Abstract :
Background: Postembolization syndrome (PES) is a common sequelae after transcatheter arterial
chemoembolization (TACE). Currently, most therapies of postembolization syndrome following TACE are aimed
at a single symptom, thus leading to limitations. Andrographis paniculata (A. paniculata) has been used as a
traditional medicine in India, China, Thailand, and Scandinavia. There have been several clinical reports on the use
of A. paniculata for antipyretic, analgesic, anti-inflammatory and hepatoprotective effects.
Objective: The aim of this study was to evaluate the efficacy of A. paniculata for the treatment of
postembolization syndrome following TACE procedure.
Methods: This study was a randomized, double-blinded and controlled trial. Forty-eight patients with
primary liver cancer were randomized into 2 groups of 24 to receive either oral A. paniculata or placebo for 3 days
following TACE. Clinical symptoms and related laboratory tests before TACE, 24 hours, 72 hours and 7 days after
TACE were monitored.
Results: Of the 48 patients, 43 (89.6%) were male. The overall mean age was 62.41 ± 10.25 years. Most
patients had cirrhosis CTP A (87.5%). The etiologies of cirrhosis were chronic hepatitis B (43.8%), chronic hepatitis
C (33.3%), alcoholic liver disease (12.5%) and NASH (22.9%). The incidence of fever was 50.0% (12/24) in the
A. paniculata group and 66.7% (16/24) in the placebo group (p = 0.242). The incidence of pain was 41.7% (10/24)
in the A. paniculata group and 50.0% (12/24) in the placebo group (p = 0.562). The changes of TB, AST, ALT and
ALP at 24 hours, 72 hours and at 7 days after TACE were not significantly different between two groups.
Conclusion: There were no significant difference in fever, hepatalgia and changing of the TB, AST, ALT,
ALP after TACE between the A. paniculata and the placebo group.
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file/Thai-Journal-of-gastroenterology-vol-17-no-2-3275332.pdf