化疗联合槐耳颗粒对原发性肝癌术后复发/转移患者预后影响研究

Chemotherapy combined with Huaier granule in the prognosis of patients with recurrent/metastatic after primary hepatocellular carcinoma

目的观察FOLFOX4(奥沙利铂+亚叶酸钙+氟脲嘧啶)方案化疗联合槐耳颗粒对原发性肝癌术后复发/转移患者预后的影响。方法将56例原发性肝癌术后复发/转移的患者随机分为化疗组与联合组,每组各28例,化疗组按照FOLFOX4方案进行化疗,联合组在化疗组基础上给予槐耳颗粒辅助治疗。比较两组患者有效率、疾病稳定率、甲胎蛋白水平、临床症状与生活质量的改善情况。结果治疗2个周期后,化疗组与联合组的有效率分别为39.2%(11/28)与42.9%(12/28),疾病稳定率分别为75.0%(21/28)与82.1%(23/28),两组比较,差异均无统计学意义(P>0.05)。化疗组与联合组的甲胎蛋白降低率分别为39.2%(11/28)与50.0%(14/28),差异有统计学意义(P<0.05);稳定率分别为42.9%(12/28)与35.8%(10/28),差异无统计学意义(P>0.05);升高率分别为17.9%(5/28)与14.2%(4/28),差异无统计学意义(P>0.05)。治疗后,化疗组患者的肝区疼痛发生率低于治疗前,差异有统计学意义(P<0.05),乏力、消瘦、食欲减退发生率与治疗前比较,差异无统计学意义(P>0.05);联合组患者的肝区疼痛、乏力、消瘦、食欲减退发生率均低于治疗前,差异有统计学意义(P<0.05)。治疗后,化疗组与联合组的生活质量降低率分别为25.0%(7/28)与10.7%(3/28),差异有统计学意义(P<0.05);稳定率分别为46.4%(13/28)与35.8%(10/28),差异无统计学意义(P>0.05);提高率分别为28.6%(8/28)与53.5%(15/28),差异有统计学意义(P<0.05)。结论 FOLFOX4方案化疗联合槐耳颗粒治疗原发性肝癌术后复发/转移患者安全有效,可降低甲胎蛋白水平与不良反应发生率,改善预后。

Objective To observe the effect of FOLFOX4 chemotherapy（Oxaliplatin,folic acid calcium and fluorouracil） combined with Huaier granule on the prognosis of patients with recurrent/metastatic after primary hepatocellular carcinoma.Methods Fifty-six patients with primary hepatocellular carcinoma were randomly divided into the chemotherapy group and the combination treatment group,with 28 cases in each group.Patients in the chemotherapy group were treated with FOLFOX4 chemotherapy,the others in the combination treatment group were given Huaier granule on the basis of chemotherapy.The effectiveness,the disease stability rate,the level of alpha fetoprotein（AFP）,the clinical symptoms and the improvement of the quality of life were compared between the two groups.Results After 2 cycles of chemotherapy,in the chemotherapy group and the combination treatment group; the effective rate was 39.2%（11/28） versus 42.9%（12/28）,the disease stability rate was 75.0%（21/28） versus 82.1%（23/28）（P0.05）; the reduced level of AFP was 39.2%（11/28） versus 50.0%（14/28）; the index of stability was 42.9%（12/28） versus 35.8%（10/28）; the elevated rate was 17.9%（5/28） versus 14.2%（4/28）（P0.05）.After the treatment,in chemotherapy group,the rate of hepatalgia was lower than that before the surgery（P0.05）,incidence of fatigue,weight loss and loss of appetite compared with those before the treatment,there were no statistical significant difference（P0.05）; in the combination treatment group,the rates of hepatalgia,fatigue,weight loss and loss of appetite were all lower than those before the treatment（P0.05）.In the chemotherapy group and the combination treatment group,the reduced quality of life was 25.0%（7/28） versus 10.7%（3/28）（P0.05）; the index of stability was 46.4%（13/28） versus 35.8%（10/28）（P0.05）; the elevated rate was 28.6%（8/28） versus 53.5%（15/28）（P0.05）.Conclusion FOLFOX4 chemotherapy combined with Huaier granule in the treatment of patients with recurrence and metastasis of primary hepatocellular carcinoma can improve the curative effect,reduce the level of AFP,reduce the adverse reactions of patients and improve the prognosis.