消瘤散联合姑息疗法治疗晚期原发性肝癌的临床观察

Clinical observation of Xiaoliu Powder combined with palliative therapy in the treatment of advanced primary hepatocarcinoma

目的观察在姑息治疗基础上加用消瘤散治疗晚期原发性肝癌的临床疗效。方法将74例已接受过姑息治疗(局部消融或经肝动脉化疗栓塞术)的晚期原发性肝癌随机分为治疗组与对照组,每组37例。对照组予鳖甲煎丸治疗,治疗组予消瘤散治疗。两组疗程均为12个月,随访观察12个月内患者的生存率,比较临床疗效及生活质量评分(KPS)的变化情况。结果 (1)随访期间,治疗组(中药组)3个月、6个月、9个月及12个月的生存率分别为78.4%,67.6%,67.6%,59.5%;对照组3个月、6个月、9个月及12个月的生存率分别为70.3%,56.8%,54.1%,45.9%。组间生存率比较,差异有统计学意义,治疗组明显高于对照组(P<0.05)。(2)治疗组有效率、控制率分别为21.6%、59.5%,对照组有效率、控制率分别为10.8%、45.9%;组间临床疗效比较,差异有统计学意义,治疗组明显优于对照组(P<0.05)。(3)治疗组、对照组KPS评分改善有效率分别为59.5%、43.2%,组间KPS评分改善有效率比较,治疗组明显优于对照组(P<0.05)。结论在姑息治疗基础上,消瘤散治疗晚期原发性肝癌的疗效满意,可显著提高患者的生存率,改善其生存质量。

Objective To observe the clinical efficacy of Xiaoliu Powder combined with palliative therapy in the treatment of advanced primary hepatocarcinoma.Methods 74 patients with advanced primary hepatocarcinoma who had received palliative treatment( partial ablation or transcatheter arterial chemoembolization)were randomly divided into the control group and treatment group,37 cases in each group. The control group was treated with Biejiajian Pill,and the treatment group was treated with Xiaoliu Powder,with a course of 12 months. The survival rate of the patients was observed within 12 months. The clinical efficacy and Karnofsky performance status( KPS) score were compared. Results(1) During the follow-up,the 3-,6-,9-and 12-month survival rates were 78.4%,67.6%,67.6%,59.5%in the treatment group and 70.3%,56.8%,54. 1%,45. 9% in the control group,respectively. There was statistically significant difference on the survival rates between the two groups,and the survival rates of the treatment group were obviously higher than those in the control group( P < 0.05).(2) The effective rate and control rate of the treatment group were 21.6% and 59.5% respectively. The effective rate and control rate of the control group were 10.8% and 45.9%,respectively.There was statistically significant difference on the clinical efficacy between the two groups,the efficacy of the treatment group was obviously better than that of the control group( P<0.05).(3)The effective rates of KPS score improvement were 59.5% in the treatment group and 43.2% in the control group. The improvement on KPS score in the treatment group was obviously better than that in the control group( P< 0.05). Conclusion Xiaoliu Powder combined with palliative treatment shows good efficacy in the treatment of advanced primary hepatocarcinoma,which can significantly improve the survival rate and enhance the survival quality.