黄芪四君子汤辅助外科手术治疗原发性肝细胞癌对肝功能及免疫水平的影响

Effect of Huangqi Sijunzi Decoction on Liver Function and Immune Level in Surgical Treatment of HCC

目的探讨黄芪四君子汤辅助原发性肝细胞癌(HCC)肝切除术后肝功能、免疫功能的影响。方法选取2016年3月—2019年1月医院肝胆外科实施肝脏切除手术治疗的HCC患者81例,根据患者的入院顺序分为中西医组41例、西医组40例,两组患者术后均给予基础的营养、支持等治疗措施,中西医组同时口服黄芪四君子汤,连续2周;对比两组患者的手术前后血清天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)、免疫球蛋白(IgG、IgM、IgA)、外周血T淋巴细胞(CD+3、CD+4、CD+8)、血清肝胆酸(CG)、透明质酸(HA)、三型前胶原肽(PC3)、层黏蛋白(LN)。结果术前,中西医组和西医组患者的血清ALT、AST、TBIL差异无统计学意义(P>0.05);术后3 d、术后7 d,中西医组患者的血清ALT、AST、TBIL显著低于西医组(P<0.05);术前,中西医组和西医组患者的IgG、IgM、IgA、CD+3、CD+4、CD+8差异无统计学意义(P>0.05);术后2周,中西医组患者的IgG、IgM、IgA、CD+3、CD+4高于西医组(P<0.05),CD+8低于西医组(P<0.05);术前,中西医组和西医组患者的CG、HA、PC3、LN差异无统计学意义(P>0.05);术后2周,中西医组患者的CG、HA、PC3、LN低于西医组(P<0.05)。结论黄芪四君子汤在肝脏切除术后应用对于改善患者肝功能、免疫功能及减轻肝纤维化水平具有重要价值。

Objective To explore the effects of traditional Chinese medicine Huangqi Sijunzi Decoction on hepatic function and immune function after hepatectomy for primary hepatocellular carcinoma(HCC). Methods Eighty-seven patients with HCC who underwent liver resection surgery in our hospital from March to September 2019 were enrolled. According to the order of admission, 41 patients were in the Chinese and Western medicine group and 40 in the western medicine group. Besides the basic nutrition, support and other treatment measures, the Chinese and Western medicine group also used Huangqi Sijunzi Decoction orally for 2 weeks. We compared serum aspartate aminotransferase(AST), alanine aminotransferase(ALT), total bilirubin(TBIL), immunoglobulin(IgG, IgM, IgA), peripheral blood T lymphocytes(CD+3, CD+4, CD+8), serum hepatic acid(CG), hyaluronic acid(HA), type III Procollagen peptide(PC3) and laminin(LN) of two groups before and after treatment. Results Before operation, there were no significant differences in serum ALT, AST or TBIL between the Chinese and Western medicine group and the Western medicine group(P>0.05). The serum levels of ALT, AST and TBIL of the Chinese and Western medicine group were significantly lower than those of the Western medicine groups 3 days after surgery(P<0.05). Before operation, the difference of IgG, IgM, IgA, CD+3, CD+4 and CD+8 between the Chinese and Western medicine group and the Western medicine group was not statistically significant(P>0.05). Two weeks after surgery, the levels of IgG, IgM, IgA, CD+3 and CD+4 in the Chinese and Western medicine group were higher than those of the Western medicine group(P<0.05), CD+8 was lower than that of the Western medicine group(P<0.05). The levels of CG, HA, PC3 and LN between Chinese and Western medicine group and Western medicine group had no statistical significance(P>0.05). The levels of CG, HA, PC3 and LN of the Chinese and Western medicine group were lower than those of the western medicine group(P<0.05). Conclusion The application of traditional Chinese medicine Huangqi Sijunzi Decoction after liver resection is of great value for improving liver function, immune function and reducing liver fibrosis.