华蟾素对TACE术治疗肝细胞肝癌后肝内复发和血清VEGF/TSGF表达的影响

Effects of Cinobufagin on Intrahepatic Recurrence and Serum VEGF/TSGF after TACE in Treatment of Hepatocellular Carcinoma

目的 探讨华蟾素对经导管肝动脉化疗栓塞术(TACE)治疗肝细胞肝癌后肝内复发和血清血管内皮生长因子(VEGF)/肿瘤特异性生长因子(TSGF)表达的影响。方法 将2019年1月—2019年12月在丹东市第一医院治疗的90例肝癌患者随机分为两组,对照组使用TACE治疗,在此基础上,观察组使用华蟾素治疗,对比两组的近期疗效、肿瘤标志物、中医证候积分、不良反应、转移、复发及生存情况。结果 观察组治疗有效率为46.67%(21/45)、临床控制率为82.22%(37/45),明显高于对照组的22.22%(10/45)、66.67%(30/45)(P<0.05);观察组治疗后血清甲胎蛋白(AFP)、糖类抗原199(CA199)、VEGF、TSGF水平明显低于对照组(P<0.05);观察组治疗后胁痛、乏力、纳差、目涩、喜太息、失眠等中医证候积分明显低于对照组(P<0.05);观察组治疗后恶心呕吐、肝区疼痛、腹胀、白细胞下降、血小板下降等不良反应发生率明显低于对照组(P<0.05),但两组红细胞及血红蛋白下降、丙氨酸转氨酶(ALT)/谷草转氨酶(AST)异常升高、直接胆红素(DBIL)/间接胆红素(IBIL)异常升高、尿素氮(BUN)/肌酐(Cr)异常升高、发热等不良反应发生率差异无统计学意义(P>0.05);观察组转移率、复发率明显低于对照组,1年生存率明显高于对照组(P<0.05),但两组疾病进展生存时间(PFS)差异无统计学意义(P>0.05)。结论 中药华蟾素对TACE术治疗肝细胞肝癌疗效有明显提升作用,能增强对肿瘤标志物、血清VEGF/TSGF的抑制效果,降低转移及复发率,提高1年生存率,减轻中医证候,减少不良反应。

Objective To investigate the effects of cinobufagin on intrahepatic recurrence and serum vascular endothelial growth factor(VEGF)/tumor specific growth factor(TSGF)after transcatheter hepatic artery chemoembolization(TACE)in the treatment of hepatocellular carcinoma.Methods Ninety patients with liver cancer treated in the hospital from January 2019 to December 2019 were randomly divided into two groups.The control group was treated with TACE.On this basis, the observation group was treated with cinobufagin.The short-term efficacy, tumor markers, TCM syndrome scores, adverse reactions, metastasis, recurrence and survival of the two groups were compared.Results The effective rate was 46.67%(21/45) and the clinical control rate was 82.22%(37/45) in the observation group, which were significantly higher than 22.22%(10/45) and 66.67%(30/45) in the control group(P<0.05).The levels of serum alpha fetoprotein(AFP),carbohydrate antigen 199(CA199),VEGF and TSGF in the observation group were significantly lower than those in the control group(P<0.05).After treatment, the scores of TCM syndromes such as hypochondriac pain, fatigue, anorexia, eye astringency, euphoria and insomnia in the observation group were significantly lower than those in the control group(P<0.05).After treatment, the incidence of adverse reactions such as nausea and vomiting, liver pain, abdominal distension, leucopenia and thrombocytopenia in the observation group was significantly lower than that in the control group(P<0.05),but there was no significant difference in the incidence of adverse reactions such as decreased erythrocyte and hemoglobin, abnormal elevation of alanine aminotransferase(ALT)/aspartate aminotransferase(AST),abnormal elevation of direct bilirubin(DBIL)/indirect bilirubin(IBIL),urea nitrogen(BUN)/creatinine(Cr)or fever between the two groups(P>0.05).The metastasis rate and recurrence rate in the observation group were significantly lower than those in the control group, and the 1-year survival rate was significantly higher than that in the control group(P<0.05),but there was no significant difference in progression free survival time(PFS)between the two groups(P>0.05).Conclusion Cinobufagin can significantly improve the efficacy of TACE in the treatment of hepatocellular carcinoma, enhance the inhibitory effect on tumor markers and serum VEGF/TSGF,reduce the metastasis and recurrence rate, improve the 1-year survival rate, reduce TCM syndromes and adverse reactions.