Clinical study of Peiyuan Kangai Decoction combined with acupuncture in the treatment of advanced liver cancer with qi deficiency and blood stasis syndrome / 国际中医中药杂志

ABSTRACT

Objective:To evaluate the efficacy of Peiyuan Kangai Decoction combined with acupuncture in the treatment of advanced liver cancer with qi deficiency and blood stasis syndrome.Methods:Randomized controlled trial. From May 2019 to May 2021, 162 advanced liver cancer patients with qi deficiency and blood stasis syndrome in Shizhong District Cancer Hospital of Leshan were randomly divided into three groups by random drawing method, with 54 in each group. All patients were given FOLFOX4 chemotherapy regimen. Based on the chemotherapy, the 1st control group was given Peiyuan Kangai Decoction, and the 2nd control group was given acupuncture therapy, and the combined group was given decoction and acupuncture therapy. All three groups were treated for 6 weeks. Traditional Chinese Medicine syndrome score was performed before and after treatment, Piper fatigue scale was used to evaluate the fatigue degree of patients. Vimentin (VIM), Golgi transmembrane glycoprotein 73 (GP73) and chemokine ligand 1 (CXCL1) were determined by ELISA. The adverse reactions during treatment were observed and the clinical efficacy was evaluated.Results:The combined group showed the response rate was 61.11% (33/54), the disease control rate was 72.22% (39/54), the 1st control group showed the response rate was 40.74% (22/54), the disease control rate was 53.70% (29/54), and the 2nd control group showed the response rate was 38.89% (21/54), and the disease control rate was 51.85% (28/54). The response rate and disease control rate of the combined group were significantly higher than either the control group 1 and 2 ( χ2 values were 6.59, 5.68, respectively, and P values were 0.037, 0.043, respectively). After treatment, the scores of liver swelling and pain, fatigue and shortness of breath, anorexia, sallow and emaciation in the combined group were significantly lower than those in the control group 1 and the control group 2 ( F values were 13.90, 15.69, 13.20, 10.55, respectively, P<0.01); the scores of emotions, feeling, behavior and cognition were significantly lower than those in the control group 1 and control group 2 ( F values were 49.55, 27.42, 19.69, 20.55, respectively, P<0.01). After treatment, the levels of serum VIM [(52.54±6.69) ng/L vs. (61.29±7.89) ng/L, (65.11±7.92) ng/L, F=39.63], GP73 [(19.72±3.90) ng/L vs. (24.42±4.23) ng/L, (25.12±4.76) ng/L, F=25.05], CXCL1 [(3.12±0.72) ng/L vs. (4.85±0.95) ng/L, (4.98±0.91) ng/L, F=77.67] in the combined group were significantly lower than those in the control group 1 and the control group 2 ( P<0.01). During the treatment, the incidence of toxic and side effects in the combined group was 18.52% (10/54), the control group 1 was 27.78% (15/54), and the control group 2 was 24.07% (13/54). There was no statistically significant difference in the incidence of toxic and side effects among the three groups ( χ2=1.31, P=0.520). Conclusion:On the basis of FOLFOX4 chemotherapy, combined therapy with Peiyuan Kangai Decoction and acupuncture treatment can improve the symptoms and fatigue of patients with advanced liver cancer, reduce the levels of serum VIM, GP-73, CXCL1, improve the efficacy safely.