扶正消瘤颗粒治疗综合介入术后Ⅲa期原发性肝癌患者临床疗效及对血清FGFR4、TGF-β1的影响

The clinical efficacy of FuzhengXiaoliu granule in the treatment of stage Ⅲa primary liver cancer after comprehensive intervention and its effect on serum FGFR4 and TGF-β1

目的:观察扶正消瘤颗粒治疗综合介入(肝动脉化疗栓塞联合碘125粒子植入)术后Ⅲa期原发性肝癌患者的临床疗效,分析治疗前后患者血清成纤维细胞生长因子受体4(FGFR4)、转化生长因子β1(TGF-β1)的变化及其临床意义。方法:纳入我院住院及门诊经综合介入治疗术后Ⅲa期原发性肝癌患者60例,采用随机数字表法分为对照组和治疗组各30例。对照组患者采用基础治疗,包括抗病毒、保肝、护胃、补充白蛋白等;治疗组患者在对照组患者治疗基础上口服扶正消瘤颗粒,1剂/d,200 ml开水冲化,分两次服用。治疗6个月时比较两组患者无进展生存时间(PFS)、治疗前及治疗后2个月时血清FGFR4、TGF-β1、甲胎蛋白(AFP)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)的水平及卡式评分和中医证候积分的变化。结果:治疗组患者与对照组患者PFS分别为(4.37±0.31)月、(3.32±0.27)月,两组比较差异有统计学意义(P=0.011);治疗后两组患者AFP、ALT、AST水平均较治疗前降低,且治疗组患者各项指标均低于对照组,差异有统计学意义(P=0.041、P<0.001);治疗后两组患者中医证候积分和KPS评分均较治疗前改善,且治疗组优于对照组,差异有统计学意义(P=0.004、P=0.041)。结论:综合介入治疗是Ⅲa期原发性肝癌的有效治疗方法,联合中药扶正消瘤颗粒可提高疗效,延长患者综合介入术后无进展生存期,降低血清中FGFR4、TGF-β1的水平,延缓病情进展,改善肝功能,提高生存质量。

Objective:We aim to investigate the clinical efficacy of FuzhengXiaoliu granule in the treatment of stage Ⅲa primary liver cancer(PLC)after comprehensive interventional therapy(transcatheter arterial chemoembolization combined with Iodine 125 seeds implantation),and observe the changes and clinical significance of fibroblast growth factor receptor 4(FGFR4)and transforming growth factor β1(TGF-β1)before and after treatment.Methods:A total of 60 patients with stage Ⅲa PLC after comprehensive interventional therapy in our hospital were enrolled in this study.They were divided into the control group and the treatment group with 30 cases each by a random number table.The control group was given basic treatment,and the treatment group was given FuzhengXiaoliu Granule on the basis of the control group.The changes in progression-free survival(PFS)of the two groups were compared after 6 months of treatment.The levels of serum FGFR4,TGF-β1,alpha fetoprotein(AFP),alanine aminotransferase(ALT),and aspartate aminotransferase(AST)were compared before treatment and two months after treatment,and the changes in card score and TCM symptom score were compared.Results:The PFS of the treatment group and the control group were 4.37±0.31(month)and 3.32±0.27(month),respectively.There was a statistical difference between the two groups(P=0.011);After treatment,the levels of AFP,ALT,and AST in the two groups were lower than before treatment,and the treatment group was lower than the control group.There was a statistical difference between the two groups(P=0.041,P<0.001);After treatment,the TCM syndrome score and KPS score of the two groups were improved compared with before treatment,and the treatment group was better than the control group.There was a statistical difference between the two groups(P=0.004,P=0.041).Conclusion:SION The results show that comprehensive intervention is an effective treatment for stage Ⅲa PLC.traditional Chinese medicine(Fuzheng Xiaoliu Granules)can improve the efficacy,prolong the progression-free survival after the comprehensive intervention,and reduce serum FGFR4 and TGF-β1 at the same time,delay the progression of the disease,improve liver function,and improve the quality of life.