消水汤治疗原发性肝癌腹水的临床及实验研究

目的观察消水汤治疗原发性肝癌腹水脾虚湿困证的，临床疗效及实验研究。方法61例确诊为原发性肝癌腹水，中医辨证为脾虚湿困证的患者随机分成治疗组（33例）和对照组（28例），治疗组采用消水汤口服结合顺铂局部腹腔灌注治疗，对照组采用单纯顺铂局部腹腔灌注治疗，治疗时间2个月。观察癌性腹水改善情况、治疗后生存期、生存质量、中医症状改善情况、实验研究对小鼠模型分组治疗，观察腹水消退情况及生存期。结果 临床研究：中西医结合治疗的近期总有效率为42．4％，单纯西医治疗的总有效率为21．4％，两组比较差异有显著性（P〈0．05）；治疗后抽取腹水时间间隔分别为（17．95±9．63）天和（10．87±7．76）天，两组比较差异有显著性（P〈0．05）；治疗后1年生存率分别为33．3％和14．3％，两组比较差异有显著性（P〈0．05）。两组治疗后生活质量均改善，但差异无显著性。两组患者各项中医症状均有改善，治疗组尤以乏力、腹胀、恶心呕吐改善明显．安全性检测结果表明，消水汤无明显的不良反应，服用安全：动物实验表明：在接种两种瘤株的小鼠腹水模型中，治疗组在腹水减少和生存期延长方面均优于对照组，差异有显著性（P〈0．05）。结论消水汤治疗原发性肝癌腹水脾虚湿困证可收到满意的近期疗效，延长生存期，得到实验证实；且能够改善中医症状，提高生活质量，是一种治疗肝癌腹水可靠、有效的方法。

Clinical and Experimental Study of Xiaoshui Decoction in the Treatment of Primary Liver Cancer Caused Ascites

OBJECTIVE: To observe the clinical efficacy of Xiaoshui Decoction (XSD) in treating ascites in patients suffered from primary liver cancer of Pi-deficiency with damp harassment syndrome (PDDHS) as well as to study the effect through the experiment in mice. METHODS: Sixty-one patients confirmed to be primary liver cancer of PDDHS and accompanied with ascites were randomly divided into the treated group (n=33) and the control group (n=28). The treated group was treated by XSD combined with chemotherapy by locally applying of DDP via abdominal infusion, while the control group treated by DDP infusion alone. The treatment lasted for two months. The conditions of ascites, quality of life (QOL), survival period, and TCM syndrome after treatment were observed. In the experimental study, the mice models of ascites were grouped and treated to observe the conditions of ascites and their survival period. RESULTS: The short-term total effective rate of the treated group and the control group was 42.4% and 21.4%, the interval of aspirating ascites after treatment was 17.95 +/- 9.63 days and 10.87 +/- 7.76 days, and the 1-year survival rate 33.3% and 14.3%, respectively, significant difference was shown between the two groups in the three parameters (all P < 0.05 ). QOL was improved in both groups with insignificant difference (P > 0.05). Besides, the main symptoms were improved in patients of both groups, especially in the ameliorating of fatigue, abdominal distension, nausea and vomiting. Evaluation on safety of treatment showed that XSD had no obvious toxic and adverse reaction, and so it was safe in use. Experimental study showed that on the two mice models of ascites induced by inoculating two kinds of tumor cell, the effect of XSD was superior to that of the control group in aspects of reducing ascites and prolonging survival period, showing significant difference (P < 0.05). CONCLUSION: Satisfactory short-term efficacy in treating primary liver cancer with ascites of the Pi-deficiency with damp harassment syndrome could be obtained by XSD. Its effect in prolonging survival period was confirmed by experimental study. XSD can also improve the symptoms and QOL of patients, therefore, it is an effective and reliable remedy for treatment of primary liver cancer with ascites.