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目的:探讨白虎汤对原发性肝癌TACE术后患者MMP-1、MMP-3、MMP-9蛋白的影响及其临床意义。方法:选择医院感染科2010年2月—2013年3月120例确诊为原发性肝癌并行TACE术后并发发热的患者作为研究对象,随机分为2组,每组60例。对照组予常规西医治疗,予消炎痛栓纳肛,50 mg/次,每日2次,并口服头孢克肟分散片,100 mg/次,每日2次,10 d为1疗程;观察组予中药汤剂白虎汤加减治疗,每日1剂,早晚分服,10 d为1个疗程。均于1个疗程后评价治疗效果及不良反应发生率,并对比两组治疗前后基质金属蛋白酶(MMP-1、MMP-3、MMP-9)变化情况;同时对两组患者进行随访,观察患者术后6个月、1年、2年、3年的复发率及生存率。结果:观察组的有效率为86.4%(51/59),明显高于对照组的有效率75.9%,并且治疗后观察组的MMP-1、MMP-3、MMP-9均显著下降(均P<0.01);而对照组的MMP-1、MMP-3、MMP-9亦有所下降,但仅MMP-9下降具有统计学意义(P<0.05)。治疗后两组MMP-1、MMP-3表达、MMP-9水平比较,观察组均低于对照组,(均P<0.05),而MMP-1、MMP-3表达水平差异更为显著(P<0.01);此外,治疗后观察组在半年、1年、2年内的肿块复发率均低于对照组(P<0.05),而生存率均高于对照组(P<0.05)。结论:白虎汤治疗原发性肝癌TACE术后并发发热较使用西药治疗疗效高,痊愈时间快,复发率低,安全性高,且对原发性肝癌TACE术后具有防复发作用,值得临床推广应用。
Objective: To investigate the effect of Baihu decoction on the expression of MMP-1, MMP-3 and MMP-9 in patients with primary hepatocellular carcinoma after TACE and its clinical significance. Methods: A total of 120 patients with concurrent primary hepatocellular carcinoma diagnosed with concurrent hepatocellular carcinoma (HCC) complicated with fever were selected as the study subjects from February 2010 to March 2013 in our hospital. Patients were randomly divided into two groups (60 in each group). The control group was treated with conventional western medicine, with indomethacin suppository, 50 mg twice daily, and cefixime orally dispersible tablets orally, 100 mg twice daily for 10 days. The observation group Decoction of traditional Chinese medicine Decoction White Tiger Decoction, daily 1, morning and evening service, 10 d for a course of treatment. The therapeutic effect and the incidence of adverse reactions were evaluated after 1 course of treatment. The changes of MMP-1, MMP-3 and MMP-9 in both groups were compared before and after treatment. At the same time, the two groups were followed up and the patients Postoperative 6 months, 1 year, 2 years, 3 years the recurrence rate and survival rate. Results: The effective rate of the observation group was 86.4% (51/59), significantly higher than that of the control group (75.9%), and the levels of MMP-1, MMP-3 and MMP-9 in the observation group were significantly decreased <0.01). The levels of MMP-1, MMP-3 and MMP-9 in the control group also decreased, but only the decrease of MMP-9 was statistically significant (P <0.05). After treatment, the expression of MMP-1, MMP-3 and MMP-9 in the two groups were significantly lower than those in the control group (all P <0.05), while the expressions of MMP-1 and MMP- <0.01). In addition, the recurrence rates of the tumors in the observation group after six months, one year and two years were lower than those in the control group (P <0.05), and the survival rates were higher than those in the control group (P <0.05). Conclusion: The treatment of primary hepatocellular carcinoma after TACE with Baihu Decoction has higher curative effect, faster recovery time, lower recurrence rate and higher safety than those with western medicine, and has the anti-relapse effect after TACE of primary liver cancer, which is worthy of clinical promotion application.