扶正清毒化瘀方联合射波刀治疗原发性肝癌的临床研究

Clinical study on Fuzheng Qingdu Huayu recipe combined with cyber knife in the treatment of primary hepatic carcinoma

目的观察扶正清毒化瘀方联合射波刀治疗原发性肝癌患者的临床疗效和安全性。方法120例原发性肝癌患者,按照人院顺序分为治疗组及对照组,各60例。治疗组采用扶正清毒化瘀方联合射波刀治疗,对照组行单纯射波刀治疗。对比两组患者的近期疗效、中医症状积分疗效、肝功能[总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)]和甲胎蛋白(AFP)变化情况、生活质量疗效、社会功能缺陷情况及不良反应发生情况。结果治疗组近期疗效总有效率83.33%高于对照组66.67%,差异具有统计学意义(χ~2=4.444,P<0.05)。治疗组中医症状积分疗效总有效率78.33%高于对照组46.67%,差异具有统计学意义(χ~2=12.836,P<0.05)。治疗前,两组患者TBIL、ALT、AST、AFP比较,差异均无统计学意义(P>0.05)。治疗3个月后,治疗组患者ALT、AST、AFP均低于治疗前,且低于对照组治疗3个月后,差异均具有统计学意义(P<0.05)。治疗组生活质量疗效总有效率95.00%高于对照组83.33%,差异具有统计学意义(χ~2=4.227,P<0.05)。治疗3个月后,治疗组社会功能缺陷情况优于对照组,差异具有统计学意义(χ~2=3.851,P<0.05)。治疗组不良反应发生率20.00%低于对照组51.67%,差异具有统计学意义(χ~2=4.126,P<0.05)。结论扶正清毒化瘀方联合射波刀治疗原发性肝癌具有增效减毒协同疗效,近期疗效好,可以显著改善患者中医症状、肝功能,降低肿瘤活性,提高生存质量、社会功能,不良反应发生率低,具有疗效优势,是一种值得临床借鉴、推广的治疗模式。

Objective To observe the clinical curative effect and security of Fuzheng Qingdu Huayu recipe combined with cyber knife in the treatment of primary hepatic carcinoma. Methods A total of 120 primary hepatic carcinoma patients were divide by admission order into treatment group and control group, with 60 cases in each group. The treatment group received Fuzheng Qingdu Huayu recipe combined with cyber knife for treatment, and the control group received simple cyber knife treatment. Comparison were made on recent curative effect, curative effect of traditional Chinese medicine symptom score, liver function [ total bilirubin （TBIL）, alanine aminotransferase （ALT）, aspartate transaminase （AST） ] and alpha fetoprotein （AFP） changes, curative effect of life quality, social function defect and occurrence of adverse reactions in two groups. Results The treatment group had recent total effective rate as 83.33%, which was higher than 66.67% in the control group, and the difference had statistical significance （X2=4.444, P〈0.05）. The treatment group had total effective rate of traditional Chinese medicine symptom score as 78.33%, which was higher than 46.67% in the control group, and the difference had statistical significance （X2=12：836, P〈0.05）. There was no statistically significant difference in TBIL, ALT, AST and AFP before treatment （P〉0.05）. After 3 months of treatment, the treatment group had lower ALT, AST and AFP than before treatment and the control group after 3 month of treatment. Their difference had statistical significance （P〈0.05）. The treatment group had higher total effective rate in life quality as 95.00% than 83.33% in the control group, and the difference had statistical significance （X2=4.227, P〈0.05）. After 3 months of treatment, the treatment group had better social function defect than that of the control group, and the difference had statistical significance （X 2=3-851, P〈0.05）. The treatment group had lower incidence of adverse reactions as 20.00% than 51.67% in the control group, and the difference had statistical significance （X2=4.126, P〈0.05）. Conclusion Fuzheng Qingdu Huayu recipe combined with cyber knife has a synergistic effect of effect-enhancing and toxicity-reducing, as well as good recent curative effect in the treatment of primary hepatic carcinoma, which can significantly improve the patients＇ traditional Chinese medicine symptoms, liver function, reduce tumor activity, improve the quality of survival, social function with low incidence of adverse reactions. It has advantages in curative effect, and it is a treatment mode worthy of clinical reference and promotion.