The history of interventional therapy for liver cancer in China

In China interventional therapy of liver cancer started in the 1980s. It is well-known that Professor Lin Gui is the founding father of Interventional radiology. Under the leadership of Lin Gui and other professors, interventional therapy of liver cancer has swiftly progressed in China. Indeed, TAI, TAE, TACE and ablation therapy have witnessed great innovations in hardware facil ities, technical means, and therapeutic philosophy, while incorporating Chinese characteristics. As with the development of combined interventional therapy in China, interventional treatment of liver cancer has gradually started the process of precision and individualization. Actually, multidisciplinary, multimodal, and polymorphic treatments will be the most suitable pattern for liver cancer in the future, among which combination of interventional therapy with targeted, immunological treatments and information technology(IT) tools may bring a revolutionary breakthrough in liver cancer treatment.

The effect of Jinlong capsule on the immune function for intervened patients with primary liver cancer

Objective: The aim of this study was to evaluate the effect of Jinlong capsule on the immune function for intervened patients with primary liver cancer. Methods: Matched the inclusion criteria, 60 patients were selected and randomly divided into two groups. The treatment group had 30 cases treated with Jinlong capsule combined with the transcatheter arterial chemoembolization(TACE); the control group had 30 cases treated with TACE. Each group was treated 30 days as a cycle, which had completed at least two cycles. Indicators of cellular immune function about the activity of CD3, CD4, CD8, CD4/CD8 and natural killer(NK) cell were detected before and after treatment, then to compare and analysis with each other. Results: Before treatment, the activity of peripheral blood CD3, CD4, CD8, CD4/CD8 and NK cell in the two groups was no significant difference(P > 0.05); after treatment, the activity of CD3, CD4 and NK cell in the treatment group was significantly increased, the ratio of CD4/CD8 increased, and the value of CD8 decreased(P < 0.05), the activity of CD3, CD4 and NK cell in the control group was significantly decreased, the ratio of CD4/CD8 decreased(P < 0.05), and the value of CD8 slightly higher than before treatment(P > 0.05), the difference between the two groups indicated the statistical significance(P < 0.05). Incidence of gastrointestinal reactions, leucopenia, hemoglobin, platelet decline in the treatment group was lower than those in the control group, but without presenting the statistical significance(P > 0.05). Conclusion: Jinlong capsule with hepatic arterial infusion chemotherapy can improve the patients' immune function, and reduce the adverse reactions of interventional chemotherapy. Hence,it deserves to be promoted in clinically.

Changed clinical aspects of primary liver cancer in China during the past 30 years

BACKGROUND: Primary liver cancer (PLC) is one of the most frequently seen tumors in China. Thirty years ago, patients with PLC were often detected at relatively late stage, with a palpable mass or marked clinical symptoms and poor prognosis. In the past 30 years, the diagnosis and treatment of PLC have been greatly improved with better prognosis. METHODS: In order to study the changes of PLC during the 30 years, the clinical data of 3250 patients with PLC from 10 medical institutions of China were collected, ana- lyzed , and compared with those of 3254 PLC patients be- fore the 30 years. RESULTS: In the 3250 patients aged 1-80 years, with an average age of 49.1 years, the male to female ratio (2.3:1) was lower than that before the 30 years. 73.5% of the 3250 patients sought medical advice within 3 months after the onset of the disease in contrast to 63.8% before the 30 years. Compared with those patients before the 30 years the symptoms and signs were alleviated generally. The HBsAg positive rate was 81.0%, but the HCV-Ab positive rate was 13.2%. The AFP level in 75% of patients was elevated, but in the remaining 25% was normal. 1912 patients (58.8%) were confirmed pathologically. Among them 1755 patients (91.8%) had hepatocellular carcinoma. The overall resec- tion rate was 46.3%. Those who had early, middle, late stage carcinoma accounted for 29.9%, 51.5%, and 18.6%respectively in contrast to 0.4%, 47.0%, and 52.6% repor- ted before the 30 years. The 1-, 3-, 5-year survival rates of the patients were 66.1%, 39.7%, and 32.5% respectively, whereas 93.5%, 70.1%, and 59.1% for the early stage pa- tients, and 65.3%, 30.5%, and 23.5% for the middle stage patients. The half and 1-year survival rates of the late stage patients were 52.5%, and 14.7%, respectively. CONCLUSION: Comparison with the clinical data before and after the 30 years show that PLC can be diagnosed ear- ly. More PLC patients tend to undergo resection while re- ceiving a better conservative treatment, which ensures a prognosis.

Retrospective analysis of TACE times after primary liver cancer operation

Objective The aim of the study was to probe into the impacts of the times of preventive transcatheter arterial chemoembolization (TACE) after operation treatment for patients with primary liver cancer on their survival.

Current status of yttrium-90 microspheres radioembolization in primary and metastatic liver cancer

Liver malignancy,including primary liver cancer and metastatic liver cancer has become one of the most common causes of cancer-related death worldwide due to the high malignant degree and limited systematic treatment strategy.Radioembolization with yttrium-90(^(90)Y)-loaded microspheres is a relatively novel technology that has made significant progress in the local treatment of liver malignancy.The different steps in the extensive work-up of radioembolization for patients with an indication for treatment with^(90)Y microspheres,from patient selection to follow up,both technically and clinically,are discussed in this paper.It describes the application and development of^(90)Y microspheres in the treatment of liver cancer.

The Efficacy of Different Interventiona|Che moembolization Regiments Combined with Radiofrequency Ablation in the Treatment of Primary Liver Cancer and its Effects on Patients’Immune Function

Objective:To study and compare the clinical effects of the combination of different interventional embolization chemotherapy and radiofrequency ablation in patients with primary liver cancer.Methods:In this paper,based on the target data validation of those 60 patients with primary liver cancer treated in the hospital during the period from May 2017 to May 2018,the double-blind method was used for the comparison between groups.Patients in the reference group were treated with the combination of cisplatinum interventional chemoembolization regimen and radiofrequency ablation,while those in the experimental group were treated with the combination of lobaplatin interventional chemoembolization regimen and radiofrequency ablation.Then,the efficacy of both groups was compared.Results:After the treatment,the clinically effective total value,the calculation value of adverse reactions,and the value of IgA,IgM,IgG and AFP of the experimental group were compared with those of the reference group.In addition,the value of IgA,IgM,IgG and AFP of both groups after and before the treatment were compared.The experimental results showed that the data was statistically significant(P<0.05).Conclusion:The combination of lobaplatin and cisplatin interventional embolization chemotherapy and radiofrequency ablation has some effects in patients with primary liver cancer,but the former one showed more significant effects.

Effects of intensity modulated radiation therapy + local hyperthermia on the cancer cell apoptosis and invasion in liver cancer lesion

Objective: To investigate the effects of intensity modulated radiation therapy + local hyperthermia on the cancer cell apoptosis and invasion in liver cancer lesion. Methods:A total of 94 patients with middle-advanced primary liver cancer who were diagnosed and treated in this hospital between November 2015 and February 2017 were divided into control group (n=47) and experimental group (n=47) by random number table method. Control group received intensity modulated radiation therapy and experimental group received intensity modulated radiation therapy + local hyperthermia. Both groups accepted peritoneal lesion biopsy before and after treatment, and the expression of apoptosis and invasion genes in specimen tissue were detected by fluorescence quantitative PCR. Results: There was no statistically significant difference in apoptosis and invasion gene expression between the two groups of patients before treatment. After treatment, apoptosis genes Fas, caspase-3, Bax and p53 mRNA expression in lesion tissue of experimental group were higher than those of control group whereas FasL and Bcl-2 mRNA expression were lower than those of control group;invasion genes Cofilin-1, Bmi-1, STAT3 and SOX18 mRNA expression in lesion tissue of experimental group were lower than those of control group whereas Tip30 and TP53IP1 mRNA expression were higher than those of control group. Conclusion: intensity modulated radiation therapy + local hyperthermia can effectively promote cancer cell apoptosis and inhibit its invasion activity in patients with middle and advanced primary liver cancer.

Successful totally laparoscopic right trihepatectomy following conversion therapy for hepatocellular carcinoma:A case report

BACKGROUND About 20%-30%of newly diagnosed hepatocellular carcinoma(HCC)patients are surgically feasible due to a variety of reasons.Active conversion therapy may provide opportunities of surgery for these patients.Nevertheless,the choice of surgical procedure is controversial after successful conversion therapy.We report a patient with HCC who underwent successful laparoscopic right trisectionectomy after conversion therapy with portal vein embolization and transarterial chemoembolization.CASE SUMMARY A 67-year-old male patient presented to our hospital with epigastric distention/discomfort and nausea/vomiting for more than 1 mo.Contrast-enhanced computed tomography scan of the abdomen demonstrated multiple tumors(the largest was≥10 cm in diameter)located in the right liver and left medial lobe,and the left lateral lobe was normal.The future remnant liver(FRL)of the left lateral lobe accounted for only 18%of total liver volume after virtual resection on the three-dimensional liver model.Conversion therapy was adopted after orally administered entecavir for antiviral treatment.First,the right portal vein was embolized.Then tumor embolization was performed via the variant hepatic arteries.After 3 wk,the FRL of the left lateral lobe accounted for nearly 30%of the total liver volume.Totally laparoscopic right trisectionectomy was performed under combined epidural and general anesthesia.The in situ resection was performed via an anterior approach.The operating time was 240 min.No clamping was required during the surgery,and the intraoperative blood loss was 300 mL.There were no postoperative complications such as bile leakage,and the incision healed well.The patient was discharged on the 8th postoperative day.During the 3-mo follow-up,there was no recurrence and obvious hyperplasia of residual liver was observed.Alpha-fetoprotein decreased significantly and tended to be normal.CONCLUSION Due to the different biological characteristics of the liver cancer and the pathophysiological features of the liver from other organs,the conversion treatment should take into account both the feasibility of tumor downstaging and the volume and function of the remnant liver.Our case provides a reference for clinicians in terms of both conversion therapy and laparoscopic right trisectionectomy.

Unraveling the efficacy network: A network meta-analysis of adjuvant external beam radiation therapy methods after hepatectomy

BACKGROUND Primary liver cancer is a malignant tumor with a high recurrence rate that significantly affects patient prognosis.Postoperative adjuvant external radiation therapy(RT)has been shown to effectively prevent recurrence after liver cancer resection.However,there are multiple RT techniques available,and the differ-ential effects of these techniques in preventing postoperative liver cancer re-currence require further investigation.AIM To assess the advantages and disadvantages of various adjuvant external RT methods after liver resection based on overall survival(OS)and disease-free survival(DFS)and to determine the optimal strategy.METHODS This study involved network meta-analyses and followed the PRISMA guidelines.The data of qualified studies published before July 10,2023,were collected from PubMed,Embase,the Web of Science,and the Cochrane Library.We included relevant studies on postoperative external beam RT after liver resection that had OS and DFS as the primary endpoints.The magnitudes of the effects were determined using risk ratios with 95%confidential intervals.The results were analyzed using R software and STATA software.RESULTS A total of 12 studies,including 1265 patients with hepatocellular carcinoma(HCC)after liver resection,were included in this study.There was no significant heterogeneity in the direct paired comparisons,and there were no significant differences in the inclusion or exclusion criteria,intervention measures,or outcome indicators,meeting the assumptions of heterogeneity and transitivity.OS analysis revealed that patients who underwent stereotactic body radiotherapy(SBRT)after resection had longer OS than those who underwent intensity modulated radiotherapy(IMRT)or 3-dimensional conformal RT(3D-CRT).DFS analysis revealed that patients who underwent 3D-CRT after resection had the longest DFS.Patients who underwent IMRT after resection had longer OS than those who underwent 3D-CRT and longer DFS than those who underwent SBRT.CONCLUSION HCC patients who undergo liver cancer resection must consider distinct advantages and disadvantages when choosing between SBRT and 3D-CRT.IMRT,a RT technique that is associated with longer OS than 3D-CRT and longer DFS than SBRT,may be a preferred option.

Management of Malnutrition in Liver Cancer Patients with Chronic Liver Diseases

Liver cancer is the fifth most common cancer and the third leading cause of cancer death globally. Malnutrition is found in 65-90% of patients with liver cancer and often enhances cancer occurrence and complications, deteriorates liver functions, and promotes early development of refractory ascites and hepatic encephalopathy (HE), increasing both morbidity and mortality. Malnutrition may develop as a result of poor dietary intake, anorexia, medications, side effects to chemotherapy, encephalopathy, as well as socioeconomic limitations. A dedicated clinical team should provide proper assessment of patient’s nutritional status and nutrition supplemental plan to restore liver health and prevent or treat malnutrition. Nutrition assessment is based on medical, nutritional, and medication histories, physical examination for body composition and signs of malnutrition, anthropometric measurements, radio-imaging, laboratory tests, and flow charts or algorithms on patient’s dietary intake and changes in bodyweight. Clinical management depends on patient’s disease and nutritional status. Patients with minor liver affection or compensated liver cirrhosis may have normal diet without any restrictions in carbohydrates, proteins, and fat, but preferably take other supplements supporting the liver. Patients with decompensated liver should consume 25-40 kcal/kg/day and 1.0-1.5 g protein/kg/day. For patients with acute episodes of HE, a temporary protein restriction of 0.6-0.8 g/kg/day should be implemented until HE is eliminated. Patients should consume small, frequent meals throughout the day and add a carbohydrate- and protein-rich evening snack. Other approaches to supporting optimal digestion and nutrition and managing side effects of cancer therapies may be added as well.

Immunotherapy prototype Mark 3.0 model in primary liver cancer:adding locoregional stereotactic therapy and prognostic factors classification management

Immune checkpoint inhibitors(ICIs)like programmed cell death-1(PD-1)/programmed death-ligand 1(PD-L1)inhibitor have shown considerable efficacy in several important cancers including primary liver cancer(PLC)like hepatocellular carcinoma and cholangiocarcinoma.However,only some patients with PLC will benefit,so combination therapy and biomarker classification detected by next-generation sequencing or immunohistochemistry are very important.Herein,we briefly summarize ICI-based therapies and stratify these evolving therapies for advanced PLC into three stages of immunotherapies Mark(Mk.)1.0,2.0,and 3.0.We illustrated the significance of ICI monotherapy(Mk.1.0),offering combinational approaches with traditional strategies(Mk.2.0)and additional locoregional therapy(Mk.3.0)to achieve longer survival and even meet the“No Evidence of Disease”status.We also highlight the importance of biomarkers and prognostic factors for patients with advanced PLC treated with ICI-based therapies.Multidisci-plinary team management should be investigated and collaborated closely to manage adverse events and sequential therapy suggestions for patients.

Therapy of Primary Liver Cancer

Primary liver cancer(PLC)is a fatal disease that affects millions of lives worldwide.PLC is the leading cause of cancer-related deaths and the incidence rate is predicted to rise in the coming decades.PLC can be categorized into three major histological subtypes:hepatocellular carcinoma(HCC),intrahepatic cholangiocarcinoma(ICC),and combined HCC-ICC.These subtypes are distinct with respect to epidemiology,clinicopathological features,genetic alterations,and clinical managements,which are thoroughly summarized in this review.The state of treatment strategies for each subtype,including the currently approved drugs and the potential novel therapies,are also discussed.

Clinical effect of Cidan capsule on primary hepatocellular carcinoma in 325 cases

OBJECTIVE： To observe the clinical effect of Cidan capsules, a traditional Chinese medicine applied as an antitumor drug for decades, on the treatment of primary hepatocellular carcinoma（HCC）. A two-month experiment was carried out. METHODS： A total of 325 patients with primary HCC were randomly divided into 3 groups. The 125 patients in Group A were treated with Cidan capsules exclusively. The 100 patients in Group B were treated with Cidan capsules combined with chemotherapy. And as control group, the 100 patients in Group C were treated by chemotherapy only. The efficacy of Cidan was analyzed by monitoring associated symptoms and liver function tests and measuring the levels of the NK cell, CD3, CD4, CRJ and CD8, alpha fetoprotein（AFP）. The evaluation of Cidan＇s effects on enhancing the patients＇ life quality was through clinical and pathological observations. RESULTS： The result showed that the steady rate following the standard for evaluation of Kamofsky was over 87.0% in group B, 72.0% in Group A and 57.0% in Group C, respectively. The life quality of the patients treated with Cidan capsules and chemotherapy was improved more obviously than that in Group A and C. The NK cell,CD3, CD4,CRJ and CD8 in Group C were obviously decreased, while those in Group A and Group B were without apparent vacillation. AFP descended markedly in Group A and B, but did not in Group C. CONCLUSION： Cidan capsules combined with chemotherapy had superior curative effects on primary HCC.

改良正念减压疗法在原发性肝癌切除术患者中的应用

目的探究改良正念减压疗法在原发性肝癌(primary liver cancer,PLC)切除术患者中的应用。方法选取2020年5月至2022年5月北京市和平里医院收治的160例PLC患者作为研究对象,按照随机数字表法分为对照组(n=80)和研究组(n=80)。对照组采用风险管理护理模式,研究组在对照组基础上联合改良正念减压疗法干预,比较两组患者干预前后癌症疲乏量表(cancer fatigue scale,CFS)评分、中文版压力知觉量表(Chinese perceived stress scale,CPSS)评分、心理弹性水平、疼痛程度、心理应激程度和满意度。结果研究组患者干预后躯体疲乏、情感疲乏、认知疲乏CPSS评分均显著低于对照组(均P<0.05),坚韧性、自强、乐观评分和疼痛改善程度均显著优于对照组(均P<0.05)。两组患者干预后焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS)评分较干预前均显著降低(均P<0.05),且研究组患者干预后SAS和SDS评分均显著低于对照组(均P<0.05)。两组患者干预后CFS各项评分均较干预前显著降低(均P<0.05),且研究组降低幅度显著大于对照组(均P<0.05)。研究组患者的干预满意度显著高于对照组(P<0.05)。结论采取风险管理护理模式联合改良正念减压疗法干预PLC患者,能显著降低术后并发症发生率,缓解患者疼痛、疲乏感和心理应激反应,减轻患者的知觉压力并有效改善患者的心理弹性,提升生活质量。

原发性肝癌介入治疗依从性的影响因素及护理对策分析

目的 分析原发性肝癌(PLC)患者介入治疗依从性的影响因素,制定护理对策。方法 选取2019年1月至2023年10月在濮阳市安阳地区医院接受治疗的共计98例PLC患者进行分析,统计介入治疗依从性情况,进行单因素与多因素Logistic回归分析以明确介入治疗依从性的影响因素。结果 98例PLC患者介入治疗不依从29例,不依从率为29.59%;不依从组与依从组相比年龄> 60岁、高中及以下文化程度、个人月收入≤4 000元、疾病认知水平未掌握、肿瘤大小≥5 cm、低社会支持状态、消极应对占比更高,差异有统计学意义(P <0.05);多因素Logistic回归分析发现,年龄> 60岁(OR=2.731)、文化程度高中及以下(OR=3.022)、个人月收入≤4 000元(OR=4.510)、疾病认知水平未掌握(OR=6.074)、肿瘤大小≥5 cm(OR=2.943)、低社会支持状态(OR=5.284)、消极应对(OR=6.224)是影响PLC患者介入治疗依从性的独立危险因素,差异有统计学意义(P <0.05)。结论 PLC患者介入治疗依从性的影响因素包括年龄、个人月收入、文化程度、肿瘤大小、疾病认知水平、社会支持度及应对方式等,临床需要制定相应的护理对策,促进治疗依从性提高。

超声介入微波消融术联合仑伐替尼治疗原发性小肝癌的疗效分析

目的探讨超声介入微波消融术联合仑伐替尼治疗原发性小肝癌的临床疗效。方法纳入88例原发性小肝癌患者为研究对象,按照随机数字表法分为观察组和对照组,各44例。对照组患者行超声介入微波消融术治疗,观察组在此基础上联合仑伐替尼治疗,观察两组临床疗效、血清甲胎蛋白、肝功能[天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)及白蛋白(ALB)]、不良反应发生情况及术后1年复发情况。结果观察组术后9周短期疗效100%,与对照组(97.73%)比较,差异无统计学意义(χ^(2)=1.000,P>0.05);随访12个月,观察组复发率(2.27%)低于对照组(27.27%),差异有统计学意义(χ^(2)=10.921,P<0.05);治疗后,观察组AST(38.29±5.23)U/L、ALT(52.21±5.78)U/L,与对照组AST(45.21±5.38)U/L、ALT(57.25±5.56)U/L比较,差异有统计学意义(t=6.121、4.167,P均<0.05),观察组ALB(29.85±1.61)g/L、AFP(18.21±2.25)μg/L,与对照组ALB(28.42±1.57)g/L、AFP(23.12±2.12)μg/L比较,差异有统计学意义(t=4.244、10.539,P均<0.05);观察组用药期间总不良反应发生率为11.36%,经干预均好转。结论相较于单纯超声介入微波消融术治疗,其与仑伐替尼联合治疗原发性小肝癌的短期疗效相当,但联合治疗可改善患者肝功能损伤,明显降低患者肿瘤复发率。

多学科个性化动态营养干预对促进老年原发性肝癌患者术后恢复效果的影响

目的 分析多学科个性化动态营养干预对促进老年原发性肝癌患者术后恢复效果的影响。方法 选取开滦总医院2022年1―12月收治的接受营养风险筛查2002(nutritional risk screening 2002,NRS 2002)风险评估且存在营养不良风险的老年原发性肝癌患者80例作为研究对象,按随机数字表法分为对照组(n=40)和干预组(n=40)。对照组给予常规术后护理,干预组给予多学科个体化动态营养干预。比较两组患者术后恢复评分、术后恢复速度指标及护理前后患者的衰弱程度、绝望量表评分和营养指标。结果 干预组患者术后早期进食时间、肛门排气时间、达到目标70%进食量时间均显著早于对照组(均P <0.05),干预组患者住院天数显著短于对照组(P <0.05),干预组患者住院费用显著少于对照组(P <0.05)。干预组患者术后7 d恢复评分显著高于对照组(P <0.05)。两组患者护理后健康状况、社会支持、自制力、情绪指标评分均有所下降(均P <0.05),且干预组下降幅度均显著大于对照组(均P <0.05)。两组患者护理后对未来感觉评分和对未来期望评分均有所下降(均P <0.05),且干预组患者评分下降幅度均显著大于对照组(均P <0.05)。干预组患者术后并发症发生率明显显著低于对照组(P <0.05)。结论 多学科个性化动态营养干预促进老年原发性肝癌患者术后恢复的临床效果较好。

家庭参与式护理在肝癌经导管动脉栓塞化疗患者中的应用效果

目的:观察家庭参与式护理肝癌经导管动脉栓塞化疗患者中的应用效果。方法:选取2021年3月至2022年3月该院收治的72例肝癌经导管动脉栓塞化疗患者进行前瞻性研究,按照随机数字表法将其分为观察组与对照组各36例。对照组采用常规护理,观察组在对照组基础上采用家庭参与式护理,比较两组营养指标(转铁蛋白、白蛋白)水平、T细胞亚群指标(CD4^(+)、CD4^(+)/CD8^(+))水平、Connor-Davidson心理弹性量表(CD-RISC)评分、汉密尔顿抑郁量表(HAMD)评分和胃肠道不适症状发生率。结果:护理后,两组转铁蛋白、白蛋白等营养指标水平和CD4^(+)、CD4^(+)/CD8^(+)等T细胞亚群指标水平,以及CD-RISC评分高于护理前,且观察组高于对照组,两组HAMD评分低于护理前,且观察组低于对照组,差异均有统计学意义(P<0.05);观察组胃肠道不适症状发生率为2.78%,明显低于对照组的22.22%,差异有统计学意义(P<0.05)。结论:在常规护理基础上采用家庭参与式护理可提高肝癌经导管动脉栓塞化疗患者营养指标水平、T细胞亚群指标水平和CD-RISC评分,以及降其HAMD评分和胃肠道不适症状发生率,效果优于单纯常规护理。

原发性肝癌诊疗指南(2024年版)

原发性肝癌是我国常见的恶性肿瘤之一。2022年中国癌症统计报告显示,我国原发性肝癌的发病率和死亡率在所有恶性肿瘤中分别居第5位和第2位,新发病例为36.77万例,死亡病例为31.65万例。近年来,随着诊疗技术的不断提升,高级别循证医学证据相继涌现,为进一步规范我国肝癌诊疗行为,国家卫生健康委员会医政司特别委托中华医学会肿瘤学分会,联合国内多学科专家,参考肝癌诊断、分期及治疗方面的最新研究成果,结合我国肝癌临床诊治实践,修订并更新形成了《原发性肝癌诊疗指南(2024年版)》。本指南及时反映了肝癌诊疗领域的新进展与新理念,将为临床医师提供最新诊疗依据,更好地指导临床实践,提升中国肝癌规范化诊疗水平。

基于肝主疏泄探讨原发性肝癌的治则治法

原发性肝癌致死率高,治疗有效率低,中西医结合治疗有助于稳定病情,改善患者临床症状。中医理论中肝的主要生理功能为“主疏泄”,肝癌发病的病理基础也是从肝失疏泄开始,继而气滞血瘀、痰凝湿聚、邪郁化火生毒。因此治疗上提出原发性肝癌的论治应把握以通为要的原则,从“木郁达之”入手,行气活血,化痰利水,清热解毒,并配合柔养肝体,从而恢复“肝主疏泄”的正常状态,并以临床典型验案具体说明了攻补兼施、通利气血,使肝体阴用阳、维持正常功能的中医药治法。