有毒中药治疗原发性肝癌的文献研究与实验研究

【作者】 汤秀红；

【导师】 王锦鸿； 秦叔逵； 陈惠英；

【作者基本信息】 南京中医药大学 ， 中医学， 2001， 硕士

【摘要】 目的：深入探讨有毒中药（如砒霜）治疗原发性肝癌的历史渊源、理论基础、临床配伍应用及其作用机制。方法：采用文献调研和现代实验研究相结合的方法。（1）文献研究主要通过调研古今中医药文献，对原发性肝癌相关的古代病症名称进行考证，并概述原发性肝癌的病因病机，进而对有毒中药治疗原发性肝癌的理论基础，古今临床的配伍运用进行综合分析。（2）实验研究具体应用倒置显微镜观察法、r-谷氨酰转肽酶（GGT）和乳酸脱氢酶（LDH）的活力检测、MTT法、流式细胞光度术分析（FCM）和端粒酶活性检测等多种方法，观察三氧化二砷（As₂O₃）与顺铂（PDD）联合应用对人肝癌细胞QGY-7701和QGY-7703的生长活力、GGT和LDH的活力表达、细胞凋亡、细胞周期和端粒酶活性的影响。结果：（1）文献揭示原发性肝癌属古代的“痞气”、“伏梁”、“肥气”、“胁痛”和“黄疸”等范畴，有毒中药治疗肝癌的理论基础是“以毒攻毒”和“攻坚蚀疮”；在现代临床上有毒药与有毒药的配伍、与健脾理气药的配伍、与活血化瘀药的配伍、与清热解毒药的配伍，以及与几种功效的药物综合配伍的方法。文献表明，有毒中药治疗原发性肝癌的分子机制包括抑制杀伤、诱导凋亡和抑制端粒酶活性等作用。（2）实验研究表明As₂O₃上PDD联合应用能显著抑制人肝癌细胞QGY-7701和QGY-7703的生长繁殖；降低其GGT和LDH的活力表达；用药诱导后出现了典型的细胞凋亡形态学和生化学改变；并显著抑制肝癌细胞的端粒酶活性。结论：有毒中药治疗原发性肝癌具有坚实的中医理论基础，而且得到临床案例的验证和现代实验研究的支持。As₂O₃与化疗药PDD联合应用具有明显的协同抗肝癌作用，包括细胞毒作用、诱导凋亡作用和抑制端粒酶活性等作用的增强。更多还原

【Abstract】 Objective: To explore the historical origins of Traditional Chinese Medicine (TCM),its?rational,clinincal applying toxic TCM drugs with others drugs,modern experimental research status and the possible anti- hepatocarcinoma mechanisms. Methods: Both of the literature and experimental research were studied. (1) The literature study included summarizing the understanding of ancient disease name of 1CM ,pathogen,pathology mechanism of Primary Hepatocarcinoma (P1-IC) by consulting ancient and modern medical data of toxic drugs, and then systematically analyzing the toxic drugs TCM rationales, and its’ancient and modern clinical utilization. (2) The experimental study included detecting As,03 with cisplatin’s action on the cell growth, apoptosis, periodic return, GGT, LDH’s activity and telomerase activity of two human hepatocarcinoma cell lines, QGY-7701 and QGY-7703, by GGT and LDH’s activity assay,MTT assay ,Electronmicroscopy detection, Flow cytometry and telomerase activiy detection. Results: (1) From the literature study,it was discovered that PHC included ancient decease named “piqi”,“fuliang”,“jaundice”and “xietong”etc, the TCM retionales of toxic drugs anti-cancer effect were to treat the PHC with “poisonous agents”and “to resolve mass and swelling” The anti- hepatocarcinoma mechanisms of those toxic drugs involved the fragment action the induction of apoptosis and the inhibition the suppress of telomerase acitivity. (2) From experiment study,it was discovered that As203 togather with cisplatin could increase inhibiting the growth of human hepatocarcinoma cells lines,QGY-7701 and QGY-7703,decrease their activity of GGT, LDH, inducing the apoptosis of the cells and inhibiting the telomerase activity. Conlusion: It is showed that toxic drugs’anti-hepatocarcinoma effect can be greatly supported by suflicient rationals of TCM,clinical case and modern experimental research. As203 with cisplatin may increasing obviously anti- hepatocarcinoma effect, its mechanism includs the cellulotoxic, apoptosis and anti-telomerase effects.更多还原