健脾益肝饮联合肝动脉栓塞化疗对晚期肝癌预后的影响

Effect of Jianpi Yigan decoction combined with transcatheter arterial chemoembolization on prognosis of advanced hepatocellular carcinoma

目的探讨健脾益肝饮联合肝动脉化疗栓塞术(transarterial chemoembolization,TACE)对晚期肝癌预后的影响。方法回顾性研究2007年3月~2013年3月我院103例接受TACE治疗的晚期肝癌患者。其中53例患者在接受TACE治疗同时,服用健脾益肝饮(中药组),其余50例患者仅接受TACE治疗(对照组)。比较两组并发症和长期生存率等指标。结果两组患者的一般资料无显著差异,无TACE相关死亡发生。中药组患者便秘(7/53vs 15/50,P=0.0377)、腹胀(5/53 vs 12/50,P=0.0466)和食欲减退(35/53 vs 42/50,P=0.0360)明显减少。中药组较对照组在肝脏毒性(P=0.0265)和胃肠道毒性(P=0.0445)方面明显减轻。中药组3年总生存率显著高于对照组(37.74%vs 26.00%;HR:0.6171;95%CI:0.3832~0.9938;P=0.0365)。结论健脾益肝饮能有效减少TACE引起的并发症并减轻毒副反应,提高患者对TACE耐受性,从而改善晚期肝细胞癌患者的长期生存。

Objective To investigate the effect of Jianpi Yigan decoction combined with transcatheter arterial chemoembolization（TACE） on the prognosis of advanced liver cancer. Methods A retrospective study was conducted in 103 patients with advanced hepatocellular carcinoma treated with TACE from March 2007 to March 2013. 53 patients were treated with TACE while taking Jianpi Yigan decoction（Chinese medicine group） and the remaining 50 patients received TACE treatment only（control group）. The complications and long-term survival rate and other indicators between two groups were compared. Results There was no significant difference between the two groups in general data. No TACErelated death occurred. The constipation（7/53 vs 15/50, P=0.0377）, bloating（5/53 vs 12/50, P=0.0466） and loss of appetite（35/53 vs 42/50, P=0.0360） in the Chinese medicine group were significantly decreased. Compared with the control group, the Chinese medicine group was significantly reduced in hepatotoxicity（P=0.0265） and gastrointestinal toxicity（P =0.0445）. The overall 3-year survival rate was significantly higher in the Chinese medicine group than that in the control group（37.74% vs 26.00%; HR： 0.6171; 95%CI： 0.3832-0.9938; P=0.0365）. Conclusion Jianpi Yigan decoction can effectively reduce the complications caused by TACE and reduce the side effects,which improves the patients＇ tolerance to TACE, thereby improving the long-term survival of patients with advanced hepatocellular carcinoma.