柔肝化纤解毒颗粒联合TACE治疗原发性肝癌疗效及对其血清指标和免疫功能的影响

Clinical effect of Rougan Huaxian Granules combined with TACE in the treatment of primary liver cancer and its effect on serum index and immune function

目的:探讨柔肝化纤解毒颗粒对原发性肝癌(PLC)患者的临床疗效及血清炎症指标、免疫功能的影响。方法:选取2018年9月至2020年4月就诊的PLC患者70例,采用随机数表法随机分为治疗组和对照组,每组35例。对照组给予肝动脉化疗栓塞术(TACE)治疗,治疗组在对照组治疗基础上给予柔肝化纤解毒颗粒治疗。观察两组患者治疗前后疗效、中医证候、肿瘤标志物癌胚抗原(CEA),甲胎蛋白(AFP),糖抗原(CA199)含量、缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)、基质金属蛋白酶(MMP)-2、MMP-9、胰岛素生长因子-2(IGF-2)、T淋巴细胞亚群(CD_(4)^(+)、CD_(8)^(+))及免疫球蛋白(IgA、IgG、IgM)的含量及不良反应。结果:两组患者治疗后,治疗组总有效率显著高于对照组(P<0.05);两组患者的中医症状评分(胁下痞块、胁痛、腹部胀满、恶心呕吐、倦怠乏力及腹泻便溏)均显著低于本组治疗前(P<0.05),且治疗组优于同期对照组(P<0.05);两组患者血清中CEA,AFP,CA199、HIF-1α、VEGF、MMP-2、MMP-9、IGF-2含量显著低于本组治疗前(P<0.05),且治疗组优于对照组(P<0.05);两组患者T淋巴细胞(CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))及免疫球蛋白(IgA、IgG、IgM)较本组治疗前明显改善(P<0.05),且治疗组优于对照组(P<0.05);治疗组在发热、恶心呕吐、骨髓抑制、乏力等不良反应方面均显著低于对照组(P<0.05)。结论:柔肝化纤解毒颗粒联合TACE能显著提高PLC患者的临床疗效,改善血清相关指标HIF-1α、VEGF、MMP-2、MMP-9、IGF-2及机体免疫功能,并在一定程度上提高患者生活质量,值得借鉴。

Objective:To investigate the clinical efficacy,serum inflammatory index and immune function of primary liver cancer(PLC)patients treated with Rougan Huaxian Granules.Methods:A total of 70 patients with Rougan Huaxian Granules who visited the clinic from September 2018 to April 2020 were selected.The control group was treated with hepatic artery chemoembolization(TACE).Clinical effects before and after treatment,TCM syndromes(hypogastric gangrene,flank pain,abdominal fullness,nausea,vomiting,fatigue and diarrhea),tumor markers CEA,alpha fetoprotein(AFP),Sugar antigen(CA199)content,hypoxia inducing factor-1α(HIF-1α),vascular endothelial growth factor(VEGF),matrix metalloproteinase(MMP)-2 and matrix metalloproteinases 9(MMP-9)and insulin growth factor 2(IGF-2),T lymphocyte subsets(CD4^(+),CD8^(+))and immunoglobulin(IgA,IgG,IgM)levels and adverse reactions.Results:After treatment,the total effective rate of the treatment group was significantly higher than that of the control group(P<0.05).The TCM symptom scores of the two groups were significantly lower than before treatment(P<0.05),and the treatment group was better than the control group(P<0.05).The contents of CEA,AFP and CA199 in the serum of the two groups were significantly lower than before treatment(P<0.05),and the treatment group was better than the control group(P<0.05).Serum levels of HIF-1α,VEGF,MMP-2,MMP-9 and IGF-2 in the two groups were significantly lower than before treatment(P<0.05),and the treatment group was better than the control group(P<0.05).T lymphocytes(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))and immunoglobulin(IgA,IgG,IgM)in the two groups were significantly improved compared with those before treatment(P<0.05),and the treatment group was better than the control group(P<0.05).The treatment group was significantly lower than the control group in terms of fever,nausea and vomiting,bone marrow suppression,fatigue and other adverse reactions(P<0.05).Conclusion:The combination of Rougan Huaxian Granules and TACE can significantly improve the clinical efficacy of patients with primary liver cancer,improve the serum related indicators of HIF-1α,VEGF,MMP-2,MMP-9,IGF-2 and the immune function of the body,and improve the quality of life of patients to some extent,which is worth learning.