益气活血化瘀汤联合肝动脉化疗栓塞术对肝癌切除术后患者TLR4受体及下游炎症因子的影响  

Effect of Yiqi Huoxue Huayu decoction combined with TACE on TLR4 receptor and downstream inflammatory factors in patients with liver cancer after operation

作　　者：王艳丽[1] 高英杰[1] 李凤彩 吴圆圆 刘丽娜[1] 马丹丹 WANG Yan-li;GAO Ying-jie;LI Feng-cai(Department of Oncology,Baoding Second Central Hospital(Baoding,Hebei,072750),China.)

机构地区：[1]保定市第二中心医院肿瘤内科,河北保定072750

出　　处：《中西医结合肝病杂志》2021年第3期234-237,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:探讨益气活血化瘀汤联合肝动脉化疗栓塞术(TACE)对肝癌手术切除患者Toll样受体4(TLR4)及下游炎症因子的影响。方法:选取我院2016年4月至2018年4月收治的肝癌患者120例,均行肝癌切除术。根据随机数字表法,将术后患者分成对照组、观察组各60例。对照组患者术后给予TACE预防性治疗,观察组患者采用益气活血化瘀汤联合TACE治疗,疗程均为3个月。分别在治疗前、治疗3个月时,检测患者血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBil)、丙二醛(MDA)、超氧化物歧化酶(SOD)、总抗氧化能力(TAOC)水平。与此同时,检测两组患者血清TLR4水平以及下游炎症因子,包括血清肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)、白介素-6(IL-6)、细胞间黏附分子-1(ICAM-1),记录两组患者治疗期间不良事件发生情况。随访2年,比较两组患者临床疗效和2年总生存率。结果:观察组患者总有效率为90.0%,高于对照组的75.0%(P<0.05);两组患者治疗后血清MDA、ALT、AST、TBil明显下降P<0.05,且观察组优于对照组(P<0.05);两组患者治疗后血清SOD、TAOC较治疗前显著增高(P<0.05),且观察组优于对照组;两组患者治疗后血清TLR4、TNF-α、IL-1β、IL-6、ICAM-1较治疗前明显降低,且观察组优于对照组(P<0.05);观察组患者不良反应发生率为16.67%较对照组的33.33%显著降低(P<0.05);观察组患者2年总生存率为78.33%显著高于对照组的61.67%(P<0.05)。结论:肝癌手术切除后患者采用益气活血化瘀汤联合TACE治疗,能更有效地改善患者肝功能,减轻氧化应激反应,降低不良事件发生,其可能通过降低血清TLR4及下游炎症因子水平,进一步发挥抗肿瘤作用,提升患者2年生存率。Objective:To explore the effects of Yiqi Huoxue Huayu Decoction combined with transcatheter arterial chemoemoembolization(TACE)on Toll like receptor 4(TLR4)receptors and downstream inflammatory factors in patients with liver cancer after surgery.Methods:A total of 120 liver cancer patients admitted to our hospital from April 2016 to April 2018 were selected,and all patients underwent liver cancer resection.According to the random number table method,they were divided into a control group and an observation group with 60 cases each.The control group was given TACE preventive treatment after the operation,and the observation group was treated with Yiqi Huoxue Huayu Decoction combined with TACE treatment.Both groups were observed for 3 months.The curative effect of short term TCM syndromes between the two groups were compared.The serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)were detected before and after 3 months of treatment.Malondialdehyde(MDA),superoxide dismutase(SOD),total antioxidant capacity(TAOC)levels.At the same time,the two groups of serum TLR4 levels and downstream inflammatory factors were detected,including serum tumor necrosis factor-α(TNF-α),interleukin-1-β(IL-1β),interleukin 6(IL-6),and intercellular adhesion molecules 1(ICAM 1),record the incidence of adverse events during the observation period of the two groups.Follow up for 2 years and compare the 2-year overall survival rate of the two groups.Results:The total effective rate of the observation group was 90.00%,which was higher than 75.00%of the control group(P<0.05).Serum ALT,AST and TBIL after treatment in the two groups were lower than before treatment,and the observation group was lower than the control group(P<0.05).After treatment,serum SOD and TAOC were significantly higher in the two groups than before treatment,and the observation group was higher than the control group,while serum MDA was significantly lower than before treatment,and the observation group was lower than the control group(

关 键 词：肝癌 肝动脉化学栓塞术 益气活血化瘀汤 TLR4受体 炎症因子 

分 类 号：R735.7[医药卫生—肿瘤]