The Research Of The Safety And Efficiency Of Comprehensive Treatment Of Cryoablation, TACE And Chinese Medicine On Primary Liver Cancer

ObjectiveThis paper aims to explore the clinical application and efficiency of two comprehensive treatment methods:comprehensive treatment of cryoablation, TACE and Chinese medicine;comprehensive treatment of TACE and Chinese medicine. The paper also analyzed the factors influencing the prognosis of primary liver cancer,explores the advantages and scope of application of cryoablation to treat primary liver cancer, and explores the best integration of traditional Chinese medicine and western medicine, and explores the individualized, sequential comprehensive treatment that takes account of "disease, syndrome, symptom".This paper observes and evaluates the safety of cryoablation to treat primary liver cancer, and the change pattern of syndrome type before and after treatment. The research also explores the Chinese medicine property of cryoablation.Methods1. Through the case control study, based on the clinical treatment standard of Cryoablation and TACE, the research selected 90 patients with primary liver cancer and conducted follow-up visits. The qualified cases were divided into 2 groups:Group 1 adopts comprehensive treatment of cryoablation, TACE and Chinese medicine and Group 2 adopted comprehensive treatment of TACE and Chinese medicine. According to the baseline balance analysis of T-test and chi-square test, the paper compared the survival time and the difference of survival rate of 6 months,1 year and 2 years. The research calculated the survival curves of two groups using the method of Kaplan-Meier (product-limit method) and compared them in log-rank test, in the aim of comparing the efficiency of these two treatment methods. The risk assessment adopted the COX proportional hazards regression mode, using the patients’OS as the primary end-point, analyzed the survival data with multi-factors, analyzed the prognosis factors influencing primary liver cancer.2. The Chinese medicine property of cryotherapy:Compared different symptoms, signs, examination results and changes of tongue and pulse;observed the change pattern of the before and after syndrome of cryotherapy;analyzed the effect on syndrome change. Ranked ordinal data using Wilcoxon paired rank sum test, and measured data using paired T test, to evaluate the complication and syndrome change pattern comprehensively.Results1. Case-control study:The moderate survival time and the mean survival time of Group 1 (Cryoablation+TACE+Chinese medicine) was 29±6.88 months and 35.83±6.25 months;The moderate survival time and the mean survival time of Group 2 (TACE+Chinese medicine) was 6.00±1.64 months and 18.12±3.96 months, (P<0.05).In group 1, the survival rate of six months,1 year,2 years were 2.11%,83.78%,62.50%; In group 2, the survival rate of six months,1 year,2 years were 65.71%,50%,24.14%(P<0.01). COX regression analysis results showed that type of treatment, TCM syndromes, grading of tumor thrombus, Child-Pugh had statistical significance (P<0.05). Multivariable COX regression analysis results showed that type of treatment, TCM syndromes, grading of tumor thrombus had statistical significance (P<0.05)2. Research of TCM properties of Cryoablation:Transient costal pain was at first more obvious after the operation, and the pain was less than the postoperative pain after 24 hours. (P<0.01); Postoperative nausea and vomiting, chill was greater after the operation, and after one day, the degree was lighter (P<0.05);Slippery pulse turned to non-slippery pulse after the operation (P< 0.05);Deep pulse was more apparent compared to that of before and 1-day-after operation(P<0.05);After the operation, the delayed pulse was more obvious, but was reduced one day later(P<0.01). The heart rate was obviously slower after the operation, and reduced 13.13 times/min in average (P<0.01); After 24 hours, the heart rate obviously increased, and it increased 13.63 times/min in average (P<0.01);The heart rate did not show obvious change before and after operation within 24 hours (P>0.05). The body temperature showed slight decrease after the operation, and after 24 hours, the body temperature did not reflect obvious change(P> 0.05);The systolic blood pressure after the operation showed slight decrease (P>0.05), and after 24 hours, the systolic blood pressure was lower than that of before and after operation. The fatigue, dizziness, sweating, bleeding, tongue, tongue coating, respiratory frequency, diastolic blood pressure change of before, after and 24 hour operation have no statistic value (P>0.05). LT decreased after operation, dropping 56.50×10-9/L in average(P<0.01);The PLT increased 81.44×10-9/L in average one month after the operation; The PLT change has no statistic value (P>0.05). ALT, AST had obvious increase after operation, and ALT increased 294.7U/L,and AST increased 307.00 U/L(P< 0.05);The ALT, AST had obvious decrease one month after the operation;The changer of WBC, PT, APTT, TB, AFP, AFU, CEA have no statistic value (P>0.05).ConclusionsUnder the guidance of the concept of traditional Chinese medicine, the group(Cryoablation+TACE+TCM) has better effect of synergy and attenuation. The combind treatment of three methods can reduce toxicity reaction and increase the survival time of liver cancer, increase the survival rate, improve the quality of life and the prognosis. Postoperative symptoms of cryotherapy are transient costal pain, nausea and vomiting, chill, deep pulse, slippery pulse, obvious transient decreased heart rate and slight drop in body temperature, and decrease of systolic blood pressure, decrease of HGB, PLT, and obvious increase of ALT, AST. The above symptoms can return to normal 1 day after operation. The laboratory results are returned to normal in a month after operation. Combined with TACE and Chinese medince, cryotherapy is worth promoting in liver cancer comprehensive treatment for its high safety, clod in nature Chinese medicine.