大黄■虫丸合消瘿汤对老年晚期原发性肝癌患者生存率的影响

Study on Effect of Dahuang Zhechong Pill Combined with Xiaoying Decoction on Survival Rate of Elderly Patients with Advanced Primary Hepatocellular Carcinoma

目的:探讨大黄?虫丸合消瘿汤对老年晚期原发性肝癌患者生存率的影响。方法:将2012年8月—2015年8月本院晚期原发性肝癌老年患者90例,随机分两组,各45例,对照组采用吉西他滨+奥沙利铂化疗方案;在此基础上,观察组采用大黄?虫丸9 g口服合消瘿汤治疗,每日1剂,持续治疗4周。比较两组患者的临床疗效、中医证候积分及血谷丙转氨酶(Alanine aminotransferase,ALT)、天冬氨酸转氨酶(Aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBIL)、甲胎蛋白(Alpha fetoprotein,AFP)水平,进行随访,比较两组间生存率。结果:对照组客观缓解率71. 11%低于观察组88. 89%,差异具有统计学意义(P <0. 05)。治疗后对照组和观察组腹部积块评分(1. 02±0. 45)、(0. 61±0. 40),面色黧黑为(0. 93±0. 42)、(0. 58±0. 39),纳减乏力为(0. 86±0. 47)、(0. 43±0. 35),舌质紫黯为(0. 97±0. 45)、(0. 39±0. 32),血ALT为(50. 21±9. 23) IU/L、(44. 89±8. 94) IU/L,AST为(53. 18±12. 86) IU/L、(45. 89±12. 25) IU/L,TBIL为(18. 52±5. 67)μmol/L、(15. 82±5. 29)μmol/L,AFP为(79. 24±9. 57)μg/L、(71. 35±8. 95)μg/L,对照组和观察组上述指标比较,差异具有统计学意义(P <0. 05)。两组患者不良率比较,差异无统计学意义(P> 0. 05)。对照组第3年生存率31. 11%低于观察组48. 89%,差异具有统计学意义(P <0. 05)。结论:大黄?虫丸合消瘿汤对老年晚期原发性肝癌患者的疗效显著,改善中医证候和肝功能,提高生存状况,且安全性高,值得推广。

Objective:To investigate the effect of Dahuang Zhechong Pill combined with Xiaoying Decoction on the survival rate of elderly patients with advanced primary liver cancer.Methods:Ninety elderly patients with advanced primary liver cancer in our hospital from August 2012 to August 2015 were randomly divided into two groups,45 cases in each group.The control group received gemcitabine and oxaliplatin chemotherapy regimen.The observation group additionally received Dahuang Zhechong Pill 9 g orally combined with Xiaoying Decoction,one dose a day,and two groups were treated for 4 weeks.The clinical efficacy,TCM syndrome score and the levels of Alanine aminotransferase(ALT),Aspartate aminotransferase(AST),total bilirubin(TBIL)and alpha fetoprotein(AFP)were compared between the two groups and the survival rates were compared.Results:The objective remission rate of the control group(71.11%)was lower than that of the observation group(88.89%)(P<0.05).After treatment,the scores of abdominal mass were(1.02±0.45)and(0.61±0.40)in the control and observation groups.The dark complexion scores in the control and observation groups were(0.93±0.42)and(0.58±0.39).Subtraction and fatigue scores in the control and observation groups were(0.86±0.47)and(0.43±0.35).Purple tongue scores in the control and observation groups were(0.97±0.45)and(0.39±0.32).The serum ALT levels in the control and observation groups were(50.21±9.23)IU/L and(44.89±8.94)IU/L.AST levels in the control and observation groups were(53.18±12.86)IU/L and(45.89±12.25)IU/L,TBIL levels in the control and observation groups were(18.52±5.67)μmol/L and(15.82±5.29)μmol/L.AFP levels in the control and observation groups were(79.24±9.57)μg/L and(71.35±8.95)μg/L.The difference between the control group and the observation group was statistically significant(P<0.05).There was no significant difference in the adverse rate between the two groups(P>0.05).The 3-year survival rate of the control group(31.11%)was lower than that of the observation group(48.89%)(P<0.05).Conclusion:Dahuang Zhechong Pill combined with Xiaoying Decoction is effective in the treatment of elderly patients with advanced primary liver cancer.They can improve TCM syndromes and liver function,survival status,and have high safety,being worthy of promotion.