The Clinical Effects In Patients With Primary Liver Cancer And The Influence On The Apoptosis In Cells Of Liver Tumors Of Aitongxiao Granule

Objective:To explore the clinical effects and the mechanism of Aitongxiao granule(ATX) on the patients with primary liver cancer(PLC) and Spradue-Dawley rats which were implanted liver tumors(Walker-256 carcinosarcoma).Methods:First, having reviewed documents of traditional Chinesemedicine,we summarized PLC according to the knowledge of TCM inappellation, etiopathogenisis, pathogenesis, therapeutical principle,therapeutic method, prognosis, etc, and then produced a new hypothesisabout genesis and growth of PLC. Second, strictly selected by followingdiagnostic code,internalize code, eliminant code and so on,twenty-sevenpatients with PLC were treated with ATX. And safety index, AFP,syndrome, Karnofsky score and multiple auxiliary examination wereinspected and analyzed before and after treatment. Third, spradue-Dawleyrats,which were implanted liver tumors(Walker-256 carcinosarcoma),were divided into 5 groups (model group, 5-Fu group, minute dosagegroup of ATX, medium dosage group of ATX, large dosage group ofATX) randomly. After the model was made, rats in 5 groups were treatedwith aqua stillata,5-Fu,minute,medium and large dosage of ATXrespectively. The treatment course lasted for 14 days and no medicine wasgiven for on the 15th day. On the 16th day,the animals were killed andtheir transplanted tumors were cut off for detection further. The contentsof DNA in tumor cells were detected by DNA staining and flow cytometry. Generation cycle were determined by Annexin-V/PI double staining and apoptosis from rats liver tumor cells were revealed by membrane potential of mitochondrion.Results: By reviewing documents,we advanced a new hypothesis of TCM about genesis and growth of PLC,which was: 'The genesis and growth of liver cancer,are caused by blockage of pathogens under flank or in liver, which is the result of poison aggregation, stagnated blood, abnormal hoisting of activities of qi and asthenia of healthy energy.' The clinical study showed that: the total effective rate in relieving TCM syndromes of ATX was 21/27(77.78%).The different score of the syndrome between before and after treatment was 10.31±4.71, which had significant differences counted by statistical analysis (P<0.01).The same as the statistical result of AFP, quality of life(Karnofsky score),which were 316.31±62.74,11.15±5.65 by turns. The experimental study showed that: the contents of DNA of tumor cells in minute, medium and large dosage groups of ATX, contrasted with that of the model group,were obviously reduced. And there were significant differences counted by statistical analysis (all P<0.01). Compared with the normal group, there were significant differences also(all P<0.01).It gave us a demonstration that although the contents of DNA in groups of ATX couldn't decrease to the normal level, ATX did reduced the composition of DNA;The bulk of cells of liver tumors in every dosage group of ATX stayed in G₀/G₁ phase,compared to that of the model group,there were significant differences altogether(all P<0.01),as well as comparing to that of the 5-Fu group(all P<0.01). There were also significant differences of tumor cells in S phase between all groups of ATX and the model group(all P<0.01). It showed that ATX could prevent the cells from G₁ phase to S phase. Data of Membrane potential of mitochondrion in every dosage group of ATX were obviously improved,and the changes compared with that of the model group,there were significant differences altogether(all P<0.01).The apoptosis rates of tumor cells in every dosage group of ATX were obviously elevated,compared with that of the model group and the normal group,there were significant differences. It proved that every dosage group of ATX could induce the apoptosis of tumor cells,and then markedly improved their apoptosis rates.Conclusions: 1.The new hypothesis of TCM about genesis and growth of PLC: The genesis and growth of liver cancer,are caused by blockage of pathogens under flank or in liver,which is the result of poison aggregation, stagnated blood, abnormal hoisting of activities of qi and asthenia of healthy energy. Through the therapeutic methods such as heat-clearing and detoxicating,disengaging blood stasis and eliminating stagnation, invigorating the spleen and vital energy,we can gain a better therapeutic effect.2.The total effective rate of ATX granule on the syndrome of TCM of PLC was 77.78%. ATX could lower the level of AFP in patients with PLC obviously, and improve the quality life of patients.3.The ATX granule could reduce the contents of DNA in cells of liver tumors, and make generation cycle of tumor cells stayed in G₀/G₁ phase. It could promote the alter of membrane potential of mitochondrion in cells of liver tumors. And as a result, the ATX granule cells could obviously elevated apoptosis rates and promote the apoptosis of cells in liver tumors.