| [Research Purpose]Malignant hydrothorax and ascites induce the deep falling of tumor patients’life quality, shorten their survival time, What is more serious is that the incidence of malignant hydrothorax and ascites is higher and higher in these years. Although there are many kinds of treatments, rare reports show that one kind of therapy can efficiently inhibit the growth of malignant hydrothorax and ascites in a well-tolerated way. After evaluated and analyzed the curative effects and possible mechanisms in some of our clinical observations,combined with the reviews of mechanism in antitumor of Huachansu, we came to a conclusion that Huachansu is something cold and poisonous with damp evil, on the one hand it can kill the cancer cells direct, on the other hand it has the ability to contract blood vessels and inhibit the formation of tumor new vessels, thus we propose using cold and poisonous Huachansu treating hot and poisonous malignant hydrothorax and ascites with the support of both Chinese and western theory. Therefore, under the guidance of my tutor, I designed the research in order to observe its curative effect systematically and preliminarily explore the possible mechanism.[Research Methods]All case studies involving in the research originate from in-patients diagnosed malignant hydrothorax and ascites treated in the oncology department of No.2attached hospital of Beijing University. We choose30patients met the inclusion criteria, there are14patients with hydrothorax,16patients with ascites, mean age (62.03±14.82),mean KSP (44.67±7.76) Central venous catheters were preserved for drainage of pleural effusion and ascites, after the drainage of most of pleural effusion and ascites, we slowly injected a dilute concentration of Huachansu through the catheters, then in order to help the drug absorbed evenly, we told the patients to turn over every10minutes,4times in total, this treatment was given3times every week, one course include two weeks. We will evaluate the effect after one course, including symptoms and the volume、color、tumor marker and RBC concentration of hydrothorax and ascites.Last, analyze the observing outcomes, so as to evaluate clinical efficacy and security of our treatments.[Results]①the volume of hydrothorax and ascites:CR1case (3.33%),PR6cases (20%),NC7cases (23.33%),PD16cases (53.33%), the total efficacy rate was46.67%(14/30)②local symptom:Comparing with their local symptom-sign before and after treatment, there is a very significant difference between each other(P<0.05),it shows this treatment can improve the symptoms effectively.③KSP:Comparing their KSP before and after treatment, there is no difference between each other(P>0.05),it shows this treatment can’t improve the KSP.④the color of hydrothorax and ascites(the concentration of RBC in hydrothorax and ascites):there are16cases with bloody hydrothorax and ascites, the color of water in14cases was lighter after the treatment with a large and sudden decrease in the concentration of RBC in hydrothorax and ascites, improving rate is75%(14/16),including three cases whose water color was changed to non-bloody.⑤the concentration of tumor maker in hydrothorax and ascites:there are27cases with high lever of TM,bloody hydrothorax and ascites, the TM lever in19cases decreased obviously aftet the treatment;⑥adverse reactions:pain occur with a rate of60%(18/30), diarrhea with a rate of6.67%(2/30), Nausea and vomiting with a rate of10%(3/30), it can be cure with symptomatic treatment. And there is a strong correlation between adverse reactions and good effect.[Conclusions]①The therapy of peritoneal and pleural cavity perfusion with Huanchasu can obviously decrease the concentration of RBC in hydrothorax and ascites, it can be the first step of the local treatment for patients with bloody hydrothorax and ascites, indole alkaloids may be the most important part associated with this kind of effect.②The therapy of peritoneal and pleural cavity perfusion with Huanchasu can obviously decrease the concentration of tumor maker in hydrothorax and ascites, it has great significance for reducing the burden of local cancer, bufadienolides may be the most important part associated with this kind of effect.③The local syndrome differentiation of the most of malignant hydrothorax and ascites is damp-heat-toxin, Huachansu is some cold and poisonous, so this kind of treatment may effectively improve heat-toxin, the point of further treatment is clearing damp, to sum up, treatment is our study is the first step of sequential therapy.④The therapy of peritoneal and pleural cavity perfusion with Huachansu can inhibit the growth speed of hydrothorax and ascites with a limited cut. We can improve the effect through two ways, one is to increase the dose or extract and purify the antitumor elements in order to increase the ability of kill cancer; one is to change our treatment immediately while hot and poisonous hydrothorax and ascites is turn to be cold and poisonous(the color of the water turn to light and clear from dark red and cloudy),for example, warm Huachansu in order to change its hot or cold property, transfer to use intraperitoneal hyperthermic therapy and so on.⑤the therapy of peritoneal and pleural cavity perfusion with Huanchasu can obviously improve the patients’ symptoms, it’s helpful in relieving oppression symptoms upon these patients with serious symptoms;but it had no ability to improve the cases’general condition especially these patients with a mean KSP of (44.67±7.76),thus you should start the general treatments after the local problem is solved.⑥the rate of adverse reactions of pain and the digestive symptoms after the therapy of peritoneal and pleural cavity perfusion with Huanchasu is relatively high, so we should give prevention before our treatment. After the analysis on the correlation between adverse reactions and effect, we found that people may get better effect if the adverse reactions occurs. |
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