中药防治肝癌化疗栓塞术后肝储备功能损害的临床研究

Treatment of Hepatic Functional Reserve Injury after TACE in Hepatocellular Carcinoma with Chin ese Herbal Medicines

背景与目的:肝癌化疗栓塞术(Transcatheterarterialchemoembolization,TACE)可引起肝储备功能下降。探讨中药预防和治疗肝癌TACE后肝储备功能的损害。方法:61例中晚期肝癌患者随机分成中西医治疗组(n=30)和西医治疗组(n=31),两组在TACE后均予西药常规护肝治疗及对症处理,中西医治疗组在TACE前、后加服用健脾活血为主的中药,再根据TACE后出现的症状对症选药。两组病例分别在第一、第二次TACE治疗前和第二次TACE治疗后一个月各检查吲哚靛青绿15分钟潴留率(RetentionRateofIndocyanineGreenat15Minutes,ICGR15)。结果:第一次TACE前ICGR15:中西医治疗组11.18%±7.30%,西医治疗组11.83%±7.18%,P>0.05;第二次TACE前ICGR15:中西医治疗组11.69%±5.13%,西医治疗组16.64%±10.15%,P<0.05;第二次TACE后一个月ICGR15:中西医治疗组为11.53%±5.30%,西医治疗组19.80%±11.26%,P<0.05。结论:健脾活血中药可防治肝癌TACE后所引起的肝储备功能损害。

Background &Objective:Transcatheter arterial chemoembolization(TACE)has been proved to injure hepatic functional reserve.The cur rent study was designed to evaluate t he effect of Chinese herbal medicines in treatment of hepatic functional reserve injury a fter TACE.Methods:Sixty-one advanced hepatocellular carcinoma patients were divided into two groups:groups A(Western medicine combined with Chin ese herbal medicine group,n=30)and group B(Western medicine group,n=31).Western medicines were used to protect hepatic function and alleviate T ACE syndrome in both group A and group B.Invigorating the spleen and activating blood circula tion Chinese herbal medicines were a dded only in group A before and after TACE.Retent ion rate of Indocyanine green at 15mi nutes(ICGR 15 )was measured in both group A and group B before 1 st ,2 nd TACE and one month after 2 nd TACE respectively.Results:Hepatic functional reserve before 1 st TACE was 11.18%±7.30%in group A and 11.83±7.18%in group B,(P>0.05).Hepatic functional reserve before2 nd TACE was 11.69%±5.13%in group A and 16.64±10.15%in group B,(P<0.05).Hepatic functional reserve one month after 2 nd TACE was 11.53%±5.30%in group A and 54819.80±11.26%in group B,(P<0.05).Conclusions:Invigorating the spleen and activating blood circulation Chinese herbal medicine can prevent hepatic functional reserve injury after TACE.