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自拟解毒疏肝组方治疗肝胆湿热型原发性肝癌介入术后综合症的疗效及预后因素分析 被引量:4

Curative Effect of Using Self-made Jiedu Shugan Recipe in the Treatment of Liver-gallbladder Damp-heat Type Primary Liver Cancer Interventional Postoperative Syndrome and Analysis on Prognostic Factors
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摘要 目的:观察自拟解毒疏肝组方治疗肝胆湿热型原发性肝癌(PLC)介入术后综合症的疗效及预后因素。方法:选取2018年1月~2019年1月沧州市传染病医院收治的120例PLC患者,均接受经导管动脉化疗栓塞术(TACE)治疗,根据术后应用药物不同随机分为2组,对照组(n=52)接受常规西药对症治疗,实验组(n=68)接受自拟解毒疏肝组方中药治疗,对比两组患者临床疗效和术后综合症各症状持续时间及治疗前后中医证候积分、肝功能指标、生活质量;并进行随访,多因素COX回归分析PLC患者预后影响因素。结果:实验组治疗总有效率明显高于对照组,术后肝区疼痛、黄疸、恶心呕吐、腹胀、发热持续时间明显短于对照组(P<0.05);治疗后两组患者中医证候积分和总胆红素(TB)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平均明显降低,白蛋白(ALB)水平和(KPS)评分均明显提升,实验组改善更明显(P<0.05);本组120例均获得随访,时间7~12个月,中位随访时间11个月,多因素COX回归分析显示,多因素COX回归分析显示,PVTT、碘油沉积、Child-Pugh分级为患者预后独立危险因素(P<0.05)。结论:自拟解毒疏肝组方可有效改善PLC介入术后综合症,缩短其持续时间,降低TACE对肝功能的损害,提高生活质量,其中PVTT、碘油沉积、Child-Pugh分级是影响PLC患者预后的主要危险因素。 Objective: To explore the efficacy and prognostic factors of using Self-made Jiedu Shugan Recipe in the treatment of hepatobiliary damp-heat type primary liver cancer(PLC) syndrome after intervention.Methods: 120 PLC patients admitted to the Department of Hepatology(January 2018 to January 2019) of our hospital were treated with transcatheter arterial chemoembolization(TACE) and randomly divided into 2 groups according to the postoperative drug application.The controlled group(n=52) received symptomatic treatment of conventional western medicine, and the experimental group(n=68) received Self-made Jiedu Shugan Recipe traditional Chinese medicine treatment.The clinical efficacy and duration of symptoms of postoperative syndrome and TCM before and after treatment were compared between the two groups of patients’ syndrome scores, liver function indicators, quality of life;and follow-up, multi-factor COX regression analysis of PLC prognostic factors.Results: The total effective rate of treatment in the experimental group was significantly higher than that in the controlled group.The postoperative liver pain, jaundice, nausea and vomiting, abdominal distension, and fever duration were significantly shorter than those in the controlled group(P<0.05).And total bilirubin(TB),aspartate aminotransferase(AST),alanine aminotransferase(ALT) levels were significantly reduced, albumin(ALB) levels and(KPS) scores were significantly improved, the improvement of the experiment group was more obvious(P<0.05);All 120 patients in this group were followed up for 7~12 months, with a median follow-up time of 11 months.Multivariate COX regression analysis showed that multivariate COX regression analysis showed that PVTT,iodized oil deposition, and Child-Pugh classification were the prognosis of patients.Independent risk factors(P<0.05).Conclusion: Self-made Jiedu Shugan Recipe can effectively improve the syndrome after PLC intervention, shorten its duration, reduce the damage of TACE to liver function, and improve the quality of life.Among them, PVTT,iodized oil deposition, and Child-Pugh classification are the main risk factors for patient prognosis.
作者 王爽 杨元磊 孙韬 曹玉鹃 艾春健 张楠 李玉玲 WANG Shuang;YANG Yuanlei;SUN Tao(Department of Intervention,Cangzhou Municipal Infectious Disease Hospital,Cangzhou Hebei 061000,China;Department of Traditional Chinese Medicine Cangzhou Municipal Infectious Disease Hospital,Cangzhou Hebei 06X000,China)
出处 《四川中医》 2021年第12期127-132,共6页 Journal of Sichuan of Traditional Chinese Medicine
基金 河北省中医药管理局科研计划项目(编号:2020527)。
关键词 肝胆湿热型 原发性肝癌 解毒疏肝组方 肝动脉化疗栓塞术 疗效 预后 Hepatobiliary damp-heat type Primary liver cancer Jiedu Shugan Recipe Hepatic artery chemoembolization Efficacy Prognosis
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