酸味方对原发性肝癌经导管肝动脉化疗栓塞术后血清AFP、CEA、CA-125及CD_(4)^(+)/CD_(8)^(+)水平的影响

Effects of Suanwei Formula(酸味方)on Levels of AFP,CEA,CA-125 and CD_(4)^(+)/CD_(8)^(+) in Serum after TACE Operation for Primary Liver Cancer

目的观察酸味方对原发性肝癌经导管肝动脉化疗栓塞(TACE)术后血清甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原-125(CA-125)及CD_(4)^(+)/CD_(8)^(+)水平的影响。方法纳入2019年8月—2022年11月医院收治的82例原发性肝癌患者,采用单纯随机抽样法分为观察组(41例)和对照组(41例)。对照组采用TACE术治疗,术后给予营养支持、抗感染、保肝等对症支持治疗,观察组在对照组基础上服用酸味方,治疗4周。比较两组疾病控制率、治疗前后中医证候积分、肝癌患者生活质量测定量表(QOL-LC)评分;检测治疗前后血清AFP、CEA、CA-125水平;检测治疗前后患者外周血T淋巴细胞亚群CD_(4)^(+)、CD_(8)^(+)及自然杀伤(NK)细胞比例,并计算CD_(4)^(+)/CD_(8)^(+);记录不良反应发生情况。结果两组疾病控制率分别为92.68%(38/41)、75.61%(31/41),观察组疾病控制率较高(P<0.05);两组治疗后中医证候积分较治疗前降低并且观察组低于对照组(P<0.05);治疗后观察组AFP、CEA、CA-125水平分别为(62.35±9.12)ng/mL、(2.13±0.39)μg/mL、(32.37±5.93)U/mL,对照组AFP、CEA、CA-125水平分别为(139.65±20.71)ng/mL、(2.47±0.42)μg/mL、(49.62±6.03)U/mL,观察组血清AFP、CEA、CA-125水平低于对照组(P<0.05);观察组治疗后CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)、NK细胞水平分别为44.08%±5.41%、21.64%±2.96%、1.65%±0.28%、35.42%±3.97%,对照组治疗后CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)、NK细胞水平分别为37.26%±4.76%、25.47%±3.08%、1.22%±0.27%、29.65%±4.25%,观察组CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、NK细胞水平高于对照组,CD_(8)^(+)细胞水平低于对照组(P<0.05);两组治疗后躯体功能、症状评分较治疗前提高并且观察组高于对照组(P<0.05);两组不良反应发生率无明显差异(P>0.05)。结论原发性肝癌TACE术后应用酸味方有利于提高疾病控制率、降低中医证候积分、抑制血清肿瘤标志物水平,提高CD_(4)^(+)/CD_(8)^(+)比值、提高QOL-LC评分,并且安全性较好,具有推广价值。

Objective To observe the effects of Suanwei Formula(酸味方)on the levels of alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate antigen-125(CA-125)and CD_(4)^(+)/CD_(8)^(+)in serum after transcatheter arterial chemoembolization(TACE)for primary liver cancer.Methods A total of 82 patients with primary liver cancer admitted to the hospital from August 2019 to November 2022 were included and divided into observation group(41 cases)and control group(41 cases)by simple random sampling method.The control group was treated with TACE and received symptomatic support such as nutritional support,anti-infection and liver protection after surgery.The observation group was treated with Suanwei Formula for 4 weeks on the basis of the control group.The disease control rate,TCM syndrome score before and after treatment and the scores of liver cancer patients'post-life quality measurement scale(QOL-LC)were compared between the two groups.The levels of AFP,CEA and CA-125 in serum were detected before and after treatment.The proportions of CD_(4)^(+),CD_(8)^(+)and natural killer(NK)cells in T lymphocyte subsets of peripheral blood were detected before and after treatment,and CD_(4)^(+)/CD_(8)^(+)was calculated.The occurrence of adverse reactions was recorded.Results The disease control rates of the two groups were 92.68%(38/41)and 75.61%(31/41),respectively,and the disease control rate of the observation group was higher(P<0.05).TCM syndrome scores of the two groups after treatment were lower than those before treatment,and the score of the observation group was lower than that of the control group(P<0.05).After treatment,the levels of AFP,CEA and CA-125 in the observation group were(62.35±9.12)ng/mL,(2.13±0.39)μg/mL and(32.37±5.93)U/mL,respectively.The levels of AFP,CEA and CA-125 in the control group were(139.65±20.71)ng/mL,(2.47±0.42)μg/mL and(49.62±6.03)U/mL,respectively.The levels of AFP,CEA and CA-125 in the observation group were lower than those in the control group(P<0.05).The levels of CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+)and NK cells in the observation group after treatment were 44.08%±5.41%,21.64%±2.96%,1.65%±0.28%and 35.42%±3.97%,respectively.After treatment,the levels of CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+)and NK cells in the control group were 37.26%±4.76%,25.47%±3.08%,1.22%±0.27%and 29.65%±4.25%,respectively.The levels of CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)and NK cells in the observation group were higher than those in the control group.CD_(8)^(+)cell level was lower than that of the control group(P<0.05).The physical function and symptom scores of the two groups were improved after treatment,and those of the observation group were higher than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The application of Suanwei Formula after TACE surgery for primary liver cancer is beneficial to improve the disease control rate,reduce the TCM syndrome scores,inhibit the levels of serum tumor markers,improve the CD_(4)^(+)/CD_(8)^(+)ratio and the QOL-LC score,and has good safety and popularization value.