复方甘草酸苷防治原发性肝癌三维适形放疗后肝损伤的临床观察

Protective effects of compound glycyrrhizin on hepatic injury induced by three-dimensional conformal radiotherapy in patients with primary liver carcinoma

目的探讨复方甘草酸苷在防治原发性肝癌(PLC)三维适形放疗(3DCRT)后肝损伤的作用。方法 113例PLC患者被随机分为治疗组62例和对照组51例,两组均采用3DCRT治疗,分割剂量为2.6～3.2Gy/次,总剂量为48～60Gy;治疗组同时给予复方甘草酸苷注射液60～100 ml/日,静脉滴注,疗程4周,再改为片剂口服,共2～3个月。结果两组患者放疗后ALT和AST较放疗前均有所升高,但治疗组ALT(51.6±12.6 U/L)和AST(48.3±14.4 U/L)升高程度明显低于对照组(分别为85.2±19.9 U/L和73.8±17.8 U/L,P<0.01);治疗组发生放射性肝病(RILD)4例(6.5%),而对照组发生10例(19.6%),治疗组明显低于对照组(P<0.05)。结论复方甘草酸苷能预防和改善PLC患者在3DCRT治疗后的肝损伤,降低RILD的发生率。

Objective To investigate the protective effects of compound glycyrrhizin on hepatic injury induced by three-dimensional conformal radiotherapy（3DCRT） in patients with primary liver carcinoma（PLC）.Methods A total of 113 patients with advanced hepatocellular carcinoma were randomly divided into study group（n=62） and control group（n=51）.The patients in the two groups were treated with 3DCRT,and the dose was 2.6～3.2Gy each time with the total doses of 48～60Gy;and the patients in study group were also treated with injections of compound glycyrrhizin intravenously at dose of 60ml per day for 4 weeks,then the glycyrrhizin tablets were given orally for 2～3 months.Results The levels of ALT and AST after radiation in both groups were elevated as compared with that before radiation,but the elevated levels of ALT（51.6±12.6 U/L） and AST（48.3±14.4 U/L） in the study group were significantly lower than that in the control group（85.2±19.9 U/L and 73.8±17.8 U/L,respectively,P0.01）,and the rate of radiation-induced liver disease（RILD） in the study group（4 cases,6.5%） was lower than that in the control group（10 cases,19.6%,P0.05）.Conclusion Compound glycyrrhizin can prevent and improve the hepatic injury induced by 3DCRT in patients with PLC,and it also can reduce the rate of RILD occurrence.