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Article(id=1322927198675546578, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926985957221241, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.11.039, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793340022962, onlineDateStr=2026-10-30, pubDate=1762704000000, pubDateStr=2025-11-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793340022962, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793340022962, creator=13701087609, updateTime=1793340022962, updator=13701087609, issue=Issue{id=1322926985957221241, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='11', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1762704000000', pubDateStr='2025-11-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339972247, creator='13701087609', updateTime=1793340743335, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322930220201804556, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926985957221241, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322930220201804557, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926985957221241, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=195, endPage=199, ext={EN=ArticleExt(id=1322927199459881427, articleId=1322927198675546578, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effect of Modified Xiayuxue Decoction（下瘀血汤加减）Assisted with TACE on Serum Levels of MMP-1 and MMP-9 and Liver Function in Patients with Primary Liver Cancer, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To observe the effects of Modified Xiayuxue Decoction（下瘀血汤加减）assisted with percutaneous hepatic arterial chemoembolization（TACE）on levels of serum matrix metalloproteinase 1（MMP-1）and matrix metalloproteinase9（MMP-9）and liver function in patients with primary liver cancer.

Methods

This study selected 74 primary hepatocellular carcinoma patients who were treated in the oncology department from January 2019 to December 2022. All patients were diagnosed with liver heat and blood stasis syndrome. They were randomly divided into a control group（37 patients completed the study）and an observation group（37 patients completed the study）using simple randomization. All 74 patients received TACE treatment. The control group was given Compound Glycyrrhizin Tablets after surgery，while the observation group was given Modified Xiayuxue Decoction after surgery，continuously administered for 12 weeks. The therapeutic effects，overall Karnofsky performance status and safety of the two groups were statistically analyzed. The levels of MMP-1，MMP-9，alpha fetoprotein（AFP），AFP-L3，tumor tissue infiltration，liver function，serum albumin（ALB）and T lymphocyte subgroups were detected to evaluate the traditional Chinese medicine syndrome scores of the two groups.

Results

The effective rate of the observation group was 64.86%（24/37），which was higher than that（40.54%，15/37）of the control group with statistical difference（P<0.05）. There was no statistical difference（P>0.05）in MMP-1，MMP-9，AFP，liver function，AFP-L3 or ALB between the two groups before treatment. After 12 weeks of treatment，the levels of MMP-1，MMP-9，liver function，AFP and AFP-L3 were lower than those before treatment and ALB was higher than that before treatment in both groups（P<0.05）. The levels of MMP-1，MMP-9，AFP and AFP-L3 were lower and ALB was higher in the observation group than those in the control group after 12 weeks of treatment（P<0.05）. There was no statistical difference（P>0.05）in tumor tissue infiltration between the two groups before treatment. After 12 weeks of treatment，the values of blood volume（BV）and blood flow（BF）were lower than those before treatment and mean transit time（MTT）was higher than that before treatment in both groups（P<0.05）. The tumor tissue infiltration in the observation group was compared with that in the control group after 12 weeks of treatment，with no statistical difference（P>0.05）. There was no statistical difference（P>0.05）in T lymphocyte subgroups between the two groups before treatment. After 12 weeks of treatment in the observation group，the levels of CD3＋，CD4＋and CD4＋/CD8＋were higher than those before treatment and CD8＋was lower than that before treatment（P<0.05）. There was no statistical difference（P>0.05）in T lymphocyte subgroups before and after treatment in the control group. The levels of CD3＋，CD4＋and CD4＋/CD8＋were higher and CD8＋was lower in the observation group than those in the control group after 12 weeks of treatment（P<0.05）. The overall Karnofsky score was higher in the observation group than that in the control group，and the total incidence of adverse reactions was not statistically different（P>0.05）when compared with those in the control group. There was no statistical difference（P>0.05）in the scores of 3 main symptoms and 7 collateral symptoms between the two groups before treatment. The scores of 3 main symptoms and 7 collateral symptoms were lower after 12 weeks of treatment than those before treatment in both groups（P<0.05）. The scores of 3 main symptoms and 7 collateral symptoms after 12 weeks of treatment were lower in the observation group than those in the control group（P<0.05）.

Conclusion

In the treatment of liver blood stasis syndrome with TACE，Modified Xiayuxue Decoction can improve liver function，do not affect blood perfusion of tumor tissue，inhibit the levels of MMP-1，MMP-9，AFPand AFP-L3，and alleviate symptoms.

, authors=Chuang CHEN, Xiaoli HOU, Changzheng ZHANG, Zhenchang LIU, Xiugai WANG, authorsList=Chuang CHEN, Xiaoli HOU, Changzheng ZHANG, Zhenchang LIU, Xiugai WANG, authorCompany=null, correspAuthors=Xiugai WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322927202467197400, articleId=1322927198675546578, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=下瘀血汤加减辅助经皮肝动脉化疗栓塞术治疗原发性肝癌肝热血瘀证疗效及对血清MMP-1及MMP-9水平和肝功能的影响, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

观察下瘀血汤加减辅助经皮肝动脉化疗栓塞术（transcatheter arterial chemoembolization，TACE）治疗原发性肝癌肝热血瘀证对患者血清基质金属蛋白酶1（matrix metalloproteinase 1，MMP-1）及基质金属蛋白酶9（matrix metalloproteinase 9，MMP-9）水平和肝功能的影响。

方法

本研究选取原发性肝癌患者74例，中医辨证均为肝热血瘀证，采用简单随机法分为对照组和观察组，每组37例。74例患者均给予TACE治疗，对照组术后给予复方甘草酸苷治疗，观察组术后给予下瘀血汤加减治疗，连续给药12周。统计两组疗效、整体Karnofsky评分及安全性。检测两组MMP-1、MMP-9、甲胎蛋白（alpha fetoprotein，AFP）、甲胎蛋白异质体（alpha fetoprotein L3，AFP-L3）、肿瘤组织灌、肝功能、血清白蛋白（albumin，ALB）、T淋巴亚群水平，评估两组中医证候积分。

结果

观察组有效率为64.86%（24/37）高于对照组的40.54%（15/37），差异有统计学意义（P<0.05）。两组治疗前MMP-1、MMP-9、AFP、肝功能、AFP-L3、ALB比较，差异无统计学意义（P>0.05）。两组治疗12周后MMP-1、MMP-9、肝功能、AFP、AFP-L3低于治疗前，ALB高于治疗前（P<0.05）；观察组治疗12周后MMP-1、MMP-9、AFP、AFP-L3低于对照组，ALB高于对照组（P<0.05）。两组治疗前肿瘤组织灌注比较，差异无统计学意义（P>0.05）。两组治疗12周后血容量（blood volume，BV）、血流量（blood flow，BF）低于治疗前，对比剂平均通过时间（mean transit time，MTT）高于治疗前（P<0.05）；观察组治疗12周后肿瘤组织灌与对照组比较，差异无统计学意义（P>0.05）。两组治疗前T淋巴亚群比较，差异无统计学意义（P>0.05）。观察组治疗12周后CD3＋、CD4＋、CD4＋/CD8＋高于治疗前，CD8＋低于治疗前（P<0.05）。对照组治疗前后T淋巴亚群比较，差异无统计学意义（P>0.05）；观察组治疗12周后CD3＋、CD4＋、CD4＋/CD8＋高于对照组，CD8＋低于对照组（P<0.05）。观察组整体Karnofsky评分高于对照组，总不良反应发生率与对照组比较，差异无统计学意义（P>0.05）。两组治疗前3项主症和7项兼症评分比较，差异无统计学意义（P>0.05）。两组治疗12周后3项主症和7项兼症评分均低于治疗前（P<0.05）；观察组治疗12周后3项主症和7项兼症评分低于对照组（P<0.05）。

结论

下瘀血汤加减辅助TACE治疗原发性肝癌肝热血瘀证可改善肝功能，不影响肿瘤组织血流灌注，抑制MMP-1、MMP-9、AFP、AFP-L3的水平，减轻症状。

, authors=陈创, 侯晓利, 张长征, 刘振昌, 王秀改, authorsList=陈创, 侯晓利, 张长征, 刘振昌, 王秀改, authorCompany=null, correspAuthors=王秀改, authorNote=

陈创（1981-），男，安徽阜阳人，副主任中医师，学士，研究方向：中医肿瘤。

, correspAuthorsNote=
王秀改（1986-），女，安徽铜陵人，副主任中医师，硕士，研究方向：中医肿瘤。E-mail：。
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陈创（1981-），男，安徽阜阳人，副主任中医师，学士，研究方向：中医肿瘤。

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陈创（1981-），男，安徽阜阳人，副主任中医师，学士，研究方向：中医肿瘤。

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Genetically engineered hepatitis C virus-like particles（HCV-LPs）tagged with SP94 peptide to acquire selectivity to liver cancer cells via Grp78［J］. Curr Issues Mol Biol，2022，44（8）：3746-3756., articleTitle=Genetically engineered hepatitis C virus-like particles（HCV-LPs）tagged with SP94 peptide to acquire selectivity to liver cancer cells via Grp78, refAbstract=null), Reference(id=1322927223551963689, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, doi=null, pmid=null, pmcid=null, year=2020, volume=235, issue=12, pageStart=9071, pageEnd=9079, url=null, language=null, rfNumber=［23］, rfOrder=22, authorNames=GHAFOURI-FARD S, ESMAEILI M, TAHERI M, journalName=JCell Physiol, refType=null, unstructuredReference=GHAFOURI-FARD S，ESMAEILI M，TAHERI M，et al. Highly upregulated in liver cancer（HULC）：an update on its role in carcinogenesis［J］. 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Acta Radiol，2021，62（3）：302-312., articleTitle=Imaging of colorectal cancer liver metastases using contrast-enhanced US，multidetector CT，MRI，and FDG PET/CT：a meta-analysis, refAbstract=null), Reference(id=1322927223757484587, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, doi=null, pmid=null, pmcid=null, year=2022, volume=29, issue=1, pageStart=209, pageEnd=220, url=null, language=null, rfNumber=［25］, rfOrder=24, authorNames=VOIZARD N, NI T, KISSA, journalName=Curr Oncol, refType=null, unstructuredReference=VOIZARD N，NI T，KISSA，et al. Small particle DEBIRI TACE as salvage therapy in patients with liver dominant colorectal cancer metastasis：retrospective analysis of safety and outcomes［J］. Curr Oncol，2022，29（1）：209-220., articleTitle=Small particle DEBIRI TACE as salvage therapy in patients with liver dominant colorectal cancer metastasis：retrospective analysis of safety and outcomes, refAbstract=null), Reference(id=1322927223849759276, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, doi=null, pmid=null, pmcid=null, year=2023, volume=39, issue=4, pageStart=518, pageEnd=522, url=null, language=null, rfNumber=［26］, rfOrder=25, authorNames=刘莲, 孟宪群, 包璇, journalName=中国临床药理学杂志, refType=null, unstructuredReference=刘莲，孟宪群，包璇，等. 白芍多糖对小鼠急性肝损伤的保护与机制研究［J］. 中国临床药理学杂志，2023，39（4）：518-522., articleTitle=白芍多糖对小鼠急性肝损伤的保护与机制研究, refAbstract=null)], funds=[Fund(id=1322927219206664722, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, awardId=RZ2100001085, language=CN, fundingSource=安徽省自然科学基金项目(RZ2100001085), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322927202844684761, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, xref=null, ext=[AuthorCompanyExt(id=1322927202853073370, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, companyId=1322927202844684761, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Taihe Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Traditional Chinese Medicine，Fuyang 236600，Anhui，China), AuthorCompanyExt(id=1322927202861461979, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, companyId=1322927202844684761, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=安徽中医药大学附属太和中医院，安徽 阜阳 236600)])], figs=[ArticleFig(id=1322927212680327682, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数CRPRSDPD总有效
对照组372（5.41）13（35.14）13（35.14）9（24.32）15（40.54）
观察组376（16.22）18（48.65）11（29.73）2（5.41）24（64.86）Δ
), ArticleFig(id=1322927212873265667, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=CN, label=表1, caption=

两组原发性肝癌肝热血瘀证患者实体瘤疗效比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数CRPRSDPD总有效
对照组372（5.41）13（35.14）13（35.14）9（24.32）15（40.54）
观察组376（16.22）18（48.65）11（29.73）2（5.41）24（64.86）Δ
), ArticleFig(id=1322927212961346052, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间MMP-1MMP-9AFPAFP-L3
对照组37治疗前324.56±69.82419.85±94.41628.85±54.4668.52±12.47
12周后269.83±61.42*267.14±61.33*123.15±31.56*17.98±5.14*
观察组37治疗前328.11±70.41424.53±91.15619.72±58.5367.53±11.22
12周后221.53±53.67*Δ210.02±52.28*Δ85.98±25.74*Δ10.26±3.24*Δ
), ArticleFig(id=1322927214970417669, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=CN, label=表2, caption=

两组原发性肝癌肝热血瘀证患者MMP-1、MMP-9、AFP、AFP-L3比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间MMP-1MMP-9AFPAFP-L3
对照组37治疗前324.56±69.82419.85±94.41628.85±54.4668.52±12.47
12周后269.83±61.42*267.14±61.33*123.15±31.56*17.98±5.14*
观察组37治疗前328.11±70.41424.53±91.15619.72±58.5367.53±11.22
12周后221.53±53.67*Δ210.02±52.28*Δ85.98±25.74*Δ10.26±3.24*Δ
), ArticleFig(id=1322927215394042374, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间BV/（min/100g）BF/［mL/（min·100g）］MTT/（s）
对照组37治疗前25.56±4.15236.56±41.155.52±1.24
12周后16.58±3.23*215.47±28.86*10.47±1.85*
观察组37治疗前24.63±4.74229.41±45.265.46±1.39
12周后16.41±2.94*211.12±23.36*10.45±1.96*
), ArticleFig(id=1322927215465345543, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=CN, label=表3, caption=

两组原发性肝癌肝热血瘀证患者肿瘤组织灌注比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间BV/（min/100g）BF/［mL/（min·100g）］MTT/（s）
对照组37治疗前25.56±4.15236.56±41.155.52±1.24
12周后16.58±3.23*215.47±28.86*10.47±1.85*
观察组37治疗前24.63±4.74229.41±45.265.46±1.39
12周后16.41±2.94*211.12±23.36*10.45±1.96*
), ArticleFig(id=1322927215549231624, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间ALT/（U/L）AST/（U/L）TBIL/（μmol/L）ALB/（g/L）
对照组37治疗前120.23±12.4172.26±8.9522.98±3.1732.98±4.15
12周后72.42±10.23*56.65±6.98*19.82±2.46*36.52±4.47*
观察组37治疗前117.98±13.4773.01±8.4123.05±3.3631.86±3.92
12周后57.14±8.72*Δ52.04±6.14*Δ17.23±2.31*Δ42.49±5.09*Δ
), ArticleFig(id=1322927215821861385, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=CN, label=表4, caption=

两组原发性肝癌肝热血瘀证患者肝功能、ALB比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间ALT/（U/L）AST/（U/L）TBIL/（μmol/L）ALB/（g/L）
对照组37治疗前120.23±12.4172.26±8.9522.98±3.1732.98±4.15
12周后72.42±10.23*56.65±6.98*19.82±2.46*36.52±4.47*
观察组37治疗前117.98±13.4773.01±8.4123.05±3.3631.86±3.92
12周后57.14±8.72*Δ52.04±6.14*Δ17.23±2.31*Δ42.49±5.09*Δ
), ArticleFig(id=1322927215901553162, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间CD3+/（%）CD4+/（%）CD8+/（%）CD4+/CD8+
对照组37治疗前47.41±5.2334.12±4.2335.26±4.120.97±0.23
12周后46.95±5.7433.63±4.5634.84±3.960.98±0.22
观察组37治疗前48.12±6.0234.08±4.1935.17±4.520.96±0.26
12周后56.53±6.78*Δ40.63±5.17*Δ31.11±3.69*Δ1.30±0.29
), ArticleFig(id=1322927215977050635, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=CN, label=表5, caption=

两组原发性肝癌肝热血瘀证患者T淋巴亚群比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间CD3+/（%）CD4+/（%）CD8+/（%）CD4+/CD8+
对照组37治疗前47.41±5.2334.12±4.2335.26±4.120.97±0.23
12周后46.95±5.7433.63±4.5634.84±3.960.98±0.22
观察组37治疗前48.12±6.0234.08±4.1935.17±4.520.96±0.26
12周后56.53±6.78*Δ40.63±5.17*Δ31.11±3.69*Δ1.30±0.29
), ArticleFig(id=1322927216039965196, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数升高稳定降低
对照组3713（35.14）16（43.24）8（21.62）
观察组3720（54.05）15（40.54）2（5.41）Δ
), ArticleFig(id=1322927216312594957, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=CN, label=表6, caption=

两组原发性肝癌肝热血瘀证患者Karnofsky评分比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数升高稳定降低
对照组3713（35.14）16（43.24）8（21.62）
观察组3720（54.05）15（40.54）2（5.41）Δ
), ArticleFig(id=1322927216375509518, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间上腹肿块胸胁疼痛腹胀恶心烦热面色晦黯口干喜饮神疲乏力纳呆食少溺黄赤大便干结
对照组37治疗前4.52±1.024.21±0.964.63±0.742.32±0.522.36±0.462.14±0.422.32±0.381.96±0.252.17±0.252.25±0.34
12周后2.09±0.71*2.23±0.61*2.33±0.67*1.24±0.29*1.15±0.30*1.06±0.25*1.11±0.26*0.97±0.21*1.07±0.24*1.12±0.25*
观察组37治疗前4.47±1.164.17±1.024.58±0.812.31±0.482.31±0.522.11±0.462.29±0.412.01±0.282.21±0.292.19±0.36
12周后1.53±0.62*Δ1.67±0.52*Δ1.74±0.52*Δ0.81±0.21*Δ0.76±0.25*Δ0.74±0.22*Δ0.77±0.21*Δ0.68±0.18*Δ0.73±0.23*Δ0.82±0.22*Δ
), ArticleFig(id=1322927216664916495, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=CN, label=表7, caption=

两组原发性肝癌肝热血瘀证患者中医证候积分比较

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组别例数时间上腹肿块胸胁疼痛腹胀恶心烦热面色晦黯口干喜饮神疲乏力纳呆食少溺黄赤大便干结
对照组37治疗前4.52±1.024.21±0.964.63±0.742.32±0.522.36±0.462.14±0.422.32±0.381.96±0.252.17±0.252.25±0.34
12周后2.09±0.71*2.23±0.61*2.33±0.67*1.24±0.29*1.15±0.30*1.06±0.25*1.11±0.26*0.97±0.21*1.07±0.24*1.12±0.25*
观察组37治疗前4.47±1.164.17±1.024.58±0.812.31±0.482.31±0.522.11±0.462.29±0.412.01±0.282.21±0.292.19±0.36
12周后1.53±0.62*Δ1.67±0.52*Δ1.74±0.52*Δ0.81±0.21*Δ0.76±0.25*Δ0.74±0.22*Δ0.77±0.21*Δ0.68±0.18*Δ0.73±0.23*Δ0.82±0.22*Δ
), ArticleFig(id=1322927217096929808, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数低血钾症腹泻头晕血压升高总不良反应
对照组371（2.70）1（2.70）2（5.41）1（2.70）5（13.51）
观察组370（0.00）2（5.41）1（2.70）0（0.00）3（8.11）
), ArticleFig(id=1322927217499582993, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927198675546578, language=CN, label=表8, caption=

两组原发性肝癌肝热血瘀证患者安全性

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组别例数低血钾症腹泻头晕血压升高总不良反应
对照组371（2.70）1（2.70）2（5.41）1（2.70）5（13.51）
观察组370（0.00）2（5.41）1（2.70）0（0.00）3（8.11）
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下瘀血汤加减辅助经皮肝动脉化疗栓塞术治疗原发性肝癌肝热血瘀证疗效及对血清MMP-1及MMP-9水平和肝功能的影响
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陈创 , 侯晓利 , 张长征 , 刘振昌 , 王秀改
中华中医药学刊 | 省级项目平台 2025,43(11): 195-199
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中华中医药学刊 |省级项目平台 2025 , 43 (11) : 195 -199
下瘀血汤加减辅助经皮肝动脉化疗栓塞术治疗原发性肝癌肝热血瘀证疗效及对血清MMP-1及MMP-9水平和肝功能的影响
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陈创, 侯晓利, 张长征, 刘振昌, 王秀改
作者信息
  • 安徽中医药大学附属太和中医院，安徽 阜阳 236600
通讯作者:
王秀改（1986-），女，安徽铜陵人，副主任中医师，硕士，研究方向：中医肿瘤。E-mail：。
作者简介:

陈创（1981-），男，安徽阜阳人，副主任中医师，学士，研究方向：中医肿瘤。

Effect of Modified Xiayuxue Decoction（下瘀血汤加减）Assisted with TACE on Serum Levels of MMP-1 and MMP-9 and Liver Function in Patients with Primary Liver Cancer
Chuang CHEN, Xiaoli HOU, Changzheng ZHANG, Zhenchang LIU, Xiugai WANG
Affiliations
  • Taihe Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Traditional Chinese Medicine，Fuyang 236600，Anhui，China
出版时间: 2025-11-10 doi: 10.13193/j.issn.1673-7717.2025.11.039
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摘要
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目的

观察下瘀血汤加减辅助经皮肝动脉化疗栓塞术（transcatheter arterial chemoembolization，TACE）治疗原发性肝癌肝热血瘀证对患者血清基质金属蛋白酶1（matrix metalloproteinase 1，MMP-1）及基质金属蛋白酶9（matrix metalloproteinase 9，MMP-9）水平和肝功能的影响。

方法

本研究选取原发性肝癌患者74例，中医辨证均为肝热血瘀证，采用简单随机法分为对照组和观察组，每组37例。74例患者均给予TACE治疗，对照组术后给予复方甘草酸苷治疗，观察组术后给予下瘀血汤加减治疗，连续给药12周。统计两组疗效、整体Karnofsky评分及安全性。检测两组MMP-1、MMP-9、甲胎蛋白（alpha fetoprotein，AFP）、甲胎蛋白异质体（alpha fetoprotein L3，AFP-L3）、肿瘤组织灌、肝功能、血清白蛋白（albumin，ALB）、T淋巴亚群水平，评估两组中医证候积分。

结果

观察组有效率为64.86%（24/37）高于对照组的40.54%（15/37），差异有统计学意义（P<0.05）。两组治疗前MMP-1、MMP-9、AFP、肝功能、AFP-L3、ALB比较，差异无统计学意义（P>0.05）。两组治疗12周后MMP-1、MMP-9、肝功能、AFP、AFP-L3低于治疗前，ALB高于治疗前（P<0.05）；观察组治疗12周后MMP-1、MMP-9、AFP、AFP-L3低于对照组，ALB高于对照组（P<0.05）。两组治疗前肿瘤组织灌注比较，差异无统计学意义（P>0.05）。两组治疗12周后血容量（blood volume，BV）、血流量（blood flow，BF）低于治疗前，对比剂平均通过时间（mean transit time，MTT）高于治疗前（P<0.05）；观察组治疗12周后肿瘤组织灌与对照组比较，差异无统计学意义（P>0.05）。两组治疗前T淋巴亚群比较，差异无统计学意义（P>0.05）。观察组治疗12周后CD3＋、CD4＋、CD4＋/CD8＋高于治疗前，CD8＋低于治疗前（P<0.05）。对照组治疗前后T淋巴亚群比较，差异无统计学意义（P>0.05）；观察组治疗12周后CD3＋、CD4＋、CD4＋/CD8＋高于对照组，CD8＋低于对照组（P<0.05）。观察组整体Karnofsky评分高于对照组，总不良反应发生率与对照组比较，差异无统计学意义（P>0.05）。两组治疗前3项主症和7项兼症评分比较，差异无统计学意义（P>0.05）。两组治疗12周后3项主症和7项兼症评分均低于治疗前（P<0.05）；观察组治疗12周后3项主症和7项兼症评分低于对照组（P<0.05）。

结论

下瘀血汤加减辅助TACE治疗原发性肝癌肝热血瘀证可改善肝功能，不影响肿瘤组织血流灌注，抑制MMP-1、MMP-9、AFP、AFP-L3的水平，减轻症状。

下瘀血汤  /  经皮肝动脉化疗栓塞术  /  肿瘤组织血流灌注  /  原发性肝癌  /  肝热血瘀证  /  肝功能
Objective

To observe the effects of Modified Xiayuxue Decoction（下瘀血汤加减）assisted with percutaneous hepatic arterial chemoembolization（TACE）on levels of serum matrix metalloproteinase 1（MMP-1）and matrix metalloproteinase9（MMP-9）and liver function in patients with primary liver cancer.

Methods

This study selected 74 primary hepatocellular carcinoma patients who were treated in the oncology department from January 2019 to December 2022. All patients were diagnosed with liver heat and blood stasis syndrome. They were randomly divided into a control group（37 patients completed the study）and an observation group（37 patients completed the study）using simple randomization. All 74 patients received TACE treatment. The control group was given Compound Glycyrrhizin Tablets after surgery，while the observation group was given Modified Xiayuxue Decoction after surgery，continuously administered for 12 weeks. The therapeutic effects，overall Karnofsky performance status and safety of the two groups were statistically analyzed. The levels of MMP-1，MMP-9，alpha fetoprotein（AFP），AFP-L3，tumor tissue infiltration，liver function，serum albumin（ALB）and T lymphocyte subgroups were detected to evaluate the traditional Chinese medicine syndrome scores of the two groups.

Results

The effective rate of the observation group was 64.86%（24/37），which was higher than that（40.54%，15/37）of the control group with statistical difference（P<0.05）. There was no statistical difference（P>0.05）in MMP-1，MMP-9，AFP，liver function，AFP-L3 or ALB between the two groups before treatment. After 12 weeks of treatment，the levels of MMP-1，MMP-9，liver function，AFP and AFP-L3 were lower than those before treatment and ALB was higher than that before treatment in both groups（P<0.05）. The levels of MMP-1，MMP-9，AFP and AFP-L3 were lower and ALB was higher in the observation group than those in the control group after 12 weeks of treatment（P<0.05）. There was no statistical difference（P>0.05）in tumor tissue infiltration between the two groups before treatment. After 12 weeks of treatment，the values of blood volume（BV）and blood flow（BF）were lower than those before treatment and mean transit time（MTT）was higher than that before treatment in both groups（P<0.05）. The tumor tissue infiltration in the observation group was compared with that in the control group after 12 weeks of treatment，with no statistical difference（P>0.05）. There was no statistical difference（P>0.05）in T lymphocyte subgroups between the two groups before treatment. After 12 weeks of treatment in the observation group，the levels of CD3＋，CD4＋and CD4＋/CD8＋were higher than those before treatment and CD8＋was lower than that before treatment（P<0.05）. There was no statistical difference（P>0.05）in T lymphocyte subgroups before and after treatment in the control group. The levels of CD3＋，CD4＋and CD4＋/CD8＋were higher and CD8＋was lower in the observation group than those in the control group after 12 weeks of treatment（P<0.05）. The overall Karnofsky score was higher in the observation group than that in the control group，and the total incidence of adverse reactions was not statistically different（P>0.05）when compared with those in the control group. There was no statistical difference（P>0.05）in the scores of 3 main symptoms and 7 collateral symptoms between the two groups before treatment. The scores of 3 main symptoms and 7 collateral symptoms were lower after 12 weeks of treatment than those before treatment in both groups（P<0.05）. The scores of 3 main symptoms and 7 collateral symptoms after 12 weeks of treatment were lower in the observation group than those in the control group（P<0.05）.

Conclusion

In the treatment of liver blood stasis syndrome with TACE，Modified Xiayuxue Decoction can improve liver function，do not affect blood perfusion of tumor tissue，inhibit the levels of MMP-1，MMP-9，AFPand AFP-L3，and alleviate symptoms.

Xiayuxue Decoction（下瘀血汤）  /  percutaneous hepatic arterial chemoembolization  /  tumor tissue blood perfusion  /  primary liver cancer  /  liver blood stasis syndrome  /  liver function
陈创, 侯晓利, 张长征, 刘振昌, 王秀改. 下瘀血汤加减辅助经皮肝动脉化疗栓塞术治疗原发性肝癌肝热血瘀证疗效及对血清MMP-1及MMP-9水平和肝功能的影响. 中华中医药学刊, 2025 , 43 (11) : 195 -199 . DOI: 10.13193/j.issn.1673-7717.2025.11.039
Chuang CHEN, Xiaoli HOU, Changzheng ZHANG, Zhenchang LIU, Xiugai WANG. Effect of Modified Xiayuxue Decoction（下瘀血汤加减）Assisted with TACE on Serum Levels of MMP-1 and MMP-9 and Liver Function in Patients with Primary Liver Cancer[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (11) : 195 -199 . DOI: 10.13193/j.issn.1673-7717.2025.11.039
正文
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原发性肝癌具有复发率、病死率高、治疗难度大等特点。由于肝脏血供丰富、病情进展快，在出现明显症状时就诊已至中晚期，错过最佳的手术时机[1]。基质金属蛋白酶1（matrix metalloproteinase 1，MMP-1）及基质金属蛋白酶9（matrix metalloproteinase 9，MMP-9）具有降解细胞外基质、基底膜的作用，有利于肿瘤细胞侵袭细胞外基质而致转移或复发[2]。经动脉化疗栓塞术（transcatheter arterial chemoembolization，TACE）是指南推荐的原发性肝癌非手术治疗方法，多数患者可从中获益，但部分患者治疗后病情仍会继续进展[3]。
肝癌属于中医古籍中“肝积”“肝瘿”等范畴，起病初期湿热化火、肝气郁结导致气血不和，壅滞不通，日久转为肝积。因此对肝热血瘀型肝癌治疗时应兼顾清热疏肝、活血祛瘀[4]。下瘀血汤出自《金匮要略》卷下，原用作治疗产妇瘀阻腹痛。近年来其加减方在肝热血瘀型肝癌中亦有所应用[5]。本研究观察下瘀血汤加减辅助TACE治疗肝热血瘀型肝癌的疗效以及对患者血清MMP-1、MMP-9水平和肝功能的影响。
1　资料与方法
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1.1　诊断标准
西医参考《原发性肝癌诊疗规范（2019版）》[6]标准：①既往有肝硬化，或存在乙型或丙型肝炎病毒感染；②多参数MRI、动态增强CT、超声造影等有典型的“快进快出”的肝癌典型特征；③甲胎蛋白（alpha fetoprotein，AFP）升高，同时排除由于妊娠、肿瘤肝转移等原因引起的AFP升高；④肝穿刺活检阳性。
中医辨证参考《中药新药临床研究指导原则（试行）》[7]中肝热血瘀证标准：主症：①上腹肿块，质硬；②胸胁疼痛拒按；③腹胀恶心。兼症：①烦热；②面色晦黯；③口干喜饮；④神疲乏力；⑤纳呆食少；⑥溺黄或短赤；⑦大便干结。舌脉：①舌质红，苔白厚；②脉弦或弦滑有力。主症中①～③伴有至少1项，或兼症中①～⑦伴有1～2项，同时结合舌脉可诊断。
1.2　纳入排除
1.2.1　纳入标准
①符合西医标准，辨证大属于肝热血瘀证；②Chilld-Pugh为A级或B级；③有TACE适应证的Ⅱ、Ⅲ期患者，并自愿接受TACE治疗；④Karnofsky评分≥60分；⑤年龄18周岁以上，85周岁以下；⑥意识清楚，有自主决策能力，签署加入研究同意书。
1.2.2　排除标准
①无法口服中药或对研究药物过敏；②肝癌病灶见全身性转移；③其他重要脏器的损害、疾病；④肝肾功能障碍或既往有消化道疾病影响药物吸收；⑤专业人员评估给予生存期不足半年；⑥继发性肝癌；⑦其他影响疗效评估的系统疾病。
1.3　样本量计算
采用随机抽样的方式选取2019年1月—2022年12月符合纳入条件中医辨证分型为“肝热血瘀证”的原发性肝癌患者，依据样本量计算公式为N＝Z＾2×（P×（1-P））/E＾2［z为置信度（取1.96），E为误差值（取0.003），P为概率值（取0.5）］，进行测算得每组样本量37例。
1.4　一般资料
将符合纳入条件的74例原发性肝癌患者采用简单随机法分为两组，每组37例，所有患者均完成研究。对照组男33例，女4例；年龄44～81岁，平均（62.38±5.47）岁；其中29例乙肝阳性；Chilld-Pugh分级：A级15例，B级22例；肝癌分期Ⅱ期13例，Ⅲ期24例；瘤体大小（11.42±3.94）cm2。观察组男34例，女3例；年龄45～78岁，平均（63.01±5.22）岁；其中31例乙肝阳性；Chilld-Pugh分级：A级12例，B级25例；肝癌分期Ⅱ期16例，Ⅲ期21例；瘤体大小（11.29±4.14）cm2。两组符合纳入条件两组一般资料，可进行试验比较（P>0.05）。本研究得到医院伦理委员会批准（批号：太中医201873）。
1.5　方法
两组患者均给予TACE治疗，采用Seldinger技术在右侧股动脉进行穿刺，置入导管超选择至肝脏，在肝脏固有动脉、左、右肝动脉行数字减影血管造影术，根据结果确定肿瘤灶位置、大小、数量以及瘤体的供血动脉。将顺铂、5-氟尿嘧啶、亚叶酸钙和阿霉素等化疗药物加碘化油混合制备栓塞剂，向肿瘤供血动脉行灌注化疗栓塞。
1.5.1　对照组
术后给予复方甘草酸苷（潍坊中狮制药有限公司）治疗，3粒/次，3粒/d，于三餐后0.5 h服用。
1.5.2　观察组
术后给予下瘀血汤加减治疗，下瘀血方：土鳖虫6 g，生大黄（后下）10 g，桃仁15 g，白花蛇舌草10 g，溪黄草10 g，柴胡10 g，八月札10 g，黄芩6 g，茵陈6 g，白芍6 g，栀子6 g，莪术6 g。伴脾虚者加党参、白术；肝肾阴虚者加女贞子、山茱萸；腑气不通者加厚朴、枳实；反酸者加瓦楞子、海螵蛸。上药1剂/d，水煎2次，取汁共300 mL，早晚各服用150 mL。连续给药12周。
1.6　观察指标
1.6.1　实体瘤疗效[8]
均在12周后动脉期评估肿瘤最大直径，①完全缓解（complete remission，CR）：可测靶病灶均消失；②部分缓解（patrial relief，PR）：可测靶病灶缩小>30%；③疾病进展（progressive disease，PD）：新可测病灶发生，或可测靶病灶增大≥20%；④稳定（stabilize disease，SD）：可测靶病灶增加<20%，或缩小≤30%。有效率＝CR率＋PR率。
1.6.2　检测方法
于治疗前、治疗12周后采集两组患者晨起空腹血标本约10 mL，离心处理，离心参数：3000 r/min、10 min。取血清采用MK3酶标仪（赛默飞世尔科技公司）检测MMP-1、MMP-9、AFP、甲胎蛋白异质体（alpha fetoprotein L3，AFPL3），ELISA法试剂盒厂家：上海江莱生物科技有限公司。采用7600型生化分析仪（日本日立公司）检测肝功能指标ALT、AST、TBIL、血清白蛋白（albumin，ALB）。采用CytoFLEX流式细胞仪（美国贝克曼-库尔特公司）检测CD3＋、CD4＋、CD8＋T淋巴亚群水平，计算CD4＋/CD8＋。于治疗前、治疗12周后。64排螺旋CT机（采用美国GE公司）检测两组肿瘤组织灌注指标血容量（blood volume，BV）、血流量（blood flow，BF）、对比剂平均通过时间（mean transit time，MTT）。经肘静脉通路注射非离子型碘造影剂，流速3.5 mL/s，剂量1 mL/kg。
1.6.3　Karnofsky评分[9]
采用百分制计分，分值越高健康状况越好。治疗12周后Karnofsky评分较基线增加10分及以上为升高，增加或降低均在10分内为稳定，降低10分及以上为降低。
1.6.4　中医证候积分
3项主症，分别为上腹肿块、胸胁疼痛、腹胀恶心，根据患者情况划分为无（0分）、轻（2分）、中（4分）、重（6分）。7项兼症，分别为烦热、面色晦黯、口干喜饮、神疲乏力、纳呆食少、溺黄赤、大便干结，根据患者情况划分为无（0分）、轻（1分）、中（2分）、重（3分）。
1.6.5　安全性
记录不良反应的情况。
1.7　统计学方法
将所有数据均放入Execl整理，并用SPSS 25.0处理，定量资料先采用Shapiro-Wilk法检验是否符合正态分布，是均以（）表示，用t检验比较，定性资料用n（%）描述，用秩和检验或χ2检验比较，P<0.05表示差异有统计学意义。
2　结果
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2.1　实体瘤疗效比较
观察组有效率为64.86%高于对照组的40.54%，差异有统计学意义（P<0.05）。见表1。
2.2　MMP-1、MMP-9、AFP、AFP-L3比较
两组治疗前MMP-1、MMP-9、AFP、AFP-L3比较，差异无统计学意义（P>0.05）。两组治疗12周后MMP-1、MMP-9、AFP、AFP-L3低于治疗前（P<0.05）；观察组治疗12周后MMP-1、MMP-9、AFP、AFP-L3低于对照组（P<0.05）。见表2。
2.3　肿瘤组织灌注比较
两组治疗前肿瘤组织灌注比较，差异无统计学意义（P>0.05）。两组治疗12周后BV、BF低于治疗前，MTT高于治疗前（P<0.05）；观察组治疗12周后肿瘤组织灌注与对照组比较，差异无统计学意义（P>0.05）。见表3。
2.4　肝功能、ALB比较
两组治疗前肝功能、ALB比较，差异无统计学意义（P>0.05）。两组治疗12周后ALT、AST、TBIL均低于治疗前，ALB高于治疗前（P<0.05）；观察组治疗12周后肝功能低于对照组，ALB高于对照组（P<0.05）。见表4。
2.5　T淋巴亚群比较
两组治疗前T淋巴亚群比较，差异无统计学意义（P>0.05）。观察组治疗12周后CD3＋、CD4＋、CD4＋/CD8＋高于治疗前，CD8＋低于治疗前（P<0.05）。对照组治疗前后T淋巴亚群比较，差异无统计学意义（P>0.05）；观察组治疗12周后CD3＋、CD4＋、CD4＋/CD8＋高于对照组，CD8＋低于对照组（P<0.05）。见表5。
2.6　Karnofsky评分比较
观察组整体Karnofsky评分高于对照组，差异有统计学意义（P<0.05）。见表6。
2.7　中医证候积分比较
两组治疗前3项主症和7项兼症评分比较，差异无统计学意义（P>0.05）。两组治疗12周后3项主症和7项兼症评分均低于治疗前（P<0.05）；观察组治疗12周后3项主症和7项兼症评分低于对照组（P<0.05）。见表7。
2.8　安全性比较
两组总不良反应发生率（对照组13.51%和观察组8.11%）比较，差异无统计学意义（P>0.05）。见表8。
3　讨论
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原发性肝癌被称为“癌中之王”，其发病率位居恶性肿瘤的第6位，病死率居于第3位，预计到2025年全球肝癌病例将达到100万例[10]。肝动脉是肝脏主要的供血血管，TACE可通过肝动脉插管注入化疗药物、栓塞剂，产生局部化疗作用，减轻化疗药物的全身不良反应，并能阻断癌灶的供血血管，使肿瘤细胞因缺乏营养供给而凋亡[11]。但肝脏血供丰富，TACE治疗后仍会出现肿瘤复发或转移，且化疗药物可对正常肝细胞产生一定的毒性，复方甘草酸苷胶囊可保护肝细胞膜，减轻肝脏局部炎性反应，减轻化疗药物对肝细胞的损伤，已成为TACE术后常用的护肝药物[12]。
中医学理论对肝积的形成认识较早，《医宗必读》认为：“积之成也，正气不足，而后邪气居之”[13]。TACE术属于攻法，其使用的栓塞剂、化疗药物属于“药毒”之范畴，可导致肝脾受损，加重肝失疏泄，脾失健运[14]。下瘀血方中土鳖虫破血消瘕、生大黄活血攻下、桃仁活血祛瘀，三药共为君药，善治癥瘕积聚。白花蛇舌草清热解毒、消瘕除癥；溪黄草清热祛湿、凉血散瘀；柴胡疏肝解郁、退热解表；八月札疏肝理气、活血祛瘀。四药共为臣药，可增强清热活血之功。佐以黄芩清热泻火、燥湿解毒；茵陈疏肝利胆、清热退黄；白芍养血敛阴、柔肝止痛；栀子清热凉血、泻火解毒；莪术破血逐瘀、行气消积。伴脾虚者加党参、白术以健运脾气；肝肾阴虚者加女贞子、山茱萸以滋补肝肾之阴；腑气不通者加厚朴、枳实以通腑泄热；反酸者加瓦楞子、海螵蛸以制酸止痛。诸药共奏清热疏肝、活血祛瘀之功效[15-16]。
本研究发现，观察组有效率更高；观察组整体Karnofsky评分高于对照组，总不良反应发生率与对照组相仿。两组治疗12周后中医证候积分中3项主症和7项兼症评分均低于治疗前；观察组治疗12周后3项主症和7项兼症评分低于对照组。上述结果提示，下瘀血汤加减辅助TACE治疗肝热血瘀型肝癌可更好地减轻症状，提高机体健康状况，具有更好的疗效，且不会增加不良反应。这是由于下瘀血汤中土鳖虫中的氨基酸成分具有保肝作用，药理实验证实其可减轻四氯化碳、D-半乳糖所致的肝损伤[17]。柴胡的皂苷类成分具有抗肿瘤、保肝、抗炎、镇痛、调节免疫等药理作用，并能缓解患者的抑郁情绪[18]。白花蛇舌草提取物具有抗肿瘤、抗炎、镇痛、抗氧化等药理作用[19]。溪黄草提取物可具有良好的抗病毒作用，抑制肝炎病毒复制而减轻肝损伤程度[20]。
MMP-1、MMP-9可降解细胞外基质、基底膜，有利于肿瘤细胞的转移或复发[21]。AFP、AFP-L3均是临床诊断肝癌的特异性标志物；AFP-L3还能准确反映肿瘤早期血管浸润、转移，在预测TACE术后复发风险方面具有一定的价值[22]。肝脏基础性疾病、TACE的副损伤均可导致患者的肝功能损害、ALB下降[23]。本研究发现，两组治疗12周后MMP-1、MMP-9、肝功能、AFP、AFP-L3低于治疗前，ALB高于治疗前；观察组治疗12周后MMP-1、MMP-9、AFP、AFP-L3低于对照组，ALB高于对照组。上述结果提示，下瘀血汤加减辅助TACE治疗肝热血瘀型肝癌可抑制MMP-1、MMP-9、AFP、AFP-L3的水平，保护肝功能，预防肿瘤复发或转移。
肿瘤组织灌注增加可提高复发、转移风险，直接影响TACE疗效[24]。本研究发现，两组治疗12周后BV、BF低于治疗前，MTT高于治疗前；对照组和观察组治疗12周后BV、BF、MTT无差异。这一结果提示，TACE术后患者的肿瘤组织灌注减少，下瘀血汤加减辅助TACE治疗原发性肝热血瘀型肝癌不影响肿瘤组织血流灌注。机体免疫功能是影响TACE患者预后的重要因素，免疫功能低下时可发生肿瘤逃逸而导致复发或转移[25]。本研究通过检测两组治疗前后T淋巴亚群变化发现，观察组治疗12周后CD3＋、CD4＋、CD4＋/CD8＋高于治疗前，CD8＋低于治疗前。对照组治疗前后T淋巴亚群相仿；观察组治疗12周后CD3＋、CD4＋、CD4＋/CD8＋高于对照组，CD8＋低于对照组。这一结果提示，下瘀血汤加减辅助TACE治疗原发性肝热血瘀型肝癌可调节机体免疫功能，提高机体自身抗肿瘤能力。这可能与下瘀血汤中白芍所含的白芍总苷具有调节免疫功能的作用有关[26]。
综上所述，下瘀血汤加减辅助TACE治疗原发性肝热血瘀型肝癌可改善肝功能，不影响肿瘤组织血流灌注，抑制MMP-1、MMP-9、AFP、AFP-L3的水平，减轻症状。
基金
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  • 安徽省自然科学基金项目(RZ2100001085)
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参考文献 引证文献
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2025年第43卷第11期
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doi: 10.13193/j.issn.1673-7717.2025.11.039
  • 首发时间：2026-10-30
  • 出版时间：2025-11-10
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安徽省自然科学基金项目(RZ2100001085)
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    安徽中医药大学附属太和中医院，安徽 阜阳 236600

通讯作者:

王秀改（1986-），女，安徽铜陵人，副主任中医师，硕士，研究方向：中医肿瘤。E-mail：。
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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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