益脾养肝化瘀方对原发性肝癌肝郁脾虚证患者血清肿瘤相关细胞因子水平及生存素蛋白的影响

Effect of Yipi Yanggan Huayu recipe on serum tumor index,related cytokines and survivin protein in patients with liver depression and spleen deficiency syndrome of primary liver cancer

目的观察益脾养肝化瘀方对原发性肝癌肝郁脾虚证患者血清肿瘤相关细胞因子水平及生存素(survivin)蛋白的影响。方法将70例原发性肝癌肝郁脾虚证患者按照随机数字表法分为2组。对照组35例采用含奥沙利铂方案的肝动脉化疗栓塞术(TACE)治疗,治疗组35例在对照组治疗基础上加用益脾养肝化瘀方治疗。2组均治疗4个疗程,并随访1年。比较2组治疗前后血清肿瘤坏死因子α(TNF-α)、血管内皮生长因子(VEGF)、巨噬细胞移动抑制因子(MIF)、白细胞介素8(IL-8)水平变化及survivin蛋白的表达情况,并统计不良反应发生率及中医证候改善情况,随访1年后采用癌症患者生活质量评估量表(QLQ-52)评估2组生活质量。结果治疗组中医证候改善率88.57%(31/35),高于对照组[65.71%(23/35),P<0.05]。治疗后2组血清TNF-α、IL-8、VEGF及MIF水平均较本组治疗前降低(P<0.05),且治疗组血清TNF-α、IL-8、VEGF及MIF水平均低于对照组(P<0.05)。治疗后2组血清survivin蛋白表达水平均较本组治疗前降低(P<0.05),且治疗组血清survivin蛋白表达水平低于对照组(P<0.05)。2组治疗后恶心呕吐、皮疹、腹泻、发热及白细胞下降发生率比较差异均无统计学意义(P>0.05)。随访时,治疗组QLQ-52各项评分均高于对照组(P<0.05)。结论益脾养肝化瘀方治疗肝郁脾虚型原发性肝癌疗效确切,能下调血清肿瘤相关细胞因子及survivin蛋白的表达水平,降低不良反应的发生率,提高患者的生活质量,值得临床推广。

Objective To observe the effect of Yipi Yanggan Huayu recipe on serum tumor index,related cytokines and survivin protein in patients with liver depression and spleen deficiency syndrome of primary liver cancer.Methods 70 patients with liver depression and spleen deficiency syndrome of primary liver cancer were divided into two groups according to the random number table method.35 cases in control group were treated by transcatheter arterial chemoembolization(TACE)with oxaliplatin.35 cases in treatment group were treated by Yipi Yanggan Huayu recipe on the basis of the control group.Both groups were treated for 4 courses and followed up for 1 year.The changes of serum tumor necrosis factorα(TNF-α),vascular endothelial growth factor(VEGF),macrophage migration inhibitory factor(MIF),interleukin-8(IL-8)and the expression of survivin were compared before and after treatment in the two groups.The incidence of adverse reactions and the improvement of TCM syndromes were counted.After one year of follow-up,the quality of life of the two groups was assessed by the quality of life assessment scale for cancer patients(QLQ-52).Results The improvement rate of TCM syndromes in the treatment group was 88.57%(31/35),which was higher than that in the control group[65.71%(23/35),P<0.05].After treatment,the levels of TNF-α,IL-8,VEGF and MIF in the two groups were decreased(P<0.05),and the treatment group was lower than the control group(P<0.05).After treatment,the expression level of serum survivin protein in the two groups was decreased(P<0.05),and the treatment group was lower than the control group(P<0.05).There was no significant difference in the incidence of nausea and vomiting,rash,diarrhea,fever and leukopenia between the two groups(P>0.05).During the follow-up,the scores of QLQ-52 in the treatment group were higher than those in the control group(P<0.05).Conclusion Yipi Yanggan Huayu recipe is effective in the treatment of primary liver cancer of liver stagnation and spleen deficiency type.It can reduce the expression level of serum tumor index,related cytokines and survivin protein,reduce the incidence of adverse reactions,and improve the quality of life of patients.It is worthy of clinical promotion.