大黄[庶虫]虫丸治疗肝癌的研究进展

Research Progress on Treatment of Liver Cancer with Dahuang Zhechong Pill(大黄[庶虫]虫丸)

大黄[庶虫]虫丸出自《金匮要略》,是治疗“虚劳干血”类疾病的经典名方,近年来广泛用于多种恶性肿瘤尤其是肝癌的综合治疗中。检索整理近20年文献,从中医组方特色、临床应用、分子机制三方面总结大黄[庶虫]虫丸治疗肝癌的相关研究,发现大黄[庶虫]虫丸在中医组方上具有虫类逐瘀、草本养虚,肝脾同调、两脏兼顾,蜜丸为剂、峻药缓图等特色,配伍严谨,用药精当。在临床上无论是联合经动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)还是联合静脉化疗,均可减轻治疗不良反应,提高临床有效率,延长患者生存时间;此外,对于晚期原发性肝癌患者以及肝转移癌患者,单药应用也可明显改善症状,提高生活质量,延长终末期患者带瘤生存时间,临床疗效确切,且可长期应用,安全性较高。机制研究中发现大黄[庶虫]虫丸具有抗肝癌前病变、保护肝细胞,调节肝功能,抗肝癌细胞转移、抑制肿瘤血管新生,促进血管正常化、调节免疫等相关机制,分子机制明确。通过以上三方面,全面详细阐述了大黄[庶虫]虫丸治疗肝癌的研究现状,并对目前的临床和实验研究提出不足与改进,以期为后续深入研究及抗肿瘤新药的研发提供思路和依据。

Dahuang Zhechong Pill(大黄[庶虫]虫丸),derived from Synopsis of The Golden Chamber,is a classic formula for treating diseases such as“deficiency,fatigue and dryness of blood”.In recent years,it has been widely used in the comprehensive treatment of various malignant tumors,especially liver cancer.In this paper,the literature of nearly 20 years was searched and sorted out,the relevant research on the treatment of liver cancer by Dahuang Zhechong Pill was summarized from three aspects:the characteristics of traditional Chinese medicine(TCM)formulation,clinical application and molecular mechanism.It is found that Dahuang Zhechong Pill in TCM has the characteristics of removing blood stasis by insects,nourishing deficiency by herbs,harmonizing liver and spleen,taking both liver and spleen into consideration,honeyed bolus making drastic herbs slowly and gently and so on,both the compatibility is rigorous and the medication is precise.In clinic,transcatheter arterial chemoembolizatio(TACE)and intravenous chemotherapy can reduce the adverse reactions,improve the clinical efficiency and prolong the survival time of patients.In addition,for patients with advanced primary liver cancer and liver metastases,single drug application can also significantly improve symptoms and the quality of life,and prolong the survival time of end-stage patients.The clinical efficacy is definite,and it also can be used for a long time with high safety.In the mechanism study,it is found that Dahuang Zhechong Pill has anti-liver cancer prelesion,protecting liver cells,regulating liver function,anti-liver cancer cell metastasis,inhibiting tumor angiogenesis,promoting vascular normalization,regulating immunity and other related mechanisms.The molecular mechanism is clear.Through the above three aspects,this paper comprehensively elaborated the research status of Dahuang Zhechong Pill in the treatment of liver cancer and put forward the shortcomings and improvements of the current clinical and experimental studies,in order to provide ideas and basis for the subsequent in-depth research of this prescription and the development of new anti-tumor drugs.