柴胡疏肝散联合索拉非尼治疗肝细胞癌的效果观察

Clinical efficiency of Chaihu Shugan Powder combined with sorafenib in treatment of hepatocellular carcinoma

目的探讨柴胡疏肝散联合索拉非尼治疗肝细胞癌(HCC)的临床效果及安全性。方法将84例HCC患者随机分为两组,各42例。对照组予以索拉非尼治疗,联合组则在其基础上联合柴胡疏肝散进行治疗。比较治疗前及治疗6个月后,两组患者肿瘤标志物[甲胎蛋白(AFP)、糖类抗原19-9(CA19-9)]水平,肝功能[丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)]水平变化,分析治疗6个月后两组患者治疗效果及6个月内毒副反应发生情况。结果治疗6个月后,联合组患者治疗效果优于对照组,病死率低于对照组(P<0.05);两组患者AFP、CA19-9、ALT、TBIL水平均较治疗前显著下降,且联合组低于同期对照组(P<0.05);治疗6个月内,联合组患者消化系统、皮肤的严重毒副反应发生率均低于对照组(P<0.05)。结论柴胡疏肝散联合索拉非尼治疗HCC可取得较为理想的临床效果,利于患者预后恢复。

Objective To explore the effect of Chaihu Shugan Powder on hepatocellular carcinoma（ HCC）,combined with sorafenib. Methods Eighty-four cases of HCC patients were randomly divided into the combined group and the control group,with 42 cases in each group. The control group was treated with sorafenib,and the combined group treated with sorafenib and the Chaihu Shugan Powder. Levels of α-fetoprotein（ AFP）,carbohydrate antigen 19-9（ CA19-9） and changes in alanine aminotransferase（ ALT）,total bilirubin（ TBIL） were analyzed in the two groups,before treatment and at the end of 6 months after treatment,as well as their therapeutic effectiveness and toxicity. Results Six months after treatment,the mortality rate of the combined group was significantly lower than that of the control while the objective response rate（ ORR） was higher than that of the control（ P〈0. 05）. A significant decrease of AFP,CA19-9,ALT and TBIL in the two groups occurred compared with those before treatment. The deceased level of the combined one was significantly lower than that of the control（ P〈0. 05）. In the combined group,the incidence of sever toxic side effects in digestive system and skin was lower than that of the control group（ P〈0. 05）. Conclusion Chaihu Shugan Powder combined with sorafenib achieved an ideal effect on therapy for HCC. Our results suggest that the combined therapeutic strategy could be appropriate for HCC used here.