消瘤散联合肝动脉化疗栓塞术治疗中晚期肝癌近期疗效观察

Short-term efficacy of Xiaoliu Powder combined with transcatheter arterial chemoembolization in the treatment of advanced liver cancer

目的观察消瘤散联合肝动脉化疗栓塞术治疗中晚期肝癌的近期疗效。方法将66例中晚期肝癌患者随机分为治疗组和对照组,每组33例。两组均予肝动脉化疗栓塞术,治疗组在肝动脉化疗栓塞术前7天开始服用中药消瘤散。术后1个月评价近期疗效,观察肝功能相关实验室指标(ALT、AST、TBIL、ALB)、甲胎蛋白(AFP)、凝血酶原时间(PT)、生存质量KPS评分变化,以及不良反应发生情况。结果 (1)治疗组有效率、疾病控制率分别为63.6%、81.8%,对照组分别为45.5%、75.8%,治疗组近期疗效优于对照组(P<0.05)。(2)组内术后1个月与治疗前比较,治疗组ALT、AST、TBIL水平明显下降(P<0.05),对照组ALT、AST水平升高(P<0.05);组间术后1个月比较,ALT、AST、TBIL、ALB差异均有统计学意义(P<0.05)。(3)组内术后1个月与治疗前相比,两组AFP水平下降(P<0.05),KPS水平升高(P<0.05);组间治疗后比较,AFP、PT、KPS差异有统计学意义(P<0.05)。(4)治疗组、对照组总体不良反应发生率分别为78.8%、97.0%;组间比较,恶心呕吐、骨髓抑制及总体不良反应发生率差异有统计学意义(P<0.05)。结论消瘤散联合肝动脉化疗栓塞术治疗中晚期肝癌,可提高近期疗效,提高患者生存质量,减少不良反应。

Objective To observe the short-term efficacy of Xiaoliu Powder combined with transcatheter arterial chemoembolization（ TACE） in the treatment of advanced liver cancer. Methods 66 patients with advanced liver cancer were randomly divided into the treatment group and control group,33 cases in each group.The patients in both groups were treated with TACE,and those in the treatment group were treated with Xiaoliu Powder 7 days before TACE. One month after operation,the short-term efficacy was evaluated,and the levels of liver function related indexes such as alanine transaminase（ ALT）,aspartate aminotransferase（ AST）,total bilirubin（ TBIL） and albumin（ ALB）,the levels of alpha fetoprotein（ AFP） and prothrombin time（ PT）,the Karnofsky perfomance status（ KPS）score and the adverse reactions were observed. Results（1）The effective rates and the disease control rates were 63.6% and 81.8% in the treatment group and 45.5% and 75.8% in the control group,respectively,which indicated that the short-term efficacy in the treatment group was better than that in the control group（ P〈0.05）.（2）Compared with treatment before,the levels of ALT,AST and TBIL were significantly decreased in the treatment group one month after operation（ P〈0.05）,while the levels of ALT and AST were increased in the control group（ P〈0.05）. There were statistically significant differences on the levels of ALT,AST,TBIL and ALB between the two groups one month after operation（ P〈0.05）.（3）Compared with treatment before,the level of AFP was decreased（ P〈0.05） and the level of KPS was increased（ P〈0.05） in both groups one month after operation. After the treatment,there were statistically significant differences on the levels of AFP,PT and KPS between the two groups（ P〈0.05）.（4）The incidence rates of adverse reaction were 78. 8% in the treatment group and 97. 0% in the control group,respectively. There were statistically significant differences on the incidence rates of nausea and vomiting,myelosuppression and overall adverse reaction between the two groups（ P〈0.05）. Conclusion Xiaoliu Powder combined with TACE in the treatment of advanced liver cancer can improve the short-term efficacy,enhance the quaility of life and reduce the adverse reactions.