扶正解毒法辅助治疗原发性肝癌的疗效

Efficacy of method of strengthening vital qi and detoxication as an adjuvant therapy in the treatment of primary liver cancer

目的分析原发性肝癌患者经扶正解毒法结合腹腔镜肝癌根治术治疗后的疗效及肿瘤标志物、免疫功能变化。方法选择182例原发性肝癌患者,随机数表法分为对照组与观察组,各91例,对照组予腹腔镜肝癌根治术,观察组在对照组基础上予扶正解毒法治疗4周,2组术后均随访2年。比较2组术后4周疗效、并发症,术前、术后4周肝功能、生命质量、肿瘤标志物、免疫功能及术后2年复发率。结果术后4周,观察组总有效率(79.12%,72/91)高于对照组(64.84%,59/91)(P<0.05)。与术前比较,术后4周,2组血清总胆红素(TBIL)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、谷丙转氨酶(ALT)、癌胚抗原(CEA)、甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)、高尔基体糖蛋白73(GP73)水平降低,观察组低于对照组(P<0.05);2组生命质量(EORTC QLQ-30)评分、外周血CD16+CD56+、NK细胞水平升高,观察组高于对照组(P<0.05)。术后4周,观察组并发症发生率低于对照组(P<0.05);术后2年,观察组复发率低于对照组(P<0.05)。结论原发性肝癌患者经扶正解毒法结合腹腔镜肝癌根治术治疗后疗效显著,可抑制肿瘤标志物的分泌,改善患者肝功能与免疫功能,预防并发症发生与复发,有助于提高患者生活质量。

Objective To analyze the curative effect,and changes of tumor markers and immune function of patients with primary liver cancer treated by strengthening vital qi and removing toxicity substance combined with laparoscopic radical resection of liver cancer.Methods 182 patients with primary liver cancer were selected and divided into the control group and the observation group according to random number table method,with 91 cases in each group.The control group was treated with laparoscopic radical resection of liver cancer,and the observation group was treated with method of strengthening vital qi and removing toxicity substance for 4 weeks on the basis of the treatment of the control group.Both groups were followed up for 2 years after operation.The curative effect and complications at 4 weeks after operation,and liver function,quality of life,tumor markers,immune function before operation and at 4 weeks after operation,and 2-year recurrence rate after operation were observed and compared in the two groups.Results At 4 weeks after operation,the total effective rate in the observation group(79.12%,72/91)was higher than that in the control group(64.84%,59/91)(P<0.05).Compared with before operation,at 4 weeks after operation,the levels of serum total bilirubin(TBIL),glutamic oxaloacetic transaminase(AST),alkaline phosphatase(ALP),glutamic-pyruvic transaminase(ALT),carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP),alphafetoprotein variant(AFP-L3)and Golgi glycoprotein 73(GP73)in the two groups decreased,and the levels in the observation group were lower than those in the control group(P<0.05);The quality of life(EORTC QLQ-30)score,and the levels of CD16+CD56+and NK cell in peripheral blood in both groups increased,and the observation group was higher than the control group(P<0.05).At 4 weeks after operation,the incidence of complications in the observation group was lower than that in the control group(P<0.05);At 2 years after operation,the recurrence rate of the observation group was lower than that of the control group(P<0.05).Conclusion The treatment of the patients with primary liver cancer with the combination of strengthening vital qi and removing toxicity substance and laparoscopic radical resection of liver cancer has significant curative effect,which can inhibit the secretion of tumor markers,improve the liver function and immune function of patients,prevent complications and recurrence,and help to improve the quality of life of patients.