益气抗癌方联合含奥沙利铂方案TACE术对原发性肝癌血清肿瘤相关巨噬细胞及相关细胞因子水平的影响

Effect of Yiqi Anticancer Prescription combined with oxaliplatin-containing TACE on the levels of serum tumor associated macrophages and related cytokines in patients with primary liver cancer

目的：探讨益气抗癌方联合含奥沙利铂方案肝动脉化疗栓塞术（TACE）对原发性肝癌患者血清肿瘤相关巨噬细胞及相关细胞因子水平的影响。方法：将2011年1月—2016年4月医院收治的110例原发性肝癌患者按照随机数字表法分为对照组与观察组各55例,两组均接受含奥沙利铂方案TACE术治疗,观察组加用益气抗癌方,比较两组中医症候及体征的改善情况,评定其疗效,测定治疗前后患者血癌胚抗原（CEA）、甲胎蛋白（AFP）、肿瘤坏死因子-α（TNF-α）、巨噬细胞移动抑制因子（MIF）、血管内皮生长因子（VEGF）、白介素-8（IL-8）水平的变化,统计两组治疗不良反应,均随访1年,统计两组癌症相关生活质量评价表（QLQ-52）评分的变化。结果：（1）观察组总缓解率为61.82%,高于对照组的41.82%,对比差异有统计学意义（P〈0.05）;（2）治疗前,两组各症状及体征积分、实验室各指标比较差异无统计学意义（P〉0.05）,治疗后,两组倦怠乏力、五心烦热、口干咽燥、胁痛、脉虚无力等症状、体征积分及CEA、AFP、TNF-α、MIF、VEGF、IL-8水平均降低（P〈0.05）,观察组降低幅度高于对照组（P〈0.05）;（3）两组不良反应发生率比较差异无统计学意义（P〉0.05）;（4）治疗前,两组QLQ-52量表各维度评分比较差异无统计学意义（P〉0.05）,随访1年,观察组各维度评分高于对照组（P〈0.05）。结论：益气抗癌方联合含奥沙利铂方案TACE术可提高原发性肝癌治疗效果,下调血清肿瘤相关巨噬细胞及相关细胞因子水平,提升患者生活质量。

Objective： To investigate the effect of Yiqi Anticancer Prescription combined with oxaliplatin-containing transcatheter hepatic arterial chemoembolization（TACE） on the levels of tumor associated macrophages and related cytokines in patients with primary liver cancer. Methods： A total of 110 patients with primary liver cancer treated in our hospital from January 2011 to April 2016 were randomly divided into the control group and the observation group with 55 patients in each group by the random number table method. The two groups were treated with oxaliplatin-containing TACE,and the observation group was additionally treated with Yiqi Anticancer Prescription. The relief of TCM symptoms and signs was compared between the two groups,and the curative effect was evaluated. Levels of carcinoembryonic antigen（CEA）,alpha fetoprotein（AFP）,tumor necrosis factor α（TNF-α）,macrophage migration inhibitory factor（MIF）,vascular endothelial growth factor（VEGF） and interleukin-8（IL-8） were determined before and after treatment,and adverse reactions were statistically analyzed. Both groups were followed up for 1 year,and changes of cancer related quality of life（QLQ-52） scores in the two groups were statistically analyzed. Results：（1）The total remission rate of the observation group（61. 82%） was higher than that of the control group（41. 82%）（P〈0. 05）.（2） Before the treatment,there were no statistically significant differences between the two groups in scores of symptoms and signs,and laboratory indexes（P〉0. 05）,after treatment,scores of symptoms such as tireness and lack of power,dysphoria in chestpalms-soles,dry mouth and throat,chest pain and feeble pulse and signs,levels of CEA,AFP,TNF-α,MIF,VEGF and IL-8 decreased（P〈0. 05）,and the decrease in observation group was more obvious than that in the control group（P〈0. 05）.（3）There was no significant difference in the incidence of side effects between the two groups（P〉0. 05）.（4）Before treatment,there was no significant difference between the two groups in QLQ-52 scores（P〉0. 05）.In 1-year of follow-up,the scores of different dimensions in the observation group were higher than those in the control group（P〈0. 05）. Conclusion： Yiqi Anticancer Prescription combined with oxaliplatin-containing TACE can improve the therapeutic effect of primary liver cancer,reduce the levels of tumor associated macrophages and related cytokines,and improve the quality of life of patients.