白莲化癖汤对原发性肝癌TACE术后患者VEGF、肝功能及AFP-L3表达水平的影响

Effect of Bailian Huapi decoction on vascular endothelial growth factor,liver function,and AFP-L3 expression in patients with primary liver cancer after TACE.

目的探究白莲化癖汤对原发性肝癌患者在肝动脉栓塞化疗(TACE)术后的肝功能以及血管内皮生长因子(VEGF)、甲胎蛋白异质体(AFP-L3)表达水平的影响。方法选择2017年1月至2018年7月在西安市中医医院治疗的128例原发性肝癌患者作为研究对象,按照入院先后顺序将其分为观察组67例和对照组61例。对照组患者接受TACE治疗,观察组患者在此基础上加服白莲化癖汤。治疗3个月后,比较两组患者的实体瘤近期疗效,并于治疗前、治疗后3个月比较两组患者的肝功能水平和VEGF、AFP-L3表达水平。同时比较两组患者治疗后6个月、12个月、18个月、24个月的生存率。结果观察组患者治疗后的总缓解率为82.09%,明显高于对照组的65.57%,差异有统计学意义(P<0.05);治疗前,两组患者的谷丙转氨酶(ALT)、谷草转氨酶(AST)、白蛋白(ALB)、总胆红素(TB)水平比较,差异均无统计学意义(P>0.05);观察组患者治疗3个月后的ALT、AST、TB水平分别为(41.56±8.23)U/L、(45.38±9.71)U/L、(21.64±2.98)μmol/L,明显低于同期对照组的(53.11±10.27)U/L、(54.76±11.56)U/L、(25.06±3.13)μmol/L,ALB水平为(35.78±5.77)g/L,明显高于同期对照组的(31.21±5.06)g/L,差异均有统计学意义(P<0.05);两组患者治疗前的VEGF和AFP-L3水平比较差异均无统计学意义(P>0.05);治疗3个月后,两组患者的VEGF、AFP-L3水平均明显低于治疗前,且观察组患者的VEGF、AFP-L3水平分别为(90.33±13.86)ng/L、(16.41±3.17)ng/mL,明显低于对照组的(125.51±16.72)ng/L、(23.09±4.03)ng/mL,差异均有统计学意义(P<0.05);观察组患者治疗后6个月、12个月、18个月和24个月的生存率分别为80.60%、76.12%、70.15%、61.19%,明显高于对照组的63.93%、55.74%、42.62%、34.42%,差异均有统计学意义(P<0.05)。结论TACE术后加服白莲化癖汤能够明显改善原发性肝癌患者的肝功能以及VEGF、AFP-L3等指标,使其治疗效果及生存率均得到显著提升,值得临床上推广应用。

Objective To explore the effect of Bailian Huapi decoction on liver function,the expression of vascular endothelial growth factor(VEGF)and alpha-fetoprotein heteromeres(AFP-L3)in patients with primary liver cancer after transcatheter arterial chemoembolization(TACE).Methods A total of 128 patients with primary liver cancer treated in Xi'an Hospital of Traditional Chinese Medicine from January 2017 to July 2018 were selected as the research objects.They were divided into observation group(67 cases)and control group(61 cases)according to the order of admission.The patients in the control group were treated with TACE,and the patients in the observation group were given Bailian Huapi decoction on the basis of TACE.After 3 months of treatment,the short-term efficacy of solid tumors between the two groups was compared.The levels of liver function,VEGF and AFP-L3 were compared between the two groups before and 3 months after treatment.The survival rates of the two groups at 6 months,12 months,18 months and 24 months were analyzed and compared.Results The total remission rate of the observation group was 82.09%,which was significantly higher than 65.57%of the control group(P<0.05).There was no significant difference in the levels of alanine aminotransferase(ALT),alanine aminotransferase(AST),albumin(ALB),and total bilirubin(TB)between the two groups before treatment(P>0.05).After 3 months of treatment,the levels of ALT,AST,and TB in the observation group were(41.56±8.23)U/L,(45.38±9.71)U/L,(21.64±2.98)μmol/L,respectively,which were significantly lower than(53.11±10.27)U/L,(54.76±11.56)U/L,(25.06±3.13)μmol/L in the control group at the same period.The ALB of the observation group was(35.78±5.77)g/L,which was significantly higher than(31.21±5.06)g/L of the control group(P<0.05).There was no significant difference in VEGF and AFP-L3 levels between the two groups before treatment(P>0.05).The levels of VEGF,AFP-L3 between the two groups after 3 months of treatment were significantly lower than those before treatment,and the levels of VEGF,AFP-L3 in the observation group were(90.33±13.86)ng/L,(16.41±3.17)ng/mL,which were significantly lower than(125.51±16.72)ng/L,(23.09±4.03)ng/mL in the control group(P<0.05).The survival rates of the observation group at 6 months,12 months,18 months and 24 months were 80.60%,76.12%,70.15%,and 61.19%,respectively,which were significantly higher than 63.93%,55.74%,42.62%,and 34.42%of the control group at the same period(P<0.05).Conclusion TACE addition of Bailian Huafu decoction after operation can significantly improve the liver function and VEGF、AFP-L3 of patients with primary liver cancer,so that the therapeutic effect and survival rate are significantly improved,which is worthy of clinical application.