Clinical Observation Of Shuganning Injection On The Hepatoprotective Effect Of High-risk Trophoblastic Tumors

Purpose: To explore the hepatoprotective effect of traditional Chinese medicine Shuganning injection on chemotherapy of high-risk trophoblastic tumors.Material and method:The 105 cases investigated in this study were all high-risk trophoblastic tumor patients who were admitted to the Department of Gynecology,Liaoning Provincial Cancer Hospital from January 2002 to June 2017,and all were treated with EMA-CO or FAV regimen.During the chemotherapy,28 patients with simple Chinese medicine Shuganning injection were classified as observation group,and 26 patients with simple western medicine injection(magnesium glycyrrhizinate or polyene phosphocholine)were classified as control group 1,and 51 patients did not use any insurance.Patients with liver drugs were classified as control group 2.The liver function indexes of each group were analyzed after 1 course of chemotherapy,3 courses of treatment,and 5 courses of treatment,including serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),total protein(TP),albumin/globulin(A/G),albumin(ALB),total bilirubin(TBIL)levels.SPSS24.0 statistical software was used to compare the differences among the three groups and analyze the hepatoprotective effect of Shuganning.Results:1.The clinical data of the three groups,including age,pathological type diagnosis,prognosis score,course of treatment,chemotherapy regimen,surgery,HCG level before treatment,maximum diameter of tumors and metastasis site,were compared P > 0.05,with no statistical significance.The clinical data of the three groups were compared P>0.05,the difference was not statistically significant.2.After one course of chemotherapy,the abnormalities of liver function in observation group,control group 1 and control group 2 included 3 cases(10.7%),5 cases(19.2%)and 11 cases(21.6%)of serum ALT abnormalities,1 case(3.8%)and 4 cases(7.8%)of serum AST abnormalities,respectively.There was no significant difference in the abnormalities of liver function among the three groups(P > 0.05).The changes of TP in the three groups were allless than 0.05,with statistical significance.The TP in the observation group was significantly higher than that in the control group 2(P < 0.05),and that in the control group 1(P < 0.05)was significantly higher than that in the control group 2(P < 0.023)when magnesium isoglycyrrhizinate or polyene phosphatidylcholine injection was used than that in the control group 2(P < 0.05).3.After 3 courses of chemotherapy,the observation group,control group 1 and control group2 liver function abnormalities mainly included 5 cases of serum ALT abnormalities(17.9%),2 cases(7.7%),12 cases(23.5%);3 cases of serum AST abnormalities(10.71%),2 cases(7.69%),and 5 cases(9.80%);there was no significant difference in liver function abnormalities between the three groups compared with P>0.05.Liver function ALT,AST,ALP,TP,A/G,ALB and TBIL were changed in the three groups,P>0.05,no significant difference.4.After 5 courses of chemotherapy,the abnormalities of liver function in observation group,control group 1 and control group 2 mainly included 1 case(3.6%),3 cases(11.5%)and 10cases(19.6%)of serum ALT abnormalities;0 cases(0%),0 cases(0%)and 6 cases(11.8%)of serum AST abnormalities;P=0.032(P < 0.05)among the three groups had statistical significance.Shuganning injection was used in observation group 1 as compared with control group 2.The incidence of AST abnormalities in patients treated with ejection and magnesium isoglycyrrhizinate or polyene phosphatidylcholine injection was lower than that in patients not treated with hepatoprotective therapy.The ALT and AST abnormalities in observation group and control group 1 were P > 0.05,with no statistical significance.The changes of ALT,AST and A/G in the three groups were all less than 0.05,with statistical significance.The ALT in the observation group was significantly lower than that in the control group 2(P <0.05),and the AST in the observation group was significantly lower than that in the control group 2(P < 0.031);the AST in the observation group was significantly lower than that in the control group 2(P < 0.05),and the liver function in the observation group was significantly lower than that in the control group 2(P < 0.039).In group 2,the A/G of patients treated with Shuganning injection was significantly lower than that of patients not treated with liver protection,P=0.020(P<0.05).5.There were no significant differences in liver function ALT,AST,A/G,ALB and TBILafter 1 course of treatment,3 courses of treatment and 5 courses of treatment.There was no significant difference in liver function ALP and TP.There was a significant difference.After1 course of treatment,liver function TP was significantly higher after 5 courses of treatment,P=0.028(P<0.05).After 1 course of treatment,liver function ALP was significantly lower after 5 courses of treatment,P=0.012(P<0.05).Conclusion:1.Both Chinese medicine of Shuganning injection and western medicine of protecting liver injection can improve the liver function of patients during chemotherapy and effectively inhibit the abnormal biochemical indicators of liver;and Chinese medicine and western medicine can achieve the same liver protection effect.2.Shuganning injection has the same hepatoprotective effect as magnesium isoglycyrrhizinate or polyene phosphatidylcholine injection in GTN patients after chemotherapy.