中药联合肝动脉化疗栓塞术治疗原发性肝癌临床研究

目的观察中药联合肝动脉化疗栓塞术(TACE)治疗中晚期原发性肝癌的疗效及对机体免疫力、生活质量、毒副反应的影响。方法67例中晚期原发性肝癌患者,分为中药联合TACE组(中药组,35例)和单纯TACE组(TACE组,32例)。两组灌注的化疗药物均为健择(GEM)和顺铂(DDP),术后给予常规水化等处理。两组均进行1次TACE治疗,中药组根据中医辨证施治原则加服中药,两组均于TACE术前、术后1周和4周检查外周血T淋巴细胞亚群、NK细胞并进行生活质量评分(KPS),术后4周对患者进行CT或MRI检查并评价近期疗效。结果中药组和TACE组有效率分别为51.4%(18/35)、37.5%(12/32),两组比较差异无统计学意义。两组治疗1周后T淋巴细胞亚群中CD3+、CD4+、CD4+/CD8+、NK细胞活性以及KPS较治疗前轻度下降,差异无统计学意义;两组治疗4周后与治疗前及治疗1周后比较差异皆有统计学意义;治疗4周后两组间比较差异有统计学意义(P<0.05),中药组优于TACE组。主要的毒副反应是发热、消化道反应及白细胞、血小板减少等;其中发热的发生率中药组低于TACE组(P<0.05)。结论中药联合肝动脉化疗栓塞术治疗原发性肝癌可提高机体免疫功能,改善生活质量,减轻发热等毒副反应。

英文摘要:

Objective To observe the effect of traditional Chinese medicine(TCM)combining transcatheter arterial chemoembolization(TACE)in patients with primary hepatocarcinoma(PHC),and its influence on patients’ immunity,quality of life and adverse reaction.MethodsSixty-seven patients with mid-advanced stage PHC were assignd to two groups:the 35 patients in Group 1 treated with TCM combined TACE and the 32 in Group 2 treated with TACE alone.TACE with Gemzar(GEM)and Cisplatinum(DDP)were applied once in both groups,and followed by conventional post-operational management as hydration.The TCM used was prescribed according to syndrome differentiation.Peripheral blood T-lymphocyte subsets and natural killer(NK)cells of patients were measured before treatment(as the base line)and at the end of the 1st and 4th week after treatment(W1,W4),patients’ quality of life(QOL)was estimated at the sametime by Karnofsky sore(KPS).Moreover,CT or MRI examination was performed at end of the 4th week to evaluate the short-term efficacy of treatment.ResultsShort-term efficacy analyses showed that the effective rate was 51.4%(18/35)in Group 1 and 37.5%(12/32)in Group 2,showing insignificant difference between them(P>0.05).The levels of CD+3,CD+4,CD+4/CD+8,NK cells actionties and KPS score reduced slightly in both groups at W1,with no significant inter-group difference;but at W4,they did show significant differences between groups,and all indices in both groups were significantly different to those of the baseline and at W1(P<0.05 or P<0.01).Aduerse reaction occurred were mainly fever,digestive reaction and lowering of peripheral white blood cell counting,platelet counting,etc.and the incidence of fever in Group 1 was lower than in Group 2.ConclusionTCM treatment combined with TACE can enhance the immunity and QOL of PHC patients,and alleviate the adverse reaction of chemotherapeutic agents.

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