摘要
目的:探讨解毒疏肝组方治疗肝胆湿热型原发性肝癌(PHC)介入术后综合征的临床疗效。方法:选取2018年1月~2019年12月行经动脉化疗栓塞术(TACE)治疗的120例肝胆湿热型PHC患者,运用简单随机数字表法将其随机分成观察组(n=60)与对照组(n=60)。所有患者均行TACE治疗,对照组患者术后行西医常规对症治疗,观察组患者在此基础上内服自拟解毒疏肝组方,连续治疗4周。比较两组患者临床疗效、介入术后综合征各项症状(包括肝区疼痛、恶心呕吐和黄疸等)持续时间和体能状况[卡氏功能状态量表(KPS)评分]。观察两组患者介入术前及术后3 d、4周时血清肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)和总胆红素(TBil)]、甲胎蛋白(AFP)水平、中医证候积分及肝癌患者生存质量问卷(QOL-LC)总分的变化情况。观察并记录自拟解毒疏肝组方的副反应。结果:观察组患者中医证候疗效总有效率显著高于对照组(88.3%vs 68.3%,P<0.05)。与对照组相比,观察组栓塞后综合征各项症状持续时间均显著缩短(P<0.05)。与术前相比,两组患者介入术后第4周时血清ALT、AST、TBil、AFP水平和中医证候积分均显著降低(P<0.05),除AFP水平外,观察组下降更明显(P<0.05)。与术前相比,观察组患者介入术后第4周QOL-LC总分、KPS评分显著高于本组介入术前(P<0.05)。观察组未发生与自拟解毒疏肝组方相关的明显副反应。结论:应用自拟解毒疏肝组方治疗肝胆湿热型PHC介入术后综合征的整体疗效确切,能明显缩短患者临床不适症状持续时间,改善肝功能及体能状况,提高患者生存质量,且安全可靠。
Objective:To explore the clinical efficacy of Jiedu Shugan Prescription in the treatment of primary liver cancer(PHC)syndrome after TACE.Methods:From January 2018 to December 2019,120 PHC patients with liver-gallbladder damp-heat type treated by TACE,and randomly divided into observation group(n=60)and control group(n=60).All patients were basicly treated with TACE,the control group was treated with western medicine routine symptomatic treatment,the observation group was treated with self-made Jiedu Shugan group on the basis of the control group.The clinical effect,the duration of symptoms and the KPS score were compared between two groups.To observe the changes of ALT,AST,TBil,AFP,TCM syndrome score and QOL-LC score in the two groups before and at the 3 d and 4 week after interventional therapy.To record the side effects of Jiedu Shugan prescription.Results:The total effective rate of TCM Syndrome in the observation group was significantly higher than that in control group(88.3%vs 68.3%,P<0.05).The duration of symptoms in the observation group was significantly shorter than that in Control Group(P<0.05).The level of serum ALT,AST,TBil and the score of TCM syndrome were significantly increased(P<0.05)and the total score of QOL-LC were significantly decreased(P<0.05)at the 3rd day after intervention.At the 4th week after intervention,the serum ALT,AST,TBil,AFP level and TCM syndrome score in the two groups were significantly lower than those in control group(P<0.05),and the decrease was more significant in the observation group,except AFP(P<0.05).The total score of QOL-LC and KPS in the observation group was significantly higher than that in the control group at the 4th week after Intervention(P<0.05).The observation group had no obvious side effects related to self-made Jiedu Shugan prescription.Conclusion:The self-made Jiedu Shugan recipe is effective in the treatment of hepatobiliary damp-heat syndrome after PHC intervention.It can obviously shorten the duration of clinical symptoms,improve the liver function a
作者
曹玉鹃
杨元磊
孙韬
艾春健
王爽
张楠
CAO Yu-juan;YANG Yuan-lei;SUN Tao(Department of Hepatology,Cangzhou Infectious Diseases Hospital,Cangzhou Hebei,061000,China)
出处
《中西医结合肝病杂志》
CAS
2021年第8期702-706,共5页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
河北省中医药管理局科研计划项目(No.2020527)。
关键词
原发性肝癌
经动脉化疗栓塞术
介入术后综合征
肝胆湿热证
自拟解毒疏肝组方
primary liver cancer
transcatheter arterial chemoembolization
post-interventional syndrome
damp-heat syndrome of liver and gallbladder
self-made Jiedu Shugan Prescription
