培元抗癌汤联合甲磺酸阿帕替尼片治疗晚期原发性肝癌脾虚血瘀型的疗效及对外周血免疫细胞和肿瘤标志物的影响

Clinical efficacy of Peiyuan Kangai Decoction with apatinib mesylate tablets for advanced primary liver cancer of spleen-deficiency blood stasis and how to impact on peripheral immune cells and tumor marker

目的观察培元抗癌汤联合甲磺酸阿帕替尼片治疗晚期原发性肝癌(PLC)脾虚血瘀型的临床疗效及对外周血免疫细胞和肿瘤标志物的影响。方法将94例晚期PLC脾虚血瘀型患者按照随机数字表法分为2组,对照组47例予甲磺酸阿帕替尼片治疗,治疗组47例在对照组治疗基础上加用培元抗癌汤治疗。2组均治疗8周。比较2组疗效;观察2组毒副反应发生情况;比较2组治疗前后CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、自然杀伤(NK)细胞水平变化;比较2组治疗前后血清甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)水平变化。结果治疗组缓解率68.09%(32/47),对照组缓解率46.81%(22/47),治疗组疗效优于对照组(P<0.05)。2组高血压、蛋白尿、手足综合征、乏力、骨髓抑制发生率比较差异均有统计学意义(P<0.05),治疗组毒副反应发生率低于对照组。2组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK细胞水平均较本组治疗前升高(P<0.05),CD8^(+)水平较本组治疗前降低(P<0.05),且治疗后治疗组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK细胞水平均高于对照组(P<0.05),CD8^(+)水平低于对照组(P<0.05)。2组治疗后血清AFP、CEA、CA19-9水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论培元抗癌汤联合甲磺酸阿帕替尼片治疗晚期PLC脾虚血瘀型,可降低肿瘤标志物水平,改善细胞免疫功能,减少毒副反应发生。

Objective To observe the clinical efficacy of Peiyuan Kangai Decoction combined with apatinib mesylate tablets for advanced primary liver cancer(PLC)of spleen-deficiency blood stasis and how to impact on peripheral immune cells and tumor marker(TM).Methods Totally 94 patients with advanced PLC(spleen-deficiency blood stasis)were randomly assigned into two equal groups,patients in treatment group received Peiyuan Kangai Decoction with apatinib mesylate tablets,and patients in control group only received apatinib mesylate tablets.A 8-week treatment was performed,toxic and side reactions,CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),natural killer(NK)cells,serum alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9)were included as comparators;the curative effect was counted.Results The remission rate in treatment group and control group was 68.09%(32/47)and 46.81%(22/47),respectively,the curative effect being better in treatment group than control group(P<0.05).The difference was statistically significant in the incidence of hypertension,proteinuria,hand and foot syndrome,fatigue,myelosuppression between groups(P<0.05);incidence of toxic and side reactions was decreased in treatment group compared with cortrol group.After treatment,CD3^(+),CD4^(+),CD4^(+)/CD8^(+),NK cells levels in treatment group were up-regulated(P<0.05),which in control group were down-regulated(P<0.05);CD8^(+)in treatment group was down-regulated(P<0.05),which in control group was up-regulated(P<0.05);up-regulated CD3^(+),CD4^(+),CD4^(+)/CD8^(+),NK cells levels in treatment group were found in compared with control group(P<0.05),down-regulated CD8^(+)in treatment group was recorded when compared with control group(P<0.05);serum AFP,CEA,CA19-9 in groups were decreased(P<0.05),which in treatment group were significantly decreased(P<0.05).Conclusion For patients with advanced PLC(spleen-deficiency blood stasis),Peiyuan Kangai Decoction with apatinib mesylate tablets is capable of reducing TM level,toxic and side reactions,improving cellular immune function.