ObjectiveTo observe the
clinical efficacy of Jiawei Xiaochaihutang combined with
microwave ablation (MWA) in the
treatment of primary
hepatocellular carcinoma (HCC) and its influence on
tumor microenvironment. MethodA total of 128
patients were randomly divided into
control group (64 cases: 2 cases of dropout,2 cases of elimination,and 60 cases of completion) and
observation group (64 cases: 3 cases of dropout,2 cases of elimination,and 59 cases of completion). Both groups were given comprehensive
treatment after MWA
surgery.
Patients in
control group took Biejiajian Wan orally (3 g/
time,3 times/d), and those in
observation group took Jiawei Xiaochaihutang (1
dose/d). The
treatment lasted for 3 consecutive months. The size of solid
tumor before and
after treatment was evaluated to
record the
progression-free survival (PFS). The
alpha-fetoprotein-L13 (AFP-L3),des-γ-carboxy
prothrombin (DCP),Golgi
protein 73 (GP73),
tumor necrosis factor-α (TNF-α),
transforming growth factor-β (TGF-β),
vascular endothelial growth factor (
VEGF) and
matrix metalloproteinase-2 (
MMP-2) levels,as well as performance status (PS),
liver function and
syndrome of
liver depression and
Qi stagnation scores were also detected before and
after treatment. In addition, the
incidence of side effects of grade Ⅲ and above was compared. ResultThe total effective rate of solid
tumor in
observation group was 91.53% (54/59),higher than that (76.67%, 46/60) in
control group(χ2=4.895,P<0.05). The PFS in
observation group was (7.16±0.95) months, longer than that (6.24±0.89 months) in
control group (P<0.01). The effective rate of
traditional Chinese medicine (TCM)
syndrome in
observation and
control groups were 88.14% (52/59)and 70.00% (42/60), respectively (χ2=5.897,P<0.05). The
observation group (57.63%,34/59) had higher marked effective rate of TCM
syndrome than
control group (31.67%,19/60) (χ2=8.116,P<0.01). The AFP-13,DCP,GP73,TNF-α,TGF-β,
VEGF and
MMP-2 levels and the PS,
liver function and
syndrome of
liver depression and
Qi stagnation scores in
observation group were lower than those in
control group (both P<0.01). The
cumulative incidence of side effects of grade Ⅲ and above in
observation and
control groups was 16.95% and 33.33%, respectively(χ2=4.261,P<0.05). ConclusionConsolidation
treatment of HCC after MWA
surgery with Jiawei Xiaochaihutang relieved symptoms and side effects,improved PS and
liver function,regulated
tumor microenvironment,inhibited
tumor markers and prolonged
survival time. The clinical effect was better than that of Biejia decoction pill, and thus it was worthy of clinical use.