Clinical Study Of In Treating Primary Liver Cancer With Jianpijiedu Prescription And Its Mechanism

Primary liver cancer(PLC)is one of the most common magligant turmor in clinic, which is ranked the second palce on the cause of magligant tumor.The main treat methods include surgery, transcather and Chinese Medicine.The most PLC patients had entered later stage and lost the chance of surgery when the diagnosis was made clear. So Transcatheter Arterial Chemoembolization (TACE) has become main treat methods at present. The TACE curative effect of the quality of life and survivial rate is not satisfied, howeve, it can lessen the size of tumor and improve the prognosis.While Chinese Medicine has unique advantages.It is effective that deffentiate PLC patients in whole and threat with strengthing the vital and expelling the toxic, treating both symptoms and radical.JianPiJieDu Prescription(JJP)is an empirical presciption from the director, Professor Liu Shenlin who summary mechanization of PLC with the theory of Traditional Chinese Medicine.It is effected by many years of practises and consisted of Pseudostellaria heterophylla, Poria cocos, Atractylodes macrocephala, Coix lacryma-jobi, Portulaca grandiflore Curcuma phaeocaulis, Eupolyphaga seu, Oldenlandia diffusa, Cremastra appendiculate and Glycyrrhiza uralensis.The presription provided the effects of strengthening the spleen, invigorating Qi, expelling toxin and removing blood stasis have demonstrated the exact efficacy in clinical application. The clinical research part of our study was investigation of combination optimized treatment of Chinese and Western medicine for PLC. The experimental research part was the investigation of the mechanism of anti-hepatoma by JJP.Clinical research componentObjective Observation of the curative effect and improvement of the survival rate and quality of life in treat with combination of TACE and JJP.Methods Following the experimental principle of randomization and paralled control, the 66 cases of PLC patients were divided into 2 groups.The control group was treated with TACE only. The treatment group is treated with TACE and JJP modified. The course of treatment is 3 months. When the course was end, we evaluated the results of the symptoms, TCM syndromes, size of tumor, blood regular test, liver function, level of Child-pugh class, KPS value and time of survival and evaluation of security. All clinical results were processed by statistical analysis software.Results1. The variety of sex, age, stage of illness and symptoms base line had no statistical defference in 2 groups, P>0.052. The combination of two treatments improved the symptoms, TCM syndromes, blood cell level and value of liver function obviously. By test, the deference is distinct, vs control group, P<0.01 or P<0.05.3. The combination group had significant improvement on the class of Child-pugh, value of KPS and time of survival, vs control group, P<0.05.4. The variety of lessen of value of tumor had no difference in 2 groups, P> 0.055. The combination group had clinical safety.Conclusion The combinated treatment of TACE and JianPiJieDu Prescription can reduce toxicity and enhance curative effect, improve the quality of life and extend the time of survival. TCM can make up the shortage of TACE.Experimental reaserch componentObjective To investigate the mechanism of the anti-hepatoma cancer of JianPiJieDu Prescription.Methods With the method of pharmacological serum,3 consistencies of serum were made.And serum was manipulated into human hepatoma cells of HepG2 and SMMC-7721.With the constract of negtive and positive serum of NS and 5-FU.Observate the change of shape and size of human hepatoma cells with miscroscope and TEM. Detect the growth inhibiting rate with MTT Method, Probe the apoptosis of cell with FCM and immuno fluorscent. Assess the migration and invasion of human hepatoma cells by transwell technique.Expression levels of CD44 and VEGF mRNA in HepG2 and SMMC-7721 cell were determined by reverse transcription-polymerase-chain-reaction (RT-PCR).Results With the function of pharmacological serum,the human hepatoma cells of HepG2 and SMMC-7721 took out view of death and apoptosis. The growth of cells were significantly inhibited than in the negative control group, P<0.01.The number of migration and invasion was significantly lower in pharmacological serum group than in he negative control group,P<0.01.The inhibiting rate of high dose group of pharmacological serum is mild higher than the rate of positive group. A significant down-regulation of expression of CD44 and VEGF gene mRNA were observed in HepG2 and SMMC-7721 cells.Conclusion Pharmacological serum of JianPiJieDu Prescription has the function of anti-cancer in vitro.It is able to inhibit the growth of human hepatoma cell, induce apoptosis of cell and inhibit the invasion and metastasis of cells.It was reckon that inhibiting capable of veil liver metastasis of PLC possibly related by down regulation of CD44 and VEGF gene expression.