 4 groups randomly,respectively tumor control group,XLT group(external abdominal skin with XLT),CTX group(intraperitoneal injection of CTX),XLT+CTX group(topical XLT combined with intraperitoneal injection of CTX).The EAC cell-bearing mice were observed for the effect on body weight changes,mouse net weight at the death, ascites weight at the death,survival time,and Elisa evaluation of vascular endothelial growth factor(VEGF) and heparinase(HPA) expressions in ascites.Results:(1)XLT group reduces the deteriorating trend of body weight of tumor-bearing mice in the 0-12 days(P＜0.05),the role of XLT+CTX group is more significantly(P＜0.05).(2)XLT group have no the effect of reducing malignant ascites formation(P＞0.05),combined with the use of CTX have this effect(P＜0.05).(3)The net weight of XLT+CTX group have be effectively improved at the death(P＜0.05),better than simply with CTX(P＜0.05).(4)There is no significant difference in all groups of mice of survival time,VEGF concentration in ascites(P＞0.05).(5)XLT group,CTX group,XLT+CTX group significantly reduce HPA concentration in ascites(P＜0.05).Conclusion:The treatment of XLT reduces the deteriorating trend of body weight,combined with intraperitoneal injection of CTX resultes in a strengthening role of this trend and a decrease in the ascites weught with a concomitant increase in life quality of the EAC cell-bearing mice,but could not extend the survival time.These results probably can be explained by reducing the HPA level in ascites to cut down the peritoneal and vascular permeability.
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