OBJECTIVE  To observe the efficacy of Gegen Qinlian Decoction on embolization syndrome after transcatheter hepatic arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) patients with the syndrome of damp-heat and stasis-toxin.

  METHODS  From January 2019 to December 2021, a total of 100 HCC patients with the syndrome of damp-heat and stasis-toxin in Jiangsu Cancer Hospital were selected and randomly divided into 50 cases in the control group and 50 cases in the treatment group (with 3 cases dropped out). Both groups received TACE treatment, and the control group was treated with conventional western medicine after surgery, while the treatment group was given with Gegen Qinlian Decoction granules based on the treatment in the control group. The course of treatment in both groups was two weeks. The gradation and duration of the main symptoms of post-TACE embolism syndrome were recorded during the treatment period. In addition, the changes in the traditional Chinese medicine (TCM) syndrome score were assessed before and after the treatment. Besides, we measured the liver function indicators Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Total bilirubin (TB), Gamma-glutamyl transpeptidase (GGT), lipid metabolism related indexes Total cholesterol (TC), Triglyceride (TG), Low density lipoprotein cholesterol (LDL-C), High density lipoprotein cholesterol (HDL-C), as well as the expression levels of immune indexes (relative ratio of CD4⁺, CD8⁺, regulatory T cells and CD4⁺/CD8⁺), and also performed the morbidity factor correlation analysis.

  RESULTS  Within two weeks of treatment, patients in the treatment group had less severe fever, nausea, and vomiting than those in the control group (P < 0.05), and the duration of major symptoms was shorter than that in the control group (P < 0.05). After treatment, the TCM syndromes in both groups alleviated significantly (P < 0.01), but the treatment group had better improvement in fever, nausea, vomiting, poor appetite, and total score than the control group (P < 0.05, P < 0.01). Thus, the efficacy of TCM syndromes was better in the treatment group than in the control group (P < 0.05). On top of that, the liver function, lipid metabolism, and immune-related indexes showed better results in both groups than before treatment (P < 0.05, P < 0.01), while the results relevant to serum ALT, TB, TC, TG and LDL-C were better in the treatment group than in the control group (P < 0.05, P < 0.01). Moreover, the expression levels of peripheral blood CD4⁺, regulatory T cells, as well as CD4⁺/CD8⁺ in the treatment group were lower than those in the control group (P < 0.05, P < 0.01). It is worth noting that TG, LDL-C, TB, ALT levels, and regulatory T-cell ratio were risk factors for the development of major symptoms of III-Ⅳ embolic syndrome (P < 0.05, P < 0.01).

  CONCLUSION  Gegen Qinlian Decoction is effective in post-TACE embolization syndrome in HCC patients with the syndrome of damp-heat and stasis-toxin.