肝积方联合鸦胆子油乳介入治疗对中晚期原发性肝癌患者生活质量的影响

Effect of Ganji Recipe Combined with Fructus Bruceae Oil Emulsion Intervention on Quality of Life in Patients with Advanced Primary Hepatic Cancer

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中文关键词: 肝癌中医药疗法放射介入肝积方生活质量

英文关键词:primary hepatic cancer TCM treatment radiation intervention Ganji Recipe quality of life

基金项目:广东省科技厅资助课题(No.2005B36001012)

作者	单位
王斌	广东省佛山市中医院肿瘤科
田华琴	广东省佛山市中医院肿瘤科
梁贵文	广东省佛山市中医院肿瘤科
黄小青	广东省佛山市中医院肿瘤科
陈学彰	广东省佛山市中医院肿瘤科
黄志庆	广东省佛山市中医院肿瘤科

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中文摘要:

目的观察并比较经中药复方肝积方口服联合鸦胆子油乳介入治疗和经肝动脉化疗栓塞术治疗中晚期原发性肝癌患者的生活质量和生存期。方法将77例原发性肝癌住院患者按随机数字表法分为中药治疗组(40例)与西药对照组(37例)。两组均采用Seldinger’s技术分别行肝动脉鸦胆子油乳及化疗药介入治疗,中药治疗组同时加用中药肝积方汤剂口服治疗。4周为1个疗程,两组视情况一般间隔4～6周重复介入1次,平均每例行2.3次介入,观察两组患者的生活质量及生存期。结果两组治疗后卡氏评分变化比较差异有统计学意义,中药治疗组优于西药对照组(P<0.05);按昆明医学院万崇华等制定的肝癌患者生活质量测定量表进行评分提示:中药治疗组治疗后躯体功能改善,症状减轻,总的生活质量较治疗前提高;西药对照组治疗后其副作用较明显,总的生活质量降低。中药治疗组治疗后躯体功能、症状、总的生活质量改善程度较西药对照组佳,差异有统计学意义(P<0.05)。治疗后3个月生存率两组比较差异无显著意义(P>0.05),但0.5、1年生存率,中药治疗组分别为67.6%(25/37)、38.2%(13/34),西药对照组分别为42.4%(14/33)、16.1%(5/31),中药治疗组高于西药对照组,差异有统计学意义(P<0.05)。两组患者的中位生存期分别为8.9个月及5.3个月。结论中药复方肝积方联合鸦胆子油乳介入治疗中晚期原发性肝癌,可以提高患者生活质量,提高0.5年和1年生存率,对提高疗效和改善预后有一定的积极意义。

英文摘要:

Objective To observe and compare the quality of life(QOL)and survival time in patients with advanced primary hepatic cancer(PHC)after they have been treated by the combination of Ganji Recipe and interventional therapy with Fructus Bruceae Oil Emulsion(FBE)or by the trans-hepatic arterial chemical embolization(TACE)adopting Seldinger’s technique.MethodsSeventy-seven patients with advanced PHC were randomly assigned to two groups,37 patients in the control group treated with TACE alone,and 40 in the treatment group with the combined therapy.One therapeutic course was 4 weeks,and the intervention therapy was repeated generally after an interval of 4-6 weeks according to patients’ condition,the average intervention frequency was 2.3 for one case.The QOL and the survival time in patients were evaluated after treatment.ResultsSignificant difference was shown in the changes of the Karnofsky score between the two groups(P<0.05).The scores suggested that the improvements in the treatment group,including patients’ physical energy enhancing,symptoms alleviating and overall QOL improving,were superior to those in the control group(P<0.05).No significant difference of the 3-month survival rate between the two groups was found(P>0.05),but the 0.5-and 1-year survival rate were significantly superior in the treatment group to those in the control group(67.6% vs 42.4% and 38.2% vs 16.1%,respectively).The median survival time in the two groups was 8.9 and 5.3 months respectively.ConclusionCombination of Ganji Recipe and interventional therapy with FBE in treating PHC could improve patients’ QOL,raise the 0.5-and 1-year survival rate,and prolong the survival time,suggesting TCM treatment has an affirmative significance for enhancing the therapeutic efficacy and improving the prognosis in patients.

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