蛭岩消积方联合肝动脉化疗栓塞术治疗原发性肝癌的临床研究

Clinical study on Zhiyan Xiaoji decoction combined with transcatheter arterial chemoembolization in the treatment of primary liver cancer

目的评价蛭岩消积方联合肝动脉化疗栓塞术(TACE)治疗原发性肝癌的临床疗效和对症状、肝功能、凝血功能的影响。方法选取2018年5月—2020年6月在广西医科大学附属肿瘤医院肝脏胆道科、肝脏胰腺科、介入科、中医科的门诊或者住院治疗的原发性肝癌患者85例,随机分为TACE组和中西医联合组,TACE组予TACE治疗,术后观察12周;中西医联合组予TACE联合蛭岩消积方治疗,蛭岩消积方服用12周。治疗12周后对2组患者进行实体瘤疗效评定,观察2组患者治疗第12周中医症状评分、肿瘤指标、肝功能[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBil)、白蛋白(ALB)]、凝血功能[凝血酶原时间(PT)]、体重、KPS评分的变化。结果中西医联合组实体瘤的客观缓解率、疾病控制率均明显高于TACE组(P均<0.05)。2组患者治疗第12周的中医症状评分及血清甲胎蛋白(AFP)、ALT、AST、TBil水平均明显低于治疗前,PT明显短于治疗前,ALB水平和KPS评分明显高于治疗前,且中西医联合组各指标改善情况均显著优于TACE组,差异均有统计学意义(P均<0.05)。TACE组治疗后的体重较治疗前有所下降(P<0.05),中西医联合组治疗后的体重无明显变化(P>0.05)。2组均未出现与药物相关的不良反应。结论蛭岩消积方联合TACE治疗原发性肝癌可以提高实体瘤的客观缓解率和疾病控制率,减轻TACE术后肝损害,改善凝血功能和临床症状,维持体重稳定。

Objective It is to evaluate the clinical efficacy of Zhiyan Xiaoji decoction combined with transcatheter arterial chemoembolization(TACE)in the treatment of primary liver cancer and its influence on symptoms,liver function and blood coagulation function.Methods Eighty-five patients with primary liver cancer who received outpatient or inpatient treatment in the Hepatobiliary Department,Hepatopancreatic Department,Interventional Department,and Traditional Chinese Medicine Departments of the Affiliated Cancer Hospital of Guangxi Medical University from May 2018 to June 2020 were selected and randomly divided into TACE group and combination of traditional and western medicine group.The TACE group was treated with TACE and observed for 12 weeks after operation,the combination group was treated with TACE combined with Zhiyan Xiaoji decoction,the decoction was administered for 12 weeks.At the 12th week of treatment,the curative effect of solid tumors of the two groups was evaluated,and the changes of TCM symptom score,tumor indexes,liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),albumin(ALB)],coagulation function[prothrombin time(PT)],weight and KPS score of the two groups were observed.Results The objective remission rate and disease control rate of solid tumors in the combination group were significantly higher than those in the TACE group(all P<0.05).At the 12th week of treatment in both groups,the scores of TCM symptoms and the levels of serum alpha fetoprotein(AFP),ALT,AST and TBil were significantly lower than those before treatment,PT was significantly shorter than that before treatment,ALB level and KPS score were significantly higher than those before treatment,and the improvement of all indicators in the combination group was significantly better than that in the TACE group,the differences were all statistically significant(all P<0.05).The body weight of TACE group after treatment was decreased compared with that before treatment(P<0.05),but the body of the combination group was not changes obviously after treatment(P>0.05).There was no drug related adverse reaction in both groups during the treatment.Conclusion Zhiyan Xiaoji decoction combined with TACE can improve the objective remission rate and control rate of solid tumors,relieve the liver damage after TACE,improve the coagulation function and clinical symptoms,and maintain the stability of body weight in the treatment of primary liver cancer.