苦参素辅助治疗乙型病毒性肝炎相关原发性肝癌的临床观察

Clinical observation of adjuvant therapy of oxymatrine on hepatitis B virus related primary hepatocellular carcinoma

目的:观察苦参素辅助治疗乙型病毒性肝炎(HBV)相关原发性肝癌(PHC)临床疗效和安全性。方法:54例HBV相关PHC患者分为对照组和治疗组,2组均行肝动脉化疗栓塞术(TACE),治疗组加服苦参素片共6个月(2个疗程),比较2组治疗前后实体瘤近期疗效、患者生存质量、免疫功能变化、肝功能变化以及安全性指标。结果:与对照组相比,治疗组有效率明显升高(P<0.01),KPS评分升高、稳定例数增加(P<0.05),治疗后CD3+、CD4+、CD4+/CD8+比值及NK细胞活性显著性提高(P<0.05,P<0.01),Child-Pugh评分、ALT含量、HBV DNA均明显降低(P<0.05,P<0.01),发生恶心呕吐、发热、疼痛、WBC下降等不良反应的例数较少(P<0.01)。结论:苦参素可提高TACE的治疗效果并降低不良反应。

OBJECTIVE To observe the clinical efficacy and safety of adjuvant therapy of oxymatrine on hepatitis B virus（HBV）related primary hepatocellular carcinoma（PHC）after transcatheter arterial chemoembolization（TACE）.METHODS54 patients suffered from HBV related PHC were divided into control group and treatment group,TACE was operated to all patients,the treatment group administrated oxymatrine 6 months（two periods of treatment）and the immediate efficacy,quality of life,immune function changes,liver function changes and safety index were compared between the two groups before andafter treatment.RESULTS In the treatment group,the effective rate increased significantly（P〈0.01）,the KPS score raised and stabilized cases were increased（P0.05）,the CD3^＋,CD4^＋,CD4^＋/CD8^＋and NK cell activity were significantly increased after treatment（P〈0.05,P〈0.01）,the Child-Pugh score,ALT,HBV DNA levels were significantly decreased after treatment（P〈0.05,P〈0.01）,and the adverse reactions such as nausea and vomiting,fever,pain,the WBC decline were lower than those of control group（P〈0.01）.CONCLUSION Oxymatrine could improve the therapeutic effect and reduce adverse reactions of TACE.