中医药对乙型肝炎患者肝癌前期状态的干预研究

Traditional Chinese Medicine intervention for development of hepatocelullar carcinoma in patients with chronic hepatitis B: an analysis of 17 cases

目的:探讨中药对乙型肝炎相关性肝癌的干预作用. 方法:在慢性乙型肝炎患者中,筛选出肝癌高危患者30 例,治疗组17例根据审因论治的原则,以中药制剂对其进行为期2 a的肝癌干预治疗;对照组13例以中西药进行常规保肝治疗．治疗过程中每月随访临床症状、体征、肿瘤标志物、肝功能、病毒载量及T细胞亚群等项目,定期进行B超和CT检查．结果:中药干预组肿瘤标志物甲胎蛋白、甲胎蛋白异质体和γ-谷氨酰转肽酶同工酶Ⅱ的转阴率分别为86％(6／7)、 83％(5／6)和82％(9／11),对照组中所有病例肿瘤标志物持续阳性,无1例转阴．2 a期间中药干预组累计肝癌发生率为 12％(2／17),对照组为85％(11／13),两者比较差异具有极显著性(P<0．0 001)．结论:中医“养正徐图”治则能有效降低肝癌高危患者肿瘤标志物水平,并能延缓或阻止肝癌的发生．

AIM： To explore the intervention effect of Traditional Chinese Medicine （TCM） on hepatitis Brelated hepatocellular carcinoma （HCC）. METHODS： Thirty super-high risk patients of HCC were selected from patients with chronic hepatitis B. Seventeen patients were treated with TCM for 2 a, while 13 patients were treated with the routine therapy for chronic hepatitis. The symptoms, signs, tumor markers, serum indexes of liver function, virus loads, and the subtypes of T cells were monitored each month. Ultrasonic B and Computed Tomography were performed regularly. RESULTS： In TCM group, normalized serum rates of AFP, AFP-L3, and GGT Ⅱ were 86% （6/7）, 83% （5/6）, and 82% （9/11）, respectively. While in the control group, the tumor markers were turned into negative in none of the patients. During the 2 a, the accumulative incidence of HCC in TCM group was significantly lower than that in the control group [12% （2/17） vs 85% （11/13）, P〈0.0 001]. CONCLUSION： TCM can significantly decrease the levels of HCC markers, and it can also suspend or prevent the progression of HCC.