理气活血中药对原发性肝癌介入术后增效减毒的结局观察及作用机制探究

Effect and Mechanism of Traditional Chinese Medicine for Regulating Qi and Activating Blood Circulation on Enhancing Efficacy and Decreasing Toxicity in Patients with Primary Liver Cancer after Interventional Therapy

目的研究理气活血中药对原发性肝癌介入术后患者增效减毒的作用结局及机制。方法采用随机遍历抽样法抽取2019年10月—2021年9月医院收治的原发性肝癌介入患者98例作为研究对象,按照数表法将其随机分为观察组和对照组,每组49例。对照组于介入术后采用西医常规疗法、观察组选取理气活血中药干预,连续4周。比较两组患者近期疗效(病灶体积变化、中医证候、体力功能状态和化疗药物不良反应、注射用奥沙利铂神经性毒性)和远期疗效(半年和一年存活率)。结果观察组完全缓解率[26.53%(13/49)]、部分缓解率[53.06%(26/49)]和总有效率[81.63%(40/49)]分别高于对照组[18.37%(9/49)、36.73%(18/49)、63.27%(31/49)],稳定率[2.04%(1/49)]和进展率[18.37%(9/49)]分别低于对照组[8.16%(4/49)、36.73%(18/49)],差异有统计学意义(P<0.05)。治疗后较治疗前,两组患者中医证候评分下降、KPS评分升高,差异有统计学意义(P<0.05);治疗后,观察组中医证候评分低于对照组、KPS评分高于对照组,差异有统计学意义(P<0.05)。观察组患者白细胞数量、血红蛋白含量下降0度构成比均高于对照组,I~IV度构成比低于对照组,差异有统计学意义(P<0.05);血小板数量下降、肝功损伤、肾功损伤0度构成比和I~IV度构成比与对照组比较,差异无统计学意义(P>0.05)。观察组注射用奥沙利铂神经毒性0级构成比高于对照组、1~4级构成比低于对照组,半年存活率和一年存活率均高于对照组,差异有统计学意义(P<0.05)。结论理气活血中药对原发性肝癌介入术后能够起到“增效减毒”的作用且可使患者受益显著,丰富了中医治疗方案,具有光明的应用前景。

Objective To study the effect and mechanism of regulating Qi and activating blood circulation herbs on enhancing efficacy and decreasing toxicity in patients with primary liver cancer after interventional therapy.Methods A total of 98 patients with primary liver cancer undergoing interventional therapy from October 2019 to September 2019 were selected by random con⁃venience method and randomly divided into observation group and control group(49 cases in each group).The short-term effi⁃cacy(focus volume change,TCM syndrome,physical function,chemotherapy drug toxicity,oxaliplatin for injection)and long-term efficacy(half-year and one-year survival rate)were compared between the two groups.Results The complete remission rate[26.53%(13/49)],partial remission rate[53.06%(26/49)]and total effective rate[81.63%(40/49)]were higher than those[18.37%(9/49),36.73%(18/49)and 63.27%(31/49)],respectively.The rate of stability[2.04%(1/49)]and the rate of progression[18.37%(9/49)]were significantly lower than those[8.16%(4/49)and 36.73%(18/49)]of the control group(P<0.05).After treatment,the TCM syndrome score decreased and KPS score increased in the two groups(P<0.05).After treatment,the TCM syndrome score of the observation group was lower than that of the control group,and the KPS score was higher than that of the control group,and the difference was statistically significant(P<0.05).In the observation group,the pro⁃portion of leucocyte count and hemoglobin content decreased by 0 degree was higher than that in the control group,and the pro⁃portion of I-IV degree was lower than that in the control group and the difference was statistically significant(P<0.05).There was no significant difference in platelet count,liver function damage,renal function damage or I~IV ratio between the two groups(P>0.05).The 0 grade composition ratio of oxaliplatin for injection in the observation group was higher than that in the control group,and the 1~4 grade composition ratio was lower than that in the control group.The half year survival rate and one year sur⁃vival rate in the observation group were higher than that in the control group and the difference was statistically significant(P<0.05).Conclusion Traditional Chinese medicine for regulating Qi and activating blood circulation can increase the efficacy and decrease toxicity after interventional therapy of primary liver cancer,and can benefit patients significantly.