六味地黄合四君子汤对原发性肝癌介入术后患者细胞免疫功能的调节作用

Immunological Study of LiuWeiDiHuangSiJunzi Decoction on Primary Liver Cancer after Transcatheter Arterial Chemoembolization

目的:观察六味地黄合四君子汤对原发性肝癌介入术后,中医辨证属肝肾阴虚兼脾气虚证患者的临床疗效和对细胞免疫功能的调节作用。方法:45例患者随机分为治疗组、对照组。治疗组肝动脉化疗栓塞(TACE)后服用六味地黄合四君子汤,对照组TACE后服V itC等。通过观察患者临床总证候、临床症状、生活质量(KPS)变化以及安全性观察明确该方临床疗效,通过检测患者外周血T细胞亚群、NK细胞比例,外周血细胞因子IFN-γ、IL-12的产生明确该方对患者细胞免疫功能调节作用。结果:六味地黄合四君子汤临床总证候治疗有效率优于对照组(P<0.05),对口干、盗汗、乏力、纳呆症状的改善优于对照组(P<0.05),可明显提高患者生活质量(P<0.05),该方无毒副反应,可明显上调患者CD4+T淋巴细胞,NK细胞比例(P<0.05),提高IFN-γ的产生。结论:六味地黄合四君子汤治疗原发性肝癌介入术后,辨证属肝肾阴虚兼脾气虚证患者,中西医结合可明显提高诊治该病的临床疗效。

Objective： To investigate clinical efficacy and immunological mechanism of LiuWeiDiHuangSiJunzi decoction on treatment of primary liver cancer patients taken transcatheter arterial chemoembolization （TACE）, with TCM diagnosis of yin asthenia in liver and kidney, qi deficiency in spleen. Methods： 45 cases are randomly divided into two groups, one for LiuWeiDiHuangSiJunzi decoction, one for vitamins. Changes in symptoms, KPS, proportion of CD3、4、8, NK, cytokine production of IL - 12, IFN - γ are evaluated after treatment, together with side effect. Results： In clinical study parameters such as symptoms （thirsty, night sweat, fatigue, poor appetite）, KPS scores are significantly in favour of cases taking LiuWeiDiHuangSiJunzi decoction. During observation LiuWeiDiHuangSiJunzi decoction has no side effects. Proportion of CD4^＋ T lymphocyte and natural killer cell, IFN - γ production increase significantly in cases taking LiuWeiDiHuangSiJunzi decoction. Conclusion： LiuWeiDiHuangSiJunzi decoction together with TACE will be a successful strategy for primary liver cancer.