肝动脉栓塞化疗联合中医姑息疗法对中晚期原发性肝癌的临床观察

Clinical Observation of Applying TACE Combined with Traditional Chinese Medicine in thet Treatment of Primary Liver Cancer During Medium and Advanced Stage

目的:观察肝动脉栓塞化疗联合中医姑息疗法对中晚期原发性肝癌的临床疗效。方法:将78例符合标准的患者随机分为治疗组40例和对照组38例。两组均采用肝动脉栓塞化疗和西医常规对症支持治疗,治疗组加用中药汤剂治疗,以保元汤合逍遥散为基础方加减。观察患者的近期生存率(1年和2年)、T淋巴细胞亚群指标、生活质量改变情况和不良反应发生情况。结果:治疗组患者治疗后CD3、CD4淋巴细胞计数均升高,CD8淋巴细胞计数降低,CD4/CD8值升高,与治疗前比较,差异有统计学意义(P<0.05)。对照组与治疗前比较,差异无统计学意义(P>0.05)。治疗后组间比较,差异均有统计学意义(P<0.01)。治疗组患者生活质量改善率62.50%,对照组改善率21.05%,差异有统计学意义(P<0.05)。治疗组不良反应总发生率72.50%,对照组总发生率100%,差异有统计学意义(P<0.05),不良反应以消化道症状、发热、骨髓抑制和疲乏无力为主。治疗组患者2年生存率为60%,对照组患者2年生存率为36.84%,差异有统计学意义(P<0.05)。结论:以保元汤合逍遥散为基础方加减治疗中晚期原发性肝癌,可减轻肝动脉栓塞化疗产生的不良反应,增强患者免疫功能,提高患者生活质量,延长患者近期生存率。

Objective ： To observe the effect of trascatheter arterial chemoembolization （TACE） combined with Chinese med- icine in primary liver cancer （PLC） patients during medium and advanced stage. Methods： 78 patients who met the standard were randomly divided into controlled group and treatment group. In the controlled group of 38 cases were treated by TACE and routine western medicine; 40 cases in the treatment group were additionally given traditional Chinese medicine by Baoyuan Deeoe- tion and Xiaoyao Powder. Recent survival rate, quality of life, the level of T lymphocytes and adverse reactions were observed. Results： In the treatment group, the CD3 and CD4 cells count were increased, CDs cell was decreased, CDJCDs value was in- creased after treatment. Compared with the group before treatment, the difference was statistically significant （ P 〈 O. 05 ）. In the controlled group, the difference was not statistically significant （ P 〉 0. 05 ）. Comparison between groups after treatment, the difference was statistically significant （P 〈 0. 05）. The rate of adverse reactions was 72. 50% in the treatment group while 100% in the controlled group, the difference was statistically significant （P 〈 0. 05）. The main adverse reactions were gastroin- testinal symptoms, fever, bone marrow suppression and weakness. The 2 year survival rate of the treatment group was 60% while 36. 84% in the controlled group, the difference was statistically significant （P 〈 0. 05）. Conclusion ： Application of TACE com- bined with Baoyuan Decoction and Xiaoyao Powder in PLC patients during medium and advanced stage can reduce the adverse re- actions caused by TACE, enhance the immune function, improve the quality of life and prolong the recent survival rate of pa- tients.