加味茵陈蒿汤辅助肝动脉化疗栓塞术对中晚期原发性肝癌患者中医证候和Janus激酶2/信号转导与转录激活因子3信号通路的影响  

Effect of modified Yinchenhao Decoction assisted transarterial chemoembolization treatment on advanced primary liver cancer and its impacts for syndromes and JAK2-STAT3 signal pathway

作　　者：楚建设 CHU Jianshe(Department of Oncology,Quanzhou Binhai Hospital,Quanzhou,Fujian 362300)

机构地区：[1]福建省泉州滨海医院肿瘤科,福建泉州362300

出　　处：《河北中医》2024年第9期1450-1454,1459,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：福建医学科技青年培育项目(编号:18FBQN2016033)。

摘　　要：目的观察加味茵陈蒿汤辅助肝动脉化疗栓塞术(TACE)对中晚期原发性肝癌患者中医证候、Janus激酶2/信号转导与转录激活因子3(JAK2/STAT3)信号通路的影响。方法选取2020年6月至2022年6月福建省泉州滨海医院肿瘤科107例中晚期原发性肝癌患者为研究对象,按照简单随机化法分为对照组(n=53)和治疗组(n=54)。对照组予TACE,治疗组在对照组基础上加加味茵陈蒿汤治疗。统计2组实体瘤疗效、毒副反应及治疗前后中医证候(胁痛、痞块、腹胀)积分、JAK2/STAT3信号通路mRNA表达及其下游靶基因[B细胞淋巴瘤-XL基因(Bcl-XL)、细胞周期蛋白D1(Cyclin D1)、人髓细胞增生原癌基因(c-Myc)]蛋白表达、肝功能指标[天冬氨酸氨基转移酶(AST)、总胆红素(TBiL)、丙氨酸氨基转移酶(ALT)]。结果治疗组疾病控制率为79.63%(43/54),对照组疾病控制率为58.49%(31/53),治疗组疾病控制率高于对照组(P<0.05)。治疗后2组胁痛、痞块、腹胀评分,外周血JAK2、STAT3 mRNA表达,Bcl-XL、Cyclin D1、c-Myc蛋白表达,AST、TBiL、ALT水平均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。治疗组Ⅰ~Ⅱ级肝肾功能异常发生率低于对照组(P<0.05)。结论加味茵陈蒿汤辅助TACE对中晚期原发性肝癌患者症状、肝功能及疗效的改善具有积极作用,可能机制与下调JAK2/STAT3信号通路有关。Objective To explore the effects of modified Yinchenhao Decoction assisted transarterial chemoembolization(TACE)treatment on advanced primary liver cancer and its impacts for traditional Chinese medicine(TCM)syndromes and Janus kinase 2/signal transduction and transcriptional activator 3(JAK2-STAT3)signaling pathways.Methods A total of 107 patients with advanced primary liver cancer in Department of Oncology,Quanzhou Binhai Hospital from June 2020 to June 2022 were enrolled,and they were divided into control group(n=53)and study group(n=54)by a simple randomization method.All patients received TACE treatment,those in the study group additionally received modified Yinchenhao Decoction.A statistical analysis was conducted on efficacy,toxicity and side effects,TCM syndrome scores(hypochondrium pain,abdominal mass,abdominal distension),gene expression of JAK2-STAT3 signaling pathway and downstream target(B-cell lymphoma/leukemia-x long[Bcl-XL],Cyclin D1,cellular myelocytomatosis oncogene[c-Myc]),as well as liver function indicators(aspartate aminotrans-ferase[AST],total bilirubin[TBiL],alanine aminotransferase[ALT]).Results The disease control rate in the study group was significantly higher than that in the control group(79.63%[43/54]vs 58.49%[31/53],P<0.05).After treatment,the scores of hypochondriac pain,abdominal mass,abdominal distension,JAK2-STAT3 mRNA expression,protein expression of Bcl-XL,Cyclin D1,c-Myc signaling pathway,as well as the levels of AST,TBiL,ALT in the both groups were significantly lower than those before treatment(P<0.05),with significant differences between groups(P<0.05).The incidence of liver and kidney dysfunction(gradeⅠ-Ⅱ)was significantly lower in the study group than in the control group(P<0.05).Conclusion The modified Yinchenhao Decoction assisted TACE in patients with advanced primary liver cancer has a positive promoting effect on the improvement of TCM syndrome,liver function,and therapeutic effect by the downregulation of the protein expression of JAK2-STAT3 signaling pathway.

关 键 词：肝肿瘤 茵陈蒿汤 化学疗法 肿瘤 局部灌注 JANUS激酶2 信号转导与转录激活因子3 

分 类 号：R735.705.8[医药卫生—肿瘤]