穴位敷贴改善原发性肝癌患者肝功能和凝血功能的研究

Effect of acupoint application on liver function and coagulation function of patients with primary liver cancer

目的:探讨穴位敷贴对原发性肝癌患者肝功能和凝血功能的作用。方法:将64例原发性肝癌患者随机分为两组(每组32例):对照组采用常规保肝治疗。治疗组采用穴位敷贴联合常规保肝治疗。治疗前后,记录两组患者卡氏评分(karnofsky performance score,KPS)及药物不良反应;检测血液肝功能指标:谷草转氨酶(aspartate aminotransferase,AST)、谷丙转氨酶(alanine aminotransferase,ALT)和总胆红素(total bilirubin,TBIL)的含量;测定凝血因子Ⅱ(FⅡ)、Ⅶ(FⅦ)和Ⅷ(FⅧ)水平以及凝血功能四项指标:凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶时间(thromboplastin time,TT)和纤维蛋白原(fibrinogen,FIB)。结果:治疗前两组患者的基线资料无统计学差异(P>0.05)。治疗后,两组患者的各项指标均显著有改善。而且治疗组患者卡式评分(71.26±6.20)高于对照组(62.15±6.78);不良反应发生率(37.50%)低于对照组(62.63%)(P<0.05);AST(51.93±7.85)U/L、ALT(49.83±8.21)U/L和TBIL(23.56±4.75)μmol/L水平均小于对照组(56.44±8.26)U/L、(54.65±6.44)U/L和(26.17±4.01)μmol/L(P<0.05);凝血因子FⅡ(89.31±15.40)%、FⅦ(92.85±12.44)%和FⅧ(75.65±12.53)%水平高于对照组(80.11±13.82)%、(86.83±10.21)%和(68.24±10.94)%(P<0.05);PT(15.24±3.83)s、APTT(34.42±4.76)s和TT(13.69±2.86)s低于对照组(17.62±3.45)s、(37.44±6.24)s和(15.50±3.01)s,FIB(4.57±0.80)g/L高于对照组(4.05±0.91)g/L(P<0.05)。结论:穴位敷贴能有效提高原发性肝癌患者生存质量,降低药物不良反应发生率,改善患者肝功能和凝血功能。

Objective:To explore the effect of acupoint application on liver function and coagulation function of patients with primary liver cancer.Methods:Sixty-four patients with primary liver cancer were randomly divided into two groups(n=32 per group).The control group was treated with conventional hepatoprotective therapy,while the treatment group was treated with acupoint application combined with the conventional hepatoprotective therapy.Before and after treatment,the karnofsky performance score(KPS)and adverse reactions of the two groups were recorded.The levels of serum liver function indexes including aspartate aminotransferase(AST),alanine aminotransferase(ALT)and total bilirubin(TBIL)were detected.The levels of plasma coagulation factorⅡ(FⅡ),Ⅶ(FⅦ),Ⅷ(FⅧ)and four indexes of coagulation function including prothrombin time(PT),activated partial thromboplastin time(APTT),thromboplastin time(TT)and fibrinogen(FIB)were determined.Results:There was no significant difference in baseline data(gender,age,course of disease and clinical stage)between the two groups(P>0.05).After treatment,patients in both two groups showed improvement in all observation indexes.Moreover,in the treatment group,the KPS of patients(71.26±6.20)were higher than those in the control group(62.15±6.78),and the incidence of adverse reactions(37.50%)was lower than that in the control group(62.63%)(P<0.05).The levels of AST(51.93±7.85)U/L,ALT(49.83±8.21)U/L and TBIL(23.56±4.75)μmol/L in the treatment group were less than the levels of control(56.44±8.26)U/L,(54.65±6.44)U/L and(26.17±4.01)μmol/L(P<0.05).The levels of FII(89.31±15.40)%,FⅦ(92.85±12.44)%and FⅧ(75.65±12.53)%in the treatment group were higher than the control(80.11±13.82)%,(86.83±10.21)%and(68.24±10.94)%(P<0.05).The coagulation function indexes PT(15.24±3.83)s,APTT(34.42±4.76)s and TT(13.69±2.86)s in the treatment group were lower than the control(17.62±3.45)s,(37.44±6.24)s and(15.50±3.01)s,and FIB(4.57±0.80)g/L in the treatment group is higher than the control(4.05±0.91)g/L(P<0.05).Conclusion:Acupoint application can effectively improve the quality of life,decrease the incidence of adverse drug reactions,and improve the liver function and coagulation function of patients with primary liver cancer.