摘要
目的观察柔肝化纤解毒方联合肝动脉化疗栓塞术(Transarterial Chemoembolisation,TACE)治疗肝癌肝肾阴虚证的疗效及对肝纤维化指标的影响。方法选取2017年1月—2019年1月期间河南省传染病医院收治的原发性肝癌患者110例,按随机数字表法分为对照组和治疗组,每组各55例。对照组采用TACE治疗,1次/月,连续操作2~3次。治疗组采用柔肝化纤解毒方联合TACE治疗。治疗3个月后,评价两组患者临床疗效,中位生存时间及1年、2年累积生存率,不良反应发生率;观察两组患者治疗前后肝功能指标[谷氨酸氨酸转移酶(Alanine Aminotransferase,ALT)、天冬氨酸氨基转移酶(Aspartate Transaminase,AST)、总胆红素(Total Bilirubin,TBIL)]、纤维化指标[透明质酸(Hyaluronic Acid,HA)、Ⅲ型前胶原肽(Precollagen III N-terminal Peptide,PⅢP)、Ⅳ型胶原(ⅣCollagen,ⅣC)、层粘连蛋白(Laminin,LN)]的变化,采用卡氏评分表(Karnofsky,KPS)评估患者体力状况。结果治疗后治疗组有效率为45.45%、疾病控制率为83.63%,均明显高于对照组有效率32.72%及疾病控制率72.72%,两组比较,差异有统计学意义(P<0.05)。治疗组中位生存时间为(32.26±6.94)个月,与对照组中位生存时间(21.84±6.28)个月比较明显增加,差异有统计学意义(P<0.05);治疗组1年生存率为83.64%(46/55),2年生存率为56.36%(31/55)均较对照组1年生存率61.82%(34/55),2年生存率40.00%(22/55)明显升高,差异有统计学意义(P<0.05)。治疗后两组患者血清TBIL、AST、ALT、HA、LN、PCⅢ、IV-C水平均较治疗前明显降低,差异有统计学意义(P<0.05);且治疗组血清TBIL、AST、ALT、HA、LN、PCⅢ、Ⅳ-C水平均较对照组明显降低,差异有统计学意义(P<0.05)。治疗3个月后治疗组KPS评分(85.49±7.43)分与对照组(76.38±8.67)分比较明显升高,差异有统计学意义(P<0.05)。治疗组不良反应发生率与对照组比较明显降低,差异有统计学意义(P<0.05)。结论柔肝化纤�
Objective To observe the therapeutic effect of Rougan Huaxian Jiedu Decoction combined with transcatheter arterial chemoembolization(TACE)on hepatocellular carcinoma(liver-kidney yin deficiency syndrome)and liver fibrosis indexes.Methods A total of 110 patients with primary hepatic carcinoma treated in Henan Infectious Disease Hospital from January 2017 to January 2019 were randomly assigned into groups A and B,with 55 cases in each group.Group A was treated with TACE(once a month for two or three continuous months),and group B with Rougan Huaxian Jiedu Decoction combined with TACE.The treatments in both groups lasted for three months,and then the clinical efficacywas compared between the two groups.The median survival time,1-year and 2-year cumulative survival rates,and the incidence of adverse reactions in the two groups were evaluated.Furthermore,the liver function indexes[Alanine Aminotransferase(ALT),Aspartate Transaminase(AST),and Total Bilirubin(TBIL)]and fibrosis indexes[Hyaluronic Acid(HA),Precollagen III N-terminal Peptide(PIIIP),IV Collagen(IV-C),and Laminin(LN)]were compared between before and after treatment and between the two groups.Karnofsky Performance Status Scale(KPS)was employed to assess the physical status of the patients.Results Group B had higher effective rate(45.45%vs.32.72%,P<0.05)and disease control rate(83.63%vs.72.72%,P<0.05)than group A.Further,group B had longer median survival time[(32.26±6.94)months vs.(21.84±6.28)months,P<0.05],higher 1-year survival rate[83.64%(46/55)vs.61.82%(34/55),P<0.05],and higher 2-year survival rate[56.36%(31/55)vs.40.00%(22/55),P<0.05]than group A.After three months of treatment,the TBIL,AST,ALT,HA,LN,PIIIP,and IV-C levels in both groups reduced compared with those before treatment and were lower in group B than in group A(P<0.05).Conclusion Rougan Huaxian Jiedu Decoction combined with TACE demonstrates remarkable therapeutic effect on hepatocellular carcinoma(liver-kidney yin deficiency syndrome),which can increase the survival rate,improve liver fun
作者
李会杰
郑五州
郭亚南
张安娜
LI Hui-jie;ZHENG Wu-zhou;GUO Ya-nan;ZHANG An-na(Department of Integrated Traditional Chinese and Western Medicine for Hepatitis,Henan Infectious Disease Hospital/The Sixth People′s Hospital of Zhengzhou,Zhengzhou Henan 450015;Department of Critical Care Medicine,Henan Infectious Disease Hospital/The Sixth People′s Hospital of Zhengzhou,Zhengzhou Henan 450015)
出处
《世界中西医结合杂志》
2022年第5期973-977,共5页
World Journal of Integrated Traditional and Western Medicine
基金
河南省中医药科学研究专项课题(2017ZY02086)。
关键词
原发性肝癌
肝肾阴虚证
柔肝化纤解毒方
肝动脉化疗栓塞术
纤维化
Primary Hepatic Carcinoma
Liver and Kidney Yin Deficiency Syndrome
Rougan Huaxian Jiedu Decoction
Transcatheter Arterial Chemoembolization
Fibrosis
