正肝化症方联合TACE治疗中晚期原发性肝癌临床研究

Clinical study of Zhenggan recipe combined with TACE in treatment of patients with primary liver cancer

[目的]观察正肝化症方联合经导管肝动脉化疗栓塞(TACE)治疗中晚期原发性肝癌(PHC)患者疗效及对外周血CD4^+/CD8^+、甲胎蛋白(AFP)、胰岛素样生长因子-Ⅱ(IGF-Ⅱ)水平表达的影响。[方法]选取我院收治的中晚期PHC患者110例作为研究对象,按照随机数字表法分为观察组和对照组各55例,2组均给予常规保肝、营养支持等对症治疗,在此基础上对照组给予TACE治疗,观察组在对照组基础上联合正肝化症方治疗。观察2组中医症候积分、临床疗效,检测患者总胆红素(TB)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、CD4^+、CD8^+、CD4^+/CD8^+以及AFP、IGF-Ⅱ水平表达。[结果]治疗后2组中医症候积分显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);观察组总有效率72.73%显著高于对照组50.91(P<0.05);治疗后2组TB、AST、ALT水平显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);治疗后观察组CD4^+、CD8^+、CD4^+/CD8^+与治疗前比较差异无统计学意义(P>0.05),对照组CD4^+、CD4^+/CD8^+与显著低于治疗前(P<0.05),且对照组显著低于观察组(P<0.05),对照组CD8^+显著高于治疗前(P<0.05),且对照组显著高于观察组(P<0.05);治疗后2组AFP、IGF-Ⅱ水平显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05)。[结论]正肝化症方联合TACE能够明显改善中晚期PHC患者外周血CD4^+/CD8^+、AFP、IGF-Ⅱ水平,提高肝功能和临床疗效。

[Objective]To observe curative effect of Zhenggan Huazheng prescription combined with TACE in treatment of patients with primary liver cancer（PHC）at medium and advanced stage and influence on peripheral blood CD4^＋/CD8^＋,alpha fetoprotein（AFP）and insulin-like growth factor-II（IGF-II）levels.[Methods]110 cases of patients with PHC at medium and advanced stage treated in our hospital were selected as the study objects,and were divided into observation group and control group according to random number table method,55 cases in each group.All the two groups were given routine liver protection,nutritional support and other symptomatic treatment.On the basis of that,the control group were given TACE treatment,and the observation group were combined with Zhenggan Huazheng prescription on the basis of the control group.TCM symptom scores,clinical efficacy were observed,and total bilirubin（TB）,aspartate aminotransferase（AST）,alanine aminotransferase（ALT）,CD4^＋,CD8^＋,CD4^＋/CD8^＋,and AFP,IGF-II levels were detected in the two groups.[Results]After treatment,TCM symptom scores were significantly lower than those before treatment in the two groups（P 0.05）,and those in the observation group weresignificantly lower than those in the control group（P〈0.05）.Total effective rate of the observation group was 72.73%,significantly higher than that of 50.91% of the control group（P 0.05）.After treatment,TB,AST and ALT levels were significantly lower than those before treatment in the two groups（P〈0.05）,and those in the observation group were significantly lower than those in the control group（P〈0.05）.After treatment,there were no statistically significant difference in CD4^＋,CD8^＋and CD4^＋/CD8^＋of the observation group when compared with those before treatment（P〈0.05）.CD4^＋and CD4^＋/CD8^＋in the control group were significantly lower than those before treatment（P〈0.05）,and those in the control group were significantly lower than those in the observation group（P〈0.05）.CD8^＋in the control group was significantly higher than that before treatment（P〈0.05）,and that in the control group was significantly higher than that in the observation group（P〈0.05）.After treatment,AFP and IGF-II levels were significantly lower than those before treatment in the two groups（P〈0.05）,and those in the observation group were significantly lower than those in the control group（P〈0.05）.[Conclusion]Zhenggan Huazheng Prescription combined with TACE can significantly improve peripheral blood CD4^＋/CD8^＋,AFP and IGFII levels.It can improve liver function and clinical efficacy.