Prevention and treatment of primary liver cancer with Chinese MedicineEt alDepartment of oncology, Affiliated Hospital of Hunan Academy of t
Prevention and treatment of primary liver cancer with Chinese Medicine
Department of oncology, Affiliated Hospital of Hunan Academy of traditional Chinese medicine, Affiliated Hospital of traditional Chinese and Western medicine, Hunan University of Chinese Medicine, Hunan 410006, China
Primary liver cancer (primary of the liver, PLC) (hereinafter referred to as "liver cancer") refers to the primary liver cells or intrahepatic bile duct epithelial cells of cancer, one of the common malignant tumors in china. Hepatocellular carcinoma (HCC) is more than 90% of primary liver cancer (hepatocellular carcinoma) in China, and the number of intrahepatic cholangiocarcinoma, hepatocellular carcinoma and cholangiocarcinoma is less than 5%. Chinese medicine has long been similar to the records of liver cancer. Generally belongs to the category of "liver volume, fertilizer, gas mass, accumulation, bulging, or yellow, jaundice and other symptoms.
Primary liver cancer is a serious disease which is harmful to human life and health, and its incidence and mortality rate are increasing gradually. According to the statistics of the WHO in 2005 global cancer analysis shows that at present the new year suffering from liver cancer for the number 626000, the death of 598000 people, with 55% new cancer patients occurred in the diagnosis and treatment of liver cancer China, our situation is still very grim.
The early surgical treatment is the preferred method of transcatheter arterial chemoembolization and percutaneous ethanol injection therapy, cryotherapy, laser therapy, hyperthermia, radiotherapy, biological therapy and other methods also have a certain effect. However, the malignant degree of liver cancer is high, the development and change is rapid, the majority of patients have developed to the middle and late stages of treatment, the majority of patients with poor liver function and physical condition, it is difficult to tolerate the above treatment. Therefore, it is very important to control the development of the disease, improve the quality of life and prolong the survival period. In order to fully understand the current situation of traditional Chinese medicine in the prevention and treatment of liver cancer, to explore the application of these rules, the author conducted a survey of Chinese medicine since the founding of the main HCC clinical research literature and research literature, including TCM pathogenesis, etiology, symptoms, treatment, prescription, therapeutic evaluation and basic research. Now the analysis report.
1 basic methods
Document Information Center search, Internet search (www.cnki.com.cn search) and manual search
Combination of the three methods.
1.1 inclusion and exclusion criteria
1) inclusion criteria
(1) must be on primary liver cancer who;
(2) the number of samples was more than 30;
(3) experimental study of Chinese medicine on primary liver cancer.
2) exclusion criteria
(1) metastatic liver cancer;
(2) case report;
(3) prescription or a treatment without clinical summary of content introduction.
1.2 research methods and basic content
Design a "primary liver cancer TCM literature investigation table", according to table itemized record. 253 copies were screened in the clinical literature, records of total cases of liver cancer patients and 14566 cases of male and female ratio of 5:1, with an average age of 49.3 years. Which discusses the etiology and pathogenesis of 45 copies, 129 copies of records of syndromes (the syndrome differentiation and the number of cases of each type of literature in 20, the total number of cases in 1019 cases, distributed in 14 provinces and autonomous regions), this rule is 245 copies (some of which are from the syndrome, in the prescription summed up the rule), collected 234, 280 common drugs aftertaste.
A total of 30 studies on the prevention and treatment of liver cancer by traditional Chinese medicine (including a recent and comprehensive review of the total number of 8) were included. The efficacy of the study was evaluated in 3 copies.
1.3 statistical methods
Frequency, sorting and other statistical methods.
Two clinical studies
1 etiology and pathogenesis research
We collected 1.1 discusses the etiology and pathogenesis of literature in 45, will be the main cause for frequency analysis as shown in Table 1, the results show that the blood stasis, spleen and stomach, damp heat, toxic heat, deficiency of liver and kidney, stagnation of pathogenic factors most frequently discussed.
Table 1 the number and frequency of pathogenic factors of liver cancer (times,%)
Weakness of spleen and stomach
Hot and humid
Deficiency of liver and kidney
Sixty-eight point nine
Sixty-six point seven
Fifty-one point one
Forty-eight point nine
Forty-eight point nine
Forty-six point seven
Four point four
Two point two
Two point two
1.2 liver cancer pathogenesis is very complex, as a doctor
Pan  think: "stasis, poison, virtual" is the basic pathogenesis of liver cancer. Abdominal mass, pain in liver area is "objective stasis"; the development of liver cancer, disease fierce; hepatitis B and hepatitis C virus infection and aflatoxin contamination of drinking water is a major cause of liver cancer and the factors, which belongs to the Chinese medicine "toxic" category; liver cancer patients, abdominal distension, common, fatigue, weakness nausea, vomiting, diarrhea, and weight loss due to spleen deficiency syndrome; blood stasis and toxin, deficiency and three always coexist, reciprocal causation, vicious spiral, throughout the entire course of liver cancer. Zhou  thinks that "cancer is poison, blood stasis, Jian ji." This includes toxic heat, damp toxin, blood stasis and toxin, cold poison; blood stasis with stagnation of liver qi and blood stasis, blood stasis and stagnation of pathogenic heat, heat accumulation and blood stasis, qi stagnation and blood stasis is astringent and other; Kennedy by gas, blood, phlegm, fire, dampness, and toxin stagnation because of the food by. With abdominal distension mostly with jaundice mostly damp, heat, pain in liver area mostly with blood stasis and toxin. Wu  believes causcs to toxic heat dampness caused most advanced liver Qi block, spleen deficiency and dampness; late Haoshang Yin, yin deficiency of liver and kidney was formed; chemotherapy often damage the Yin fluid, so it is easy to heat common yin.
2 syndrome research
2.1 common syndromes frequency analysis as shown in Table 2, results show that the highest frequency of occurrence of qi stagnation and blood stasis, followed by heat poly drug syndrome, spleen deficiency and dampness stagnation syndrome, liver qi stagnation and liver kidney yin deficiency, again the accumulation of heat and toxic syndrome and two Qi and yin deficiency syndrome, phlegm syndrome and yang deficiency syndrome were condensed less.
Table 2 the number and frequency of common syndromes of liver cancer (times,%)
Qi stagnation and blood stasis
Moist heat accumulation
Spleen deficiency and Dampness Retention
Liver qi stagnation
Liver kidney yin deficiency
The accumulation of heat and toxic
Yang deficiency syndrome
One hundred and two
Seventy-nine point zero seven
Sixty-eight point two two
Sixty-three point five seven
Fifty-four point two six
Fifty-two point seven one
Twenty point nine three
Sixteen point two eight
Four point six five
Two point three three
Analysis of 2.2 common syndromes of population distribution statistics: 1019 patients were treated with statistical analysis of syndrome cases recorded in Table 3, results showed that: in the syndromes of the top five were: Qi stagnation and blood stasis, heat poly drug syndrome, spleen deficiency and dampness stagnation syndrome, liver qi stagnation and liver kidney yin deficiency five card type, consistent with the syndrome of spleen deficiency and frequency analysis results; the other actual cases in the first place, and then followed by liver stagnation and spleen deficiency, spleen deficiency, liver qi stagnation and blood stasis syndrome of spleen deficiency and Qi Yin deficiency syndrome, yin deficiency syndrome, two.
Table 31019 cases of primary liver cancer patients with syndrome type and its constituent ratio (cases,%)
Spleen deficiency syndrome
Qi stagnation and blood stasis
Moist heat accumulation
Spleen deficiency and Dampness Retention
Liver qi stagnation
Liver kidney yin deficiency
Liver stagnation and spleen deficiency
Qi stagnation and spleen deficiency
Liver stasis and spleen deficiency
Three hundred and nineteen
Two hundred and thirty-seven
One hundred and ninety-two
One hundred and forty-one
One hundred and twenty-five
Thirty-one point three
Twenty-three point three
Eighteen point eight
Thirteen point eight
Twelve point three
Eight point four
Six point five
Four point nine
Two point four
Two point three
Five point four
The 3 rule research
Collected a total of TCM literature 245, the rule of frequency analysis as shown in Table 4, the results show that the blood stasis, Qingrejiedu, spleen qi, liver qi stagnation, Ruanjiansanjie, Qi, tonifying the liver and kidney were 80 times above; followed by supplementing qi and nourishing yin and clearing heat dampness Xiaoshi again; and water, phlegm, heat and dampness, heat clearing fire etc..
Table 5 the number and frequency of common treatment of liver cancer
Activating blood circulation
Clearing away heat and toxic material
Replenishing qi and invigorating spleen
Softening and resolving lumps
Nourishing liver and kidney
Supplementing qi and nourishing yin
Clearing heat and purging fire
One hundred and seventy-nine
One hundred and seventy-six
One hundred and sixty-six
One hundred and twenty-seven
One hundred and twenty-four
Seventy-three point one
Seventy-one point eight
Sixty-seven point eight
Fifty-one point eight
Fifty point six
Thirty-nine point two
Thirty-two point seven
Eighteen point four
Sixteen point seven
Eight point two
Four point nine
Three point three
Two point five
Two point five
4 application rules of common prescriptions for liver cancer
Collected a total of 234 parties, including 280 common drugs aftertaste, use frequency in more than 50 times the 25 taste, summarized as in Table 5 and table 6, the results show that the commonly used herbs, mainly in the Four Gentlemen Decoction of Yinchenhao Decoction, Longdanxiegan decoction, four inverse scattered etc. based on the CD, Hedyotic diffusa and half lotus, honeysuckle and other branches to detoxify, add, etc. with Ruanjian Zhechong Biejia, plus salvia, angelica, radix curcumae, rhizoma curcumae, Rhizoma Corydalis, radix paeoniae rubra, 37 with blood stasis.
Table 5 the frequency and frequency of the most commonly used drugs for treatment of liver cancer
One hundred and twenty-one
One hundred and twenty
Fifty-one point seven
Fifty-one point three
Thirty-nine point three
Thirty-seven point six
Thirty-six point eight
Thirty-six point eight
Thirty-six point eight
Thirty-six point eight
Thirty-five point nine
Thirty-five point nine
Thirty-four point six
Thirty-three point eight
Table 6 the frequency and frequency of the most commonly used drugs for treatment of liver cancer
Dried tangerine peel
Thirty-one point six
Thirty-one point two
Thirty point eight
Twenty-nine point nine
Twenty-eight point six
Twenty-four point four
Twenty-three point nine
Twenty-three point one
Twenty-two point two
Twenty-two point two
Twenty-two point two
Twenty-one point eight
Twenty-one point four
5 curative effect evaluation research
Recently, Li Peiwen , Luo Jian, Chu Datong  raised the quality of life (referred to as QOL, the modern research began in 1976, Priestman et al., including physical, psychological, social and interpersonal relationship (including occupation) and mental health and satisfaction; broadly speaking, QOL is one of the physical and mental health and living environment overall satisfaction) of the index as a traditional Chinese medicine for the treatment of malignant tumors; and summarizes the research of QOL has three roles in tumor clinical research: 1) evaluation of cancer patients and the therapeutic effect of pain, therapy selection; 2) for anti-cancer drugs, analgesics, antiemetic drugs screening and evaluation 3); help to understand the survival after treatment of cancer patients.
6.1 generally belongs to traditional Chinese medicine "liver volume, characteristics of breakdown, accumulation, bulging disease" category. The pathogenesis is very complex, cause viscera Qi and blood deficiency, spleen and stomach, or eating disorders, damage the spleen and stomach, or emotional long depression, or Laojuan internal injuries, or six vessel virus invasion, leading to the accumulation of heat and toxic, qi stagnation and blood stasis, even liver and kidney damage; at the same time, poison and blood stasis and the formation of pathogenic factors, and each other the role, causes the body to further reciprocal causation, upright weakness, poison and blood stasis and liver cancer.
6.2 there is no uniform standard for TCM syndrome differentiation of liver cancer. But the frequency analysis and the distribution characteristics of syndromes of patients with syndrome of liver cancer type population analysis in 1019 cases, the common syndromes of qi stagnation and blood stasis syndrome, heat poly drug syndrome, spleen deficiency and dampness stagnation syndrome, liver qi stagnation and liver kidney yin deficiency syndrome five syndromes, syndrome type of statistical results with the result of the 2001 Ma reported by . Basically the same; in addition, spleen deficiency syndrome often in various types of mergers, merger is a common card.
6.3 liver cancer treatment is also inconclusive, with promoting blood circulation to remove blood stasis, or mainly Qingrejiedu, or spleen qi mainly etc.. But the statistics shows that in the spleen qi, blood stasis, Qingrejiedu Ruanjian with three methods as the basic treatment of liver cancer is more reasonable. There are three reasons: (1) pan  in 1979~1984 with "advanced spleen qi and removing blood stasis, softening and detoxification method" in the treatment of patients with hepatocellular carcinoma in 60 cases, and 52 cases of chemotherapy and radiotherapy (both simple type II) were observed after the treatment, the 1 year survival rate of Chinese medicine group is superior to radiotherapy and chemotherapy group (p< 0.05); from the perspective of clinical research confirmed the effectiveness of the treatment. (2) pan  and 61 cases (44 cases of stage II, 17 cases of stage III) of liver cancer patients were randomly divided into 3 groups, the control effect of different treatment, namely, spleen qi stasis and softening, heat clearing and detoxicating group (1 Liver Group); Spleen Qi (liver detoxification method, Group No. 2 group); blood stasis, heat clearing and detoxicating Ruanjian group (3 Liver Group); observe three treatment after 0.5 year and 1 year survival rate, the results showed: 1, 2, 3, liver group 0.5 years survival rates were 65.7%, 26%, 46.2%; 1 year survival rates were 32.8%, 8.7%, 15.4%; No. 1 group shows that liver effect is better, and from the angle of clinical research has confirmed the rationality of the treatment. (3) pan  experimental study has been conducted on 4 kinds of law, namely, invigorating spleen and regulating qi stasis and softening, detoxification method (A method), invigorating spleen and regulating qi (B), stasis and softening method (C method), detoxification method (D method); observation of 4 kinds of law tumor rate life and inhibition on mice liver cancer solid tumor extension rate, results show: 4 the inhibition rates were 48.4%, 6.9%, 34.6%, 16%; the life prolonging rate were 69.5%, 20%, 44.2%, 50.5%; from the perspective of the experimental study confirmed the rationality of the governance mechanism.
Therefore, the basic treatment of HCC is "Spleen Qi, blood stasis, Qingrejiedu Ruanjian" is more reasonable, while focusing on tonifying the liver and kidney.
6.4 records of medication to liver cancer, many doctors were 280 kinds of commonly used drugs, but by the statistics, still can reflect the basic law, the law and the 1995 and 2002  Chen Chen  reported the same result. The 25 drugs that embodies the basic treatment of spleen qi and blood stasis, softening, heat clearing and detoxifying treatment of liver cancer is. Among them, Poria, Atractylodes, Astragalus Yiqi Jianpi medicine frequency in the forefront, indicating that all doctors pay attention to spleen and stomach, is Zhong Jing in the "Golden Chamber" in the cloud "when the preventive treatment of disease, liver disease, liver spleen transfer knowledge," spleen "meaning.
6.5 at present, the traditional Chinese medicine treatment of primary liver cancer is mainly the use of Western medicine evaluation criteria, there is no manifestation of traditional Chinese medicine treatment efficacy evaluation criteria. The characteristics of combined treatment of traditional Chinese medicine, we should be leading indicators of survival with quality of life as the evaluation of the efficacy of TCM, in order to better reflect the Chinese medicine treatment to control the disease development, improve the quality of life and prolong the survival time of the role.
Three basic research
1 prevention research
In the middle of the last century in 80s, WHO (WHO) has proposed three famous 1/3: that is, the 1/3
1/3 of the tumors can be cured by early treatment, and the 1/3 tumor can prolong life and improve the quality of life. Recently, the National Cancer Institute  proposed: "less prone governance" as a long-term goal in the new century of cancer prevention, through further efforts made by common tumor lesions was a rare disease, is difficult to treat is easy to cure; emphasize prevention and early diagnosis and treatment. In China, Zhu Yuanrong and other scholars put forward : prevention of etiological prevention is the fundamental way to reduce the incidence of liver cancer, our grade prevention to prevention and treatment of hepatitis, tube grain mildew, the amount of selenium, improvement of drinking water "as the center; secondary prevention is" early "," early discovery and early diagnosis and early treatment "; III Prevention principle is" early, positive, comprehensive and specific strategy "; the emphasis should be placed in the high incidence area, susceptible populations (i.e., patients with high risk population, young people and liver cancer), grade and prevention, on this premise, will focus on the work on stage II primary prevention. Reviewing the research history of HCC in China more than half a century, from the epidemiology, etiology and prevention, early detection, early diagnosis and treatment of hepatitis, surgical and non surgical treatment, local comprehensive treatment and Research on anti recurrence and metastasis and other fields have made great progress, especially in the study of subclinical hepatocellular carcinoma (such as the study of small hepatocellular carcinoma the) has been living in the leading position in the field of basic research, the other is the gap with the world advanced level to shorten.
Chinese medicine has always emphasized "the administration did not have disease patients" thought, also will be "less prone governance" as a long-term goal in the new century the prevention and treatment of liver cancer, the three grade prevention and treatment of traditional Chinese medicine throughout the liver, such as Chinese medicine treatment has become one of the main means of treating liver cancer, the prevention of traditional Chinese medicine the recurrence and metastasis of hepatocellular carcinoma and anti treatment has great potential. At present, this research is in the ascendant, mainly in the following aspects:
(1) Chinese medicine prevention grade: such as obvious anti HBeAg effect of astragalus root, Cyrtomium fortunei, litchi and rhubarb, has anti fibrosis effect of tetrandrine, peach extract, Cordyceps sinensis, radix salviae miltiorrhizae, Fructus Gardeniae, radix paeoniae rubra, Poria, Atractylodes Poria or licorice compatibility have anti mutation and strong anti start also, oysters, pangolin, Arisaema, Flos mume have anti mutation effect of , the protective effect of seabuckthorn seed oil, ginseng saponin, liver compound, Qingkailing Injection on experimental liver injury induced by carbon tetrachloride.
(2) Chinese medicine prevention II: such as liver, Compound Muji Chongji ( wood chicken, dodder, Coriolus versicolor, sophora root, walnut bark etc.) has obvious antitumor activity, enhance immune function.
(3) traditional Chinese Medicine Anti recurrence and metastasis: Atractylodes can inhibit Lewis lung cancer transfer, there may be responsible for the transfer of selective killing of  cell subsets; 7721 cells of Salvia miltiorrhiza processing of intercellular adhesion molecule-1 (ICAM-1) expression was significantly lower than the control group, Danshen can inhibit 7721 cell invasion ability, promote cell adhesion is off 7721 and 7721, can inhibit the adhesion of cells, lymphocytes, endothelial cells, and the preventive effects of early and late stage of human hepatocellular carcinoma in nude mice after resection of intrahepatic recurrence and distant metastasis. 
Above, Chinese traditional medicine for prevention of HCC recurrence and metastasis and anti action research is carried out with the help of all aspects, modern science and technology, especially the technology of molecular biology, from the compound, single medicine to study the mechanism of monomer will further carry out.
2 treatment mechanism study
(1) cytotoxicity and inhibition of proliferation of hepatocellular carcinoma cells
The proliferation of tumor cells is the main cause of the damage of the body. Therefore, the direct killing of cancer cells and the inhibition of the growth of cancer cells can achieve the purpose of treatment.  by corter Pseudolaricis Markov B enzyme of different concentration of glycosides culture of human hepatocellular carcinoma cell line SMMC-7721, was found to have inhibitory effect of different growth corter Pseudolaricis B enzyme glycosides on liver cells, indicating that the drug has obvious anti hepatoma activity. Objective To observe the inhibitory effect of  polysaccharide LEN preparation on two kinds of tumor cell lines of ascites hepatoma H22 and sarcoma S180 in vitro, and the results showed that it had obvious anti-tumor effect on cell line. Someone [20, 21] observation of glycyrrhizin (GL), Hank As2O3 shares (GP) of two blue glycosides diethylnitrosamine (DEN) tumor suppressor role induced rat model of hepatic precancerous lesion, the results showed that GL and CP could inhibit the occurrence of carcinogenic DEN, dose effect relationship inhibition and GL. Inhibition of [22, 23] Green Tea on aflatoxin B1 and DEN induced rat liver cancer and coffee, levamisole comparative study showed that lvneng significantly inhibited aflatoxin B1 and DEN induced rat liver cancer, and the inhibition strength better than coffee and levamisole. Most of the data of  showed that the pineal gland has obvious anti-tumor effect, such as the use of human pineal extract can inhibit the growth of transplanted breast cancer, also have inhibitory effect on Ehrlich ascites cancer. The transplanted mouse solid and ascitic hepatoma, intravenous arsenic extract (As2O3) study showed that As2O3 had significant inhibitory effect on liver cancer and prolong the life of mice bearing. 
In addition, the compound preparation has a similar report. Such as S180, hepatoma H22 tumor strain such as animal transplanted tumor model, using the traditional Chinese medicine "AC899" (with different names, natural element copper, indigo, etc.) for the in vivo anti-tumor experiments results show that the compound has obvious inhibitory effect on  of H22 solid tumor. 1,  cell carcinoma Ling Injection (including arsenolite, light powder) were observed on human hepatocellular carcinoma cell killing effect showed that the direct cytotoxic effect on human hepatocellular carcinoma cells.
(2) the effect on the morphology of liver cancer cells and hepatocytes
Many traditional Chinese medicine and its compound can change the morphology of liver cells in tumor cells and pathological conditions
The role provides strong evidence from the microscopic aspect. Lili  observed flat lung (Houttuynia, Fritillaria, Oldenlandia, Trichosanthes etc.) effect on HCC cell morphology, cancer cells found in the control group have obvious deformation, inconsistent size, nuclear chromatin thickening, more visible tumor giant cells and pathological karyokinesis to visible cancer; cell drug group showed degenerative changes or a dead cell trend, giant cells and mitotic figures were less, the growth activity decreased, cancer interstitial and peripheral lymphocyte infiltration more zonal, the side of the cell killing effects of large hepatocellular carcinoma.
Xia Jianxin  observed Yiganning (cantharidin, Lithospermum) on liver cancer cells in rats during tenth weeks and 20 weeks
The morphological changes of hepatocytes were observed under transmission electron microscope, and the results showed that the effect of DEN on liver cancer cells was inhibited obviously.
From the Rubiaceae plant in the early extraction of anti-cancer substances CM36 effects on mouse hepatocellular carcinoma (HAC), electron microscope
The death of the cancer cells, cancer cells necrosis and disintegration, full of fat particles, also shows a large area of degeneration of the cancer cells, the cytoplasm and heterochromatin condensation, mitochondrial cristae were broken, organelles are not complete, the in vivo experiments showed that the inhibition rate is better than some chemotherapeutic agents, such as ADM, 5-FU, VP-16 etc.. 
Chinese medicine Xiaojieling (fresh white skin, white monkshood etc.) can destroy cancer cells in ultrastructure, the cracking, collapse, induce the tumor cells to produce a large number of lysosomes resulting in the dissolution, degeneration and necrosis of transplantedsolid type liver cancer inhibition rate
48% to 70%. 
(3) the effect on immune function of organism
Tumor immune status, and disorder of different degrees of defects exist in various aspects of immune network, the cellular immunity, thus, improve immune function, can stimulate the antitumor immune effect, thereby preventing the growth and spread of tumor recurrence and.
Guo Feng , the research on change of ascites immune cells of the experimental findings, in the early stage of liver cancer, for immune cells by intraperitoneal injection of smallpox powder 1 times and 2 times after ascites respectively 69.39%, 76.5%, compared with the control group the proportion (2.56%, 7.15%) increased significantly; at the same time, the treatment group in ascites small and large granular cell lymph, lymph around the cancer cell "satellite phenomenon", while the control group did not have this phenomenon. Table pollen can make the body's immune rejection to cancer cells to enhance the anti-cancer effect.
Anti-cancer Fuzheng oral liquid (containing zedoary, henbane, Hedyotis diffusa, Scutellaria barbata, dodder, Ligustrum lucidum, medlar, Radix Codonopsis etc) and adriamycin (ADM) can significantly improve the phagocytic activity of peritoneal macrophages in mice with Wu, Wu group than in the ADM only group, phagocytic percentage and phagocytic index were increased by 42.03% and 75% (P < 0.01), oral liquid on ADM induced immune suppression have obvious antagonism, the content of serum hemolysin in mice increased significantly, combined with group than single ADM group increased 24.24% (P < 0.05); in addition, the protective effect of oral liquid on the immune injury caused by ADM, can improve the antitumor activity. 
Astragalus polysaccharide can inhibit the liver cancer (Heps) in mice, and it is proved that the anti-tumor effect of Astragalus polysaccharide may be related to the enhancement of immune function. 
(4) inhibition of DNA, RNA and protein synthesis in hepatoma cells
The inhibition and destruction of DNA, RNA and protein synthesis of cancer cells can inhibit the growth of tumor.
Chen Wei  of Gypenosides (GP) on human hepatocellular carcinoma cell line SMMC-77, DNA and RNA contents were determined by ethidium bromide method, found that cancer cells in DAN plus GP group, RNA content decreased significantly, showed that GP can inhibit hepatocellular carcinoma cell lines DNA, RNA and protein synthesis, thereby inhibiting the growth of hepatocellular carcinoma.
Using radiolabeled precursor incorporation method of compound Sansheng injection (raw aconite, Arisaema, Radix Aconiti and six herb extracts) effect on hepatoma cell biological macromolecular synthesis in mice, the results show that the prepared injection can inhibit cancer cell nucleic acid and protein. 
Studies have found that , camptothecin POLYPHASE LIPOSOME on human hepatocellular carcinoma cell line DNA to inhibit the synthesis of the highest rate of 73.7%, about 4 hours after the effect of inhibition of cancer cell DNA rate was 82.9%, when the contents of DNA and protein in hepatocellular carcinoma using this product after intravenous injection of 10mgkg significantly decreased.
The experiment showed that tanshinone has anti-cancer effects, its mechanism may be related to the inhibition of tumor cells, DAN expression, RNA synthesis and anti proliferative cell antigen DNA polymerase delta activity. 
(5) the effect of cell cycle on proliferation of hepatocellular carcinoma cells
Cancer cell cycle can be divided into: the synthesis of DNA (G1), pre DNA synthesis phase (S phase), synthesis (G2), the late mitotic phase (M phase) 4 period, when the drugs acting on a link which block the cell cycle, proliferation of cancer cells can be blocked so as to achieve the purpose of treatment.
Guo Shimei  SMMC-7721 hepatoma cells through cytokines beta carotene treatment the percentage of S phase is only 10%, while the control group, the percentage of S phase was 27%, that of beta carotene could block the growth cycle of hepatocellular carcinoma cells in vitro.
With multi camptothecin liposomes (DL-CS) on proliferation of hepatoma cells, the results showed that DL-CS could significantly inhibit the damage of S cells, also have mild injury of G0 cells, G2 cells into M phase is restrained, which has the obvious difference with the control group, showed that DL-CS was influenced widely on the proliferation of hepatocellular carcinoma cell cycle, which belongs to cell cycle non-specific drugs, especially on the role of S cells was significant. 
(6) of cyclic nucleotide (cAMP, cGMP) effect
CAMP and cGMP are important regulators of proliferation and differentiation of biological cell membrane, and the loss of normal growth and regulation of tumor cells is closely related to the content of cAMP and cGMP in cells. In many types of cancer cells, the level of cAMP was lower than that of normal cells, and cGMP was higher than that of normal cells. Therefore, by regulating the content of the two, the inhibition of tumor growth and the differentiation and reversion of cancer cells could be achieved.
CAMP and cAMP/cGMP mice ascitic hepatoma cells were obviously lower than normal mice by cAMP and cAMP/cGMP in tumor bearing mice cancer cells of sodium cantharidinate after treatment were significantly higher than in the untreated mice were treated, the content of cAMP increased by 81%, the ratio of cAMP/cGMP increased by 192.3%; while the measured cancer cell cAMP- (phosphodiesterase low km) decreased significantly, showed that the anticancer effect of disodium cantharidate might reduce cAMP- phosphodiesterase activity, improve cancer cells cAMP. 
Application of compound Solanum nigrum injection (including Solanum nigrum, Duchesnea indica, Bai Ying, angelica, Radix Salviae Miltiorrhizae and Radix Curcumae etc.) for 8 consecutive days in mouse hepatocarcinoma ascites cancer cells (H22), found that the drug on proliferation of cancer cells was inhibited, and observed phosphodiesterase and Na+-K+-ATP enzyme on the surface of the cell membrane was obviously decreased, suggesting that this drug has anti-cancer effects, its mechanism may be in continuous action of drugs, by inhibiting the cell membrane phosphodiesterase and Na+-K+-ATP enzyme activity increased the intracellular level of cAMP, the regulation of cell proliferation and differentiation. 
(7) the effect of gene expression in hepatocellular carcinoma
Also known as cancer gene transforming gene, is a large gene family, is highly stable in the process of biological evolution, when subjected to some carcinogenic factors, cancer gene amplification, is activated to cause cancer, such as Myc, fox gene expression is an important step in the development of HCC cells, so the use of drugs to cancer gene abnormality the expression to be reversed, shut down or reduce the expression level, to achieve the purpose of treatment of cancer.
At present, there are some reports on traditional Chinese medicine. Guo Shimei as reported by  ß - significantly inhibited the expression of N-ras gene in human hepatocellular carcinoma carotene.
The compound AC960 (rhizome, Atractylodes, Radix Sophorae Flavescentis, baihuasheshecao) can significantly inhibit the proliferation of SMMC-7721 cells and promote the cell apoptosis, which may be related to inhibition of oncogene and tumor suppressor gene expression and blocking cell cycle. 
(8) induce apoptosis of hepatoma cells
Apoptosis, also known as programmed cell death, is a process of cell death in some physiological or pathological conditions. It has been found that apoptosis not only exists in normal tissues but also in tumor tissues, and plays an important role in the development and treatment of tumors.
Japanese scholars kajiro  reported patients with right liver cirrhosis taking Xiaochaihu Decoction, can prevent canceration, he thinks the mechanism is: Xiaochaihu Decoction to apoptosis proliferating precancerous nodules; tiny canceration to not capture clinically, by inducing apoptosis of cancer cells or cancer cells arrest at the stationary phase. But the delay to cancer development.
Li Jie  found that the inducing effect of Gankang granules on apoptosis of human hepatoma cell line BEL-7402: for the detection of hepatocellular carcinoma BEL-7402 cell cycle DNA content of Gankang granules and adriamycin effects showed that Gankang granules, can prevent adriamycin in human hepatocellular carcinoma G0/G1 cells into S phase, induce apoptosis.
(9) the effect of telomerase activity in hepatocellular carcinoma
Tumor cells are able to break away from the aging phenotype and become immortal, often accompanied by the activation of telomerase or the up regulation of function. Most studies have found that human tumors contain the activation of telomerase, which lacks the mechanism of regulating telomerase and can not down regulate telomerase activity. Telomerase plays an important role in the occurrence and development of tumors, and it has become a new hot spot in the research of tumor.
In vivo , Jianpiliqi herb group (hawthorn, Radix Codonopsis, Atractylodes, Poria, Fructus aurantii, August Zagreb) the telomerase activity was significantly lower than the control group (p=0.038), in vitro telomerase activity of SMMC-7721 cells was inhibited. That inhibition of telomerase activity may be a part of the anti-tumor traditional Chinese medicine of invigorating spleen and regulating qi mechanism.
According to the visible, experimental study in the treatment of liver cancer by traditional Chinese medicine compound, single medicine research to study the monomer, by purpureaa simple gradually on the level of cell and molecule; and with the accumulation of basic theoretical research of tumor molecular biology, using gene chip and protein chip technology people are expected to find prescription, high efficiency and low toxicity in the treatment of hepatocellular carcinoma; in addition, with the development of nano biological technology continues to improve, reform the forms of Chinese medicine, Chinese medicine treatment of liver cancer drug will have a reform.
Four questions and conclusions
Although the treatment of primary liver cancer with traditional Chinese medicine has made great progress in the past 50 years, it has become a primary cause of liver cancer
Liver cancer is one of the main means of treatment, but there are still many problems, mainly in the following areas:
1) the etiology and pathogenesis of different, which is difficult to unify the treatment law;
2) there is no systematic study on the syndrome types of liver cancer, and there is no big breakthrough in the study of syndrome type objective. There is no uniform standard of differentiation of symptoms and the standard of curative effect;
3) the Chinese medicine and the combination of Chinese and Western therapy for liver cancer is lack of standardization, the doctors hard to grasp the sense of propriety, the objective effect is far from, the overall level of clinical medicine to a new level above;
4) lack of basis for drug selection, selection of Chinese medicine for hepatic artery interventional therapy with little regard to the proliferation kinetics, pharmacokinetics, high efficiency and low toxicity and drug sensitive tumor cells and other issues; and as the research of traditional Chinese medicine microsphere has further deepened, and how to set up a slow, and can be used for the embolization effect target formally the clinical delivery systems, is the traditional Chinese medicine in interventional therapy of liver cancer in the field of a challenging problem.
5) at present, strictly randomized, prospective clinical study of few clinical reports, credibility is not high, it is difficult to achieve the requirements of evidence-based medical analysis system, and from the Chinese literature survey on liver cancer is difficult to find the best evidence, provide a reliable basis for clinical and scientific research of traditional Chinese Medicine in the prevention and treatment of liver cancer.
6, the breadth and depth of the basic research of traditional Chinese medicine for liver cancer is far less than that, which is not conducive to the development of traditional Chinese medicine clinical research on the treatment of liver cancer.
With the development of modern science and technology, traditional Chinese medicine research foundation of HCC will continue in-depth, clinical research must pay attention to and strengthen the standardization of TCM treatment, syndrome differentiation and efficacy evaluation standard; traditional Chinese medicine as a means of treatment, should also play a significant role in the treatment and prevention of recurrence and metastasis, primary resistance primary liver cancer.