| Laryngeal precancerosis is a particular type of EHLL. It is a kind of pathologic change which is more inclined to be cancerated than the normal mucous membrane. It mainly includes hyperplastic laryngitis, keratosis of the larynx (including leukoplakia and pachydermia) and adults' papilloma of the larynx. In clinic, not all the precancerosis of laryngeal cancer finally lead to laryngeal cancer. Some of them can partly or even completely disappear. Some of them remain its precancerous condition. Only minority of them will deteriorate into laryngeal cancers owing to endogenous or exogenous harmful factors. So, it plays a significant role in preventing the cancerization of laryngeal cancers both in theory and practice by diagnosing and controlling the pathological changes betimes, studying it's clinical manifestation, histological features and the relationship between their histological features and canceration.Laryngeal precancreosis was never mentioned in TCM ancient books. However, it was classified into the chronic hoarseness in light of its characteristic of repeated hoarseness. The local symptom in patient' s throat manifests itself as congestive, purple mucous membrane with hypertrophy hyperplasia and swelling, which is consistent with the blood stasis TCM theory. Circulation disorder is the basic pathological changes of the disease. The essence of TCM symptom reflects the physiologic and pathologic changes in human body which was considered to have close relationship with protein changes. Furthermore,the instability and adjustability of protein are more consistent with thevariability and variety of symptom in TCM. So, the study on the correlation between protein and TCM symptom is significant.INOS and VEGF were taken as the breakthrough point, which all have close relation with laryngeal precancerosis, with the immunohistoche-mical technique, We tried to find some micro-indexes that can indicate the correlation between laryngeal precancerosis and the blood stasis syndrome in TCM from cellar and molecular level, studying how micro-circulation disorder effects human body in the process from a precancerous condition to cancer, looking for some objective microindexes which are helpful to estimate the developing trend of Laryngeal precancerosis, identifying what type of syndrome a certain case is, observing the effects of the JinHou tablet which has been proved to be able to activate blood and dissipate stagnation as well. It can provide a lot of evidences of preventing and treating cancers with Chinese medicine by the research of blocking and reversing laryngeal precancerosis with Chinese medicine.1 Literature studyAt the beginning we made a review about the names, causes, pathomechanism and treatments of laryngeal precancreosis in ancient books. We also gave a general summarization about the recent progress in treating laryngeal precancerosis with Chinese medicine in recent 10 years. Then the research progress of the definition, causes, classification, diagnosis and therapy of Laryngeal precancerosis in western medicine theory, the relationship study on between the carcinoma of larynx and the INOS and the VEGF, the voice objective detection as well were all summarized.2 Clinical studyObjective:To investigate the efficacy of intervention of the JinHou tablet on the treatment of laryngeal precancerosis with blood stasis syndrome.Methods:30 cases with proved laryngeal precancerosis identified as blood stasis syndrome were chosen. The patients in the trial group were treated with JinHou tablets per os, with a dose of four tablets every time, three times a day. A course consists of 14 days. All the treatment lasted for two courses. A symptom and physical sign examination and computing analysis of voice were conducted respectively at the 14th, 28th day and two months later. The safety were checked once pre-treatment and post-treatment respectively. Self PA comparision statistical method were implemented to the analysis of thecurative effects.Results:A course later, the dominant healing rate was 43.30%. 83.30% for the end of the treatment, 73. 30% for the two -month - later-follow-up survey. There was significant difference between pre-treatment and post-treatment in the symptoms, physical signs and parameters of voice (includes SHIMMER JITTER NNE MPT) (P< 0. 01). No reverse effects was observed among 20 patients in the trial group. The safety of all cases is grade one.Conclusions:The JinHou tablet has the function of activating blood circulation, removing blood stagnation and dissipating stasis. The clinical study proved that the JinHou tablet can remarkably improved laryngeal precancerosis patient' s symptoms, physical signs as well as the voice quality. So, the tablet has a definite effect to treat laryngeal precancerosis by blocking up the development of canceration of laryngeal precancerosis without any harmful or side effect. Therefore, it deserves to be popularized and used in clinicin treating such disease. 3 Laboratory study Objective:To investigate the correlation between the essence of TCM syndrome of laryngeal precancerosis and the expression of INOS and VEGF in the level of genetic protein expression.Methods:10 paraffin embedded samples of laryngeal precancerosis identified as blood stasis syndrome were chosen as the trial group and 10 paraffin embedded tissue sections of laryngeal precancerosis with phlegm-dampness syndromes were chosen as the control grouop. 10 paraffin-embedded materials of laryngeal cancer stored in the department of pathology in Guangdong provincial TCM hospital were chosen as the laryngeal cancer grouop. Respectively, measuring their expression of INOS/VEGF and protein with the immunohistochemical technique.Results:? In the laryngeal cancer group, the positive expression rate of the JNOS and VEGF is 100.00% and 90.00% respectively. While in the trial groui/\he/~~rate is 80. 00% and 60. 00% respectively. In the control group, the rate is 30. 00% and 30. 00% respectively. There was siginificant difference between any two groups in the positive rate of the INOS and VEGF among three groups.(2) There was a significant close correlation between the expression of the INOS and VEGF and the hermorheobgy (P<0. 01) .(3) There was a positive correlation between the expression of the INOS and the expression of the VEGF (/>< 0. 05) .Conclusions:(D The experimental study showed that VEGF and iNOS of all samples in three groups expressed positively at different degrees. There was a significant difference in the expression of IONS and VEGF between any two groups among three groups. There was a significant close correlation between the expression of the INOS and VEGF and the hermorheobgy. Base on the results mentioned above, we considered that blood stasis syndrome in TCM is the basic TCM type of laryngeal precancerosis.(2) There was a positive correlation between the expression of INOS and VEGF. So, we considered that in the process of blood vessel generating of laryngeal precancerosis or laryngeal cancer, INOS and VEGF may interact to accelerate the generation of new blood vessel, which play an important role in the onset and development of laryngeal cancer. 4 ConclusionsThe JinHou tablet has a definite effect to treat laryngeal precancerosis. It can remarkably improve the patient' s voice quality, blocking up the development of canceration of laryngeal precancerosis. The expression of INOS and VEFG can be an index for evaluating the disease condition of laryngeal precancerous and forecasting the risk of canceration. The blood stasis syndrome is a basic TCM type of laryngeal precancerosis.
|
PDF Full Text Request