Clinical Study Of Chai Shao Tang Combined With Apatinib Mesylate Tablets In The Treatment Of TACE For Primary Liver Cancer (Liver Depression And Spleen Deficiency Type)

Objective:To evaluate the clinical effect of Chaishao decoction(a kind of Chinese herbal medicine)on primary liver cancer.Methods: A total of 64 TACE patients with primary liver cancer who met the inclusion criteria were selected and divided into 2 groups by random number table method.30 patients in each group were included in the final treatment group and the control group.The control group was treated with conventional treatment of Western medicine plus apatinib,and the treatment group was treated with Chaishao decoction on the basis of the control group,with a course of 4 weeks and 3 courses in total.The scores of TCM syndromes,tumor efficacy,liver function,liver cancer,coagulation function and adverse reactions of apatinib were observed before and after treatment in 2 groups,and statistical treatment was conducted to evaluate the effectiveness and safety of Chaishao Decoction.Results: AFP,AFP-L3 and PIVKA-II values in both groups decreased at 4weeks and 12 weeks after treatment,and the differences were statistically significant(P<0.05);AFP,AFP-L3 and PIVKA-II values showed no significant difference between the two groups at 4 and 12 weeks after treatment(P>0.05).ALT,AST,TBIL and ALB in both groups improved at 4and 12 weeks after treatment,and the differences were statistically significant compared with those before treatment and between the two groups(P<0.05).The TCM syndrome score of both groups decreased at 4 weeks and12 weeks after treatment,and the difference was statistically significant compared with that before treatment and between the two groups(P<0.05).The effective rate of TCM in the treatment group was 63.3% and 93.3% at 4and 12 weeks after treatment,respectively,while that in the control group was36.7% and 70% at 4 and 12 weeks after treatment,respectively.There was a significant difference between the two groups(P<0.05).KPS scores in both groups increased significantly after 4 and 12 weeks of treatment compared with before treatment,and the differences were statistically significant(P<0.05).There was no significant difference in objective response rate and tumor control rate between the two groups at 4 and 12 weeks after treatment(P>0.05).The median PFS was 4.6 months in the control group and 5.6months in the treatment group,and the difference in PFS between the two groups was statistically significant(P<0.05).The incidence of total adverse events in treatment group(80%vs50%)was lower than that in control group,and the difference was statistically significant(P<0.05).In the adverse reactions,the incidence of nausea,vomiting,fatigue and diarrhea in the treatment group was significantly lower than that in the control group,with statistical significance(P<0.05).Compared with the control group,the incidence of hypertension,proteinuria,hand-foot syndrome,WBC decline and PLT decline in the treatment group had no significant change(P<0.05).There were no special adverse events in blood routine,urine routine,renal function and electrocardiogram before and after treatment in 2 groups.Conclusion:1.Chaishao Decoction combined with apatinib in the treatment of TACE for primary liver cancer(liver depression and spleen deficiency type)has a definite clinical effect,which significantly improves the clinical symptoms of patients,improves the quality of life of patients,prolongates the progression-free survival of patients,and improves the liver function of patients to a certain extent.The symptoms of Chaishao decoction are as follow.First,frequent chills and heat,pain in chest and hypochondriac,feeling upset and vomiting,silent refusal to eat,bitter mouth and dry throat,fatigue,hypochondriac pain or abdominal pain,acute.Second,unformed stool,or with dizziness,palpitations,or with irritable,etc.Third,tongue light,thin white or greasy moss,pulse string or fine.2.Chaishao decoction combined with apatinib in TACE treatment of primary liver cancer(liver depression and spleen deficiency type)has more obvious efficacy than apatinib alone used in treatment,and the incidence of adverse reactions is reduced,which is worthy for further study.