深圳地区肝细胞癌特征及芪术抗癌方联合TACE治疗临床观察

Clinical Observation of Characteristics of Hepatocellular Carcinoma and Qishu Kang'ai Prescription Combined with TACE Therapy in Shenzhen

目的:观察深圳地区肝细胞癌(HCC)的临床特征及中药芪术抗癌方联合TACE治疗方案对HCC患者的生存期及生活质量的影响。方法:回顾性调查深圳市中医院肝病科门诊及住院的260例HCC患者,分析其性别、发病年龄、病因的分布情况;对260例HCC患者中采用芪术抗癌方联合经导管动脉化学栓塞(TACE)的63例(实验组)、采用TACE治疗的34例(对照组)和采用中药芪术抗癌方治疗的14例(中药组)进行生活质量(KPS)评分及生存分析,评价其临床疗效。结果:深圳地区男女HCC发病率比为4.5∶1,多发于40～60岁,HCC的主要病因是乙肝病毒(HBV)感染及肝硬化;实验组KPS评分与对照组比较,差异有统计学意义(P<0.05);Kaplan-Meier分析发现,与对照组比较,实验组及中药组在提高生存率方面,差异有统计学意义(P<0.05),且高于对照组;60岁以上患者中中药组的生存率较实验组及中药组为高,差异有统计学意义(P<0.05)。结论:深圳地区HCC多发于40～60岁,HBV感染或肝硬化的男性;部分老年HCC患者不行手术治疗而给予适当的中药治疗同样可以提高生存率及生活质量;中药芪术抗癌方联合TACE可以提高中晚期HCC患者的生活质量及生存期。

Objective：To observe the clinical characteristics of hepatocellular carcinoma（HCC） in Shenzhen and the effect of Qishu Kangai prescription in Chinese medicine combined with transcatheter arterial chemoembolization（TACE） therapy on the survival time and quality of life of patients. Methods：Retrospectively investigated 260 cases of patients with HCC who were in outpatients and inpatients of liver diseases in Shenzhen Traditional Chinese Medicine Hospital,analyzed their sex,age of onset and etiology. Evaluated quality of life（KPS） of 260 cases of patients with HCC and made a survival analysis,in which 63 cases（the experiment group） were given Qishu Kangai prescription in Chinese medicine combined with TACE for treatment,34 cases（the control group） were given TACE therapy for treatment, and 14 cases（the Chinese medicine group） were given Qishu Kangai prescription for treatment, and evaluated the clinical effect. Results：The incidence rate of HCC in males and females in Shenzhen was 4.5∶1,among the age of 40-60. The major causes of HCC were hepatitis B virus（HBV） infection and liver cirrhosis. There was a significant difference being found in the comparison of KPS scores in the experiment group and the control group（P〈0.05）. Kaplan-Meier analysis found that, compared with the control group,there was a statistically significant difference in the survival rate between the experiment group and the Chinese medicine group（P〈0.05）,being higher than that of the control group. The survival rate of over 60-years-old patients in the Chinese medicine group was higher than that in the experiment group,difference being significant（P〈0.05）. Conclusions：In Shenzhen,HCC occurs frequently in men between the ages of 40 and 60 with HBV infection or cirrhosis. Some elderly patients with HCC who receive appropriate Chinese medicine treatment but without surgery may also improve the survival rate and quality of life. The therapy of Qishu Kangai prescription in Chinese medicine combined with TACE can improve the quality of life and survival time of patients with HCC at middle stage.