摘要
目的:观察季德胜蛇药治疗中晚期湿热瘀毒型肝癌患者的临床疗效以及对患者血清miR-335的影响。方法:选取2019年1月—2021年9月在南通大学附属南通第三医院住院部准备接受治疗的62例符合研究条件的中晚期湿热瘀毒型肝癌患者,将他们随机分为观察组和对照组各31例,在西医对症药物治疗的基础上观察组给予季德胜蛇药口服治疗3个月,而对照组不予中药治疗,3个月后进行复诊。对比2组肝癌患者治疗前后的谷草转氨酶(AST)、谷丙转氨酶(ALT)、白蛋白(ALB)、总胆红素(TBIL)情况,治疗前后T淋巴细胞水平变化情况,加用季德胜蛇药治疗后的临床有效率以及患者生活质量改变情况,对比分析不良反应的发生率。比较治疗时、治疗后1个月、治疗后3个月患者外周血中miR-335表达水平。结果:治疗后,2组患者AST、ALT、TBIL均低于治疗前(P<0.05),同时观察组这3项指标均显著低于对照组(P<0.05);2组治疗前后ALB指标无明显变化(P>0.05)。治疗后,2组患者T淋巴细胞检测CD4^(+)、CD4^(+)/CD8^(+)指标均较治疗前升高(P<0.05),且观察组均高于对照组(P<0.05);2组治疗前后CD8^(+)表达水平无明显改变(P>0.05)。加用季德胜蛇药治疗后的肝癌患者临床治疗有效率为74.19%,高于对照组的61.29%(P<0.05);生活质量提高率为67.74%,高于对照组的48.39%(P<0.05);生活质量下降率为12.90%,低于对照组的25.81%(P<0.05);加用季德胜蛇药治疗后没有提高药物不良反应发生率(P>0.05)。2组患者治疗时外周血miR-335表达差异无统计学意义(P>0.05),治疗后1个月观察组外周血miR-335表达较治疗时有所升高,治疗后3个月明显高于治疗时(P<0.05),而对照组基本持平(P=0.969)。结论:应用季德胜蛇药对中晚期湿热瘀毒型肝癌患者可以提高患者临床疗效,改善患者生活质量,并且能提高患者外周血miR-335表达水平,具有一定的抗癌临床应用意义。
Objective:To observe the clinical effect of Jidesheng snake medicine on patients with middle and advanced liver cancer of damp-heat and stasis toxin syndrome and study its effect on serum miR-335.Methods:Sixty-two patients with middle and advanced liver cancer of damp-heat and stasis toxin syndrome who were prepared for basic treatment in the inpatient department of Nantong Third Hospital were selected from January 2019 to September 2021.They were randomly divided into observation group and control group(n=31),on the basis of western medicine symptomatic drug treatment,the observation group was given Jidesheng snake medicine oral treatment for 3 months,while the control group was not given Traditional Chinese Medicine treatment.A follow-up visit was made after 3 months.The levels of AST,ALT,ALB,TBIL and the changes of T lymphocyte level were compared between the two groups of liver cancer patients before and after treatment.To compare the clinical effective rate and life quality of patients treated with Jidesheng snake medicine.The incidence of adverse reactions was analyzed.The expression levels of miR-335 in peripheral blood of patients were compared at the time of treatment,one month and three months after treatment.Results:AST,ALT and TBIL after treatment in two groups were lower than before treatment(P<0.05),and the above three indexes in observation group were significantly lower than those in control group(P<0.05).There was no significant change in ALB before and after treatment in both groups(P>0.05).CD4^(+)and CD4^(+)/CD8^(+)indexes of T lymphocytes after treatment in two groups were increased compared with those before treatment(P<0.05),and the two indexes in observation group were higher than those in control group(P<0.05).There was no significant change in CD8^(+)expression before and after treatment(P>0.05).The effective rate of liver cancer patients treated with Jidesheng snake medicine was 74.19%,which was higher than that of 61.29%in the control group(P<0.05),the improvement rate of life quality w
作者
张玉
高倩
邵建国
达坤林
陈宇锋
翁佳欣
陈琳
ZHANG Yu;GAO Qian;SHAO Jianguo;DA Kunlin;CHEN Yufeng;WENG Jiaxin;CHEN Lin(Department of Traditional Chinese Medicine,Nantong Third Hospital,Nantong University,Nantong,Jiangsu,226006,China;Department of Respiratory Medicine,Nantong Third Hospital,Nantong University;Institute of Liver Disease,Nantong Third Hospital,Nantong University)
出处
《中国中西医结合消化杂志》
CAS
2022年第6期411-418,共8页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
基金
南通市卫生健康委员会科研立项课题(No:QA2020030)
江苏省卫健委课题(No:Z2020011)
南通市科技局(No:MS22020014)。
