| Research purposes:Malignant peritoneal effusion by tumor invasion and abdominal cavity,caused by widely planted in peritoneal.Intraperitoneal malignant ascites is one of the complications of advanced cancer,is also a common cause of death of cancer patients.Cinobufacini injection is a modern preparation of toad skin extract.Preliminary studies show that it has certain curative effect on malignant peritoneal effusion.Therefore,to observe the cinobufacini injection intraperitoneal perfusion for the treatment of malignant ascites and changes of VEGF.A preliminary study on the target of the cinobufacini injection.Under the guidance of the tutor,the author designed a prospective,single center,open clinical trial.Research method:This topic included all cases from May 2016-2017 February Beijing University of Chinese Medicine east hospital treated with malignant ascites fluid into the experimental group standard.A total of 20 patients(9 cases of male,female 11 cases);the maximum age is 81 years old,the youngest 52 years old,mean age 61 ± 8 years old.In 20 patients with bloody ascites:7 cases;non hemorrhagic ascites:13 cases.All the patients were on the basis of conventional therapy,underwent abdominal puncture and drainage,and the treatment of cinobufacini injection intraperitoneal.Perfusion configuration:0.9%NS 39ml+ cinobufacini injection 10ml*5(Anhui Jinchan Limited by Share Ltd 10ml/branch)+5mg dexamethasone +10ml lidocaine.After the infusion to patients every 10 minutes over 1 times,a total of over 4 times,with a uniform absorption promoting medicine.Record the patients with abdominal water Biochemical regulation,ascites tumor markers,ascites ascites,color,drainage and drainage as well as the number of specimens from patients with VEGF specimens were detected(this by purchasing ELISA kit to detect),while recording the blood routine,liver and kidney function,ECG in the monitoring of adverse drug reactions.The final analysis.Result:1.The changes before and after treatment in 20 patients after infusion of ascites VEGF in varying degrees,of which 45%(9/20)increased in VEGF patients,55%(11/20)in patients with decreased VEGF content after treatment.The naked eye patients with bloody ascites after treatment before and after the treatment showed that before treatment was 330.53 ± 127.09pg/ml,242.36 ± 131.53 pg/ml after treatment,compared before and after the treatment effect was statistically significant P<0.05.2.The local TCM syndrome of dampness heat toxin group,7 cases of patients with ascites after treatment VEGF content were decreased and the efficiency of 100%,there are 31%VEGF in ascites of patients with cold dampness syndrome(4/13)virus in patients has decreased,the comparison between groups after the syndrome of dampness heat toxin group was significantly better than the cold dampness toxin group,P<0.05 have statistical significance.3.20 cases of patients with ascites before and after the red.blood cells have varying degrees of change,of which 35%(7/20)in the treatment of patients with elevated red blood cells,red blood cell content decreased after treatment in patients with 65%(13/20).Red blood cell content before treatment was 47449.20 ± 43176.82*10A6/L content after treatment was 30261.70 ± 29040.82*10^6/L,the treatment effect before and after comparison,P<0.05,there was statistical significance.4.Eye color changes,20 patients after cinobufacini injection intraperitoneal perfusion after a total of 13 cases of patients with ascites color changes,of which 50%(10/20)of patients with ascites color improvement,while 15%(3/20)patients developed color burn.5.20 cases of ascites in patients with ascites before and after the LDH have varying degrees of change,of which(11/20)in the treatment of patients with elevated LDH,45%(9/20)in patients with LDH after treatment decreased.The content of LDH before treatment was 4231.78 ± 72.41 U/L,and the content after treatment was 127.06±71.70U/L,P<0.05,there was statistical significance.6.In the 20 patients before treatment,CEA was found in 75%(15/20)of treatment,and only 25%(5/20)of patients had elevated CEA.However,there was no significant difference between the two groups(P>0.05).7.Front of VEGF,erythrocytes,LDH,CEA correlation difference before and after the test results,it can be seen that the correlation coefficient,are pairwise correlation data.The correlation between red blood cell difference and VEGF difference,LDH difference and CEA and LDH were strong,the correlation coefficients were 0.745,0.828 and 0.771,the difference between red blood cell and CEA and the correlation between VEGF and LDH and CEA were weaker The coefficients were 0.696,0.618,0.668,P<0.05,statistically significant.8.The mean values of the group of damp-heat syndrome in VEGF group,erythrocyte group,LDH group and CEA group were significantly higher than those in the control group(P<0.05).Of the P<0.05,statistically significant.While the LDH group P>0.063,no statistically significant.9.Before and after treatment,the average flow rate of the patients before and after treatment showed that the average flow rate before treatment was 605 ± 180ml/times,after treatment,the average flow rate was 568 ± 174ml/times,compared with P>0.05.10.During the treatment,there were 1 cases of abdominal pain after perfusion,and the body temperature was elevated in all of the 20 patients,but there was no need for drug treatment in the 3 cases.Conclusions:1.Cinobufacini injection intraperitoneal treatment can reduce the content of VEGF in ascites,especially for hemorrhagic ascites not only red blood cells significantly decreased,while VEGF content decreased significantly,and improve the color of bloody ascites.2.The intraperitoneal injection of cinobufacin can decrease the content of CEA and LDH in some malignant ascites,but it is not statistically significant.3.After treatment with cinobufacin,the levels of erythrocyte,VEGF and LDH and CEA in ascites were affected,and there was a strong correlation between erythrocyte and VEGF and the change of erythrocyte and LDH.4.Cinobufacini injection for damp heat toxin syndrome group ascites curative effect is obviously superior to cold dampness toxin syndrome.To illustrate the above description of "correct heat treatment of cold",at the same time indirectly indicated that the importance of the environment for tumor therapy.5.Minor adverse reactions induced by Cinobufacin local treatment and peritoneal perfusion can be tolerated,especially for patients with poor body is a good treatment scheme. |
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