中医综合方案与TACE术治疗巴塞罗那C期肝癌的临床疗效比较

Comparative Study on Clinical Efficacy of Comprehensive Treatment Plan of TCM and TACE in Treatment of Barcelona Stage C Liver Cancer

目的:比较肝动脉化疗栓塞术(TACE)与中医综合治疗两种治疗方法对巴塞罗那C期(BCLC-C)原发性肝癌的疗效。方法:将98例巴塞罗那C期原发性肝癌患者随机分为TACE组和中医综合治疗组,TACE组采取肝动脉化疗栓塞术进行治疗,中医综合治疗组患者给予华蟾素静滴结合辨证论治中药汤剂口服,观察两组患者疾病进展时间、总生存时间,以及不良反应发生率。结果:中医综合治疗组中位疾病进展时间为4.17个月[95%CI(2.17-6.17)],TACE组中位疾病进展时间为4.27个月[(95%CI(2.55-5.99)],差异无统计学意义(P>0.05);中医综合治疗组的中位生存时间为8.73个月[95%CI(0-18.54)],TACE组中位生存时间为10.33个月[95%CI(4.03-16.63)],差异无统计学意义(P>0.05);中医综合治疗组的纳差、肝区疼痛、腹胀、恶心呕吐的发生率低于TACE组,差异有统计学意义(P<0.01);中医综合治疗组肝功能child-pugh评分分级A期率高于TACE组,差异有统计学意义(P<0.05)。结论:肝动脉栓塞与中医综合治疗BCLC-C期肝癌在延长生存时间与疾病进展时间方面比较无明显差异,同时中医综合治疗的不良反应更小,安全性更高。

Objective： To observe the difference between the treatment of hepatic arterial chemoembolization（TACE） and the combination of TCM and western medicine on primary liver cancer patients with barcelona stage C hepatocellular carcinoma（BCLC-C）. Methods： A total of 98 patients with primary liver cancer in barcelona stage C were randomly divided into TACE group and integrative medicine treatment group. Patients in group TACE received interventional therapy with hepatic arterial chemoembolization. Patients in integrative medicine treatment group were treated with the combination of cinobufacini intravenous infusion and traditional Chinese medicine oral decoction. The progession free survival（PFS）, overall survival（OS） and the incidence of adverse reactions were observed in the two groups. Results： The median PFS was 4.17 months [95% CI（2.17-6.17）]in the traditional Chinese medicine group and 4.27 months [95% CI（2.55-5.99）] in TACE group, which shows no significant difference（P〉0.05）. The median OS was 8.73 months [95% CI（0-18.54）] in the traditional Chinese medicine group and 10.33 months [95% CI（4.03-16.63）] in the TACE group, which shows no significant difference（P〉0.05）. The incidence of appetite loss, liver pain, abdominal distension, nausea and vomiting in sea and vomiting in Chinese medicine treatment group was significantly lower than that in TACE group, and the rate of pateints with a stage A child-Pugh score liver function was higher than that of TACE group（P〈0.05）. Conclusion： The therapeutic effect on OS and PFS between TACE and chinese medicine treatment with conventional BCLC-C liver cancer shows no significantly difference, the method of comprehensive treatment of traditional Chinese medicine has little adverse reaction and high safety.