The Clinical Observation On The Change Of TCM Syndromes Of The Heptocellular Carcinoma Pa-tients Treated With The Sorafenib

Objective:Collecting the clinical datas of the patients with hepatocellular carcinoma BCLC C phase in treatment with sorafenib which is the molecular targeted drugs and analyzing the syndrome,to study the chang of TCM syndroms treating with sorafenib,in order to provide the theory basis of syndrome differentiation of traditional Chinese medicine drugs for traditional Chinese medicine with sorafenib in treating HCC.Methods:The subject used the self controlled study, formulating clinical syndrome information collection table based on the related literatures and experts advices.Collect the four diagnostic datas of the traditional Chinese medicine in inspection, auscultation,olfaction, and inquiry, and pulse-taking and palpation which were 77 cases of patients treated with sorafenib.Summarize the evolutive regulation of the TCM syndrome distribution before and after treating with sorafenib.Results:(1)The changes of syndrome distribution which were compared before and after treating with sorafenib were significant differences(P<0.05).Liver stagnation with spleen deficiency syndrome and hepatic blood stagnation syndrome were most before treatment,25.97%,35.06%,respectively.The syndrome was focused on Spleen deficiency damp obstruction syndrome,which was 29.87%,blood stasis symptom was also increased significantly.Sorafenib effects the TCM syndromes of Hepatocellular carcinoma.(2)The changes of tongue picture’ distribution which were compared before and after treating with sorafenib were significant differences(P<0.05).The red tongue, dark red tongue and pink tongue were more seen than the other before treatment,36.36%,27.27%,28.57%,respectively.The ratio of dark red tongue was increased,making up 38.96%; The tongue coating was focused on thin and white fur, white and thick fur before treatment,31.16%,29.87%,respectively.The ratio of white and greasy fur was increased obviously after treatment,making up 32.47%, whereas the ratio of thin and white fur was decending,making up 12.98%.At the same time, the ratio of fat and teethprinted tongue was increased obviously after treatment.(3)The pulse tracing was focused on string, the number of string, the string slip before treatment,whereas soft pulse was less;The ratios of the string slip and soft pulse were increased after treatment.The sample sizes may be few,so there was no significant difference before and after treatment(P>0.05).(4)The symptoms of quantitative scores of hepatic blood stagnation syndrome and Spleen deficiency damp obstruction syndrome were no significant difference before and after treatment(P<0.05).(5)The major adverse reactions of sorafenib was diarrhea(45.45%),skin toxicity reaction(40.25%),fatigue(38.96%),hypertension(31.17%),and so on.TheⅠ~Ⅱ and Ⅲ~Ⅳ class were 91.70%,8.30%,respectively.Conclusions:(1)The TCM syndromes of patients with hepatocellular carcinoma tended to spleen deficiency damp obstruction syndrome and hepatic blood stagnation syndrome,the degree of pathogen dampness and blood stasis were gradually aggravate by analyzing the syndrome, tongue, pulse condition and adverse reactions,so we could put forward the TCM treatment,the principle was to reinforce qi strengthen spleen,resolve dampnessand and invigorate the circulation of blood.(2)By clinical observing,found that the sorafenib injured spleen and stomach,in order to the function of spleen and stomach disordering,producing a series of syndromes.Therefore,we could give the intervention of traditional Chinese medicine in early from spleen and stomach,improving the comprehensive clinical efficacy of hepatocellular carcinoma.