中医综合疗法辅助肝动脉灌注治疗晚期原发性肝癌43例

郭锰; 张成辉; 徐赟; 翟玉峰

doi:10.13422/j.cnki.syfjx.2014150195

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中医综合疗法辅助肝动脉灌注治疗晚期原发性肝癌43例

临床 | 更新时间：2024-01-04

- 中医综合疗法辅助肝动脉灌注治疗晚期原发性肝癌43例
- Integrated Traditional Chinese Medicine Assisted Hepatic Artery Infusion in Treatment of 43 Cases of Primary Liver Cancer at Middle and Advanced Stages
- 中国实验方剂学杂志 2014年20卷第15期页码：195-199
- 作者机构：
- 作者简介：
- 基金信息：
  
  河南省医学科技攻关项目（201204148）
- DOI：10.13422/j.cnki.syfjx.2014150195
  中图分类号： R735.7
- 纸质出版日期：2014
- 稿件说明：
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郭锰, 张成辉, 徐赟, 等. 中医综合疗法辅助肝动脉灌注治疗晚期原发性肝癌43例[J]. 中国实验方剂学杂志, 2014,20(15):195-199.

GUO Meng, ZHANG Cheng-hui, XU Yun, et al. Integrated Traditional Chinese Medicine Assisted Hepatic Artery Infusion in Treatment of 43 Cases of Primary Liver Cancer at Middle and Advanced Stages[J]. Chinese journal of experimental traditional medical formulae, 2014, 20(15): 195-199.
郭锰, 张成辉, 徐赟, 等. 中医综合疗法辅助肝动脉灌注治疗晚期原发性肝癌43例[J]. 中国实验方剂学杂志, 2014,20(15):195-199. DOI： 10.13422/j.cnki.syfjx.2014150195.

GUO Meng, ZHANG Cheng-hui, XU Yun, et al. Integrated Traditional Chinese Medicine Assisted Hepatic Artery Infusion in Treatment of 43 Cases of Primary Liver Cancer at Middle and Advanced Stages[J]. Chinese journal of experimental traditional medical formulae, 2014, 20(15): 195-199. DOI： 10.13422/j.cnki.syfjx.2014150195.

摘要

目的：探讨中医综合疗法辅助经肝动脉化疗灌注栓塞（TACE）术治疗中晚期原发性肝癌的近期疗效及对患者生活质量、免疫功能及转移等方面的影响。方法：83例患者根据不同的治疗方式分为对照组40例和观察组43例。对照组采用TACE术（使用药物包括吡柔比星、氟尿嘧啶、丝裂霉素及超液化碘化油），4周重复1次，共治疗2次，术后给予护肝、护胃等对症支持治疗。观察组在对照组治疗基础上加用①榄香烯注射液，0.4～0.6 g/次，静脉滴注，连续使用3周，停药1周后再注射3周；②参麦注射液，60 mL/次，静脉滴注，每次TACE术后连续使用2周；③解毒消癌方：1剂/d，常规水煎分2~3次服用。两组疗程均为8周。采用CT或核磁共振成像（MRI）观察治疗前后实体瘤大小；采用欧洲癌症研究和治疗组织生命质量核心量表（EORTCQLQ-C30）进行治疗前后评分；采用流式细胞仪法检测治疗前后外周血T淋巴细胞亚群（CD3+，CD4+，CD4+/CD8+）和自然杀伤细胞（NK）水平；检测治疗前后血管内皮生长因子（VEGF）、细胞间黏附分子-1（ICAM-1）和血甲胎蛋白（AFP）水平。结果：对照组实体瘤疗效有效率为77.5%，观察组为93%，观察组优于对照组（P<0.05）；治疗后对照组T淋巴细胞亚群（CD3+，CD4+，CD4+/CD8+）和NK细胞水平均呈下降趋势；观察组T淋巴细胞亚群和NK细胞水平较治疗前上升（P<0.05或P<0.01），治疗后观察组CD3+，CD4+，CD4+/CD8+和NK水平均高于对照组（P<0.01）；治疗后观察组认知功能外的其他功能维度评分均较治疗前上升（P<0.01），并高于对照组（P<0.05或P<0.01）；治疗后观察组在疲倦、疼痛、恶心与呕吐、失眠、食欲丧失等维度评分方面低于对照组（P<0.01）；观察组治疗后AFP，ICAM-1和VEGV水平均低于对照组（P<0.01）。结论：采用榄香烯注射液、参脉注射液静脉滴注及解毒消癌方口服配合TACE治疗中晚期原发性肝癌起到了增效作用，并能提高患者生活质量和免疫功能，减轻患者病情，对肿瘤的转移可能具有一定的抑制作用。

Abstract

Objective: To discuss short-term effects of adjuvant therapy of integrated traditional Chinese medicine therapy combined with transcatheter chemoembolization in treating primary hepatic carcinoma at middle and advanced stages and influence to patients' quality of life

immunity and metastasis rate. Method: Eighty-three patients were divided into control group (40 cases) and observation group (43 cases) by different methods of treatment.Patients in the control group received Hepatic arterial infusion chemotherapy and embolization(TACE) operation(drugs including pirarubicin

fluorouracil

mitomycin and super liquefaction iodinated oil)

repeated one time for every four weeks

two times in total

after operation

patients got symptomatic and supportive treatment of liver protection and stomach protection.Based on the treatment of the control group

patients in the observation group received elemene injections with 0.4-0.6 g/time

intravenous infusion

used for 3 weeks

stoped for 1 week and used for 3 weeks finally;Shenmai injections with 60 mL/time

intravenous infusion

used for 2 weeks after TACE operation;Jiedu Xiaoai decoctions with 1dose/day

conventional water frying

taken divides 2-3 times.Course of treatment in two groups were both 8 weeks.After treatment

size change of solid tumor was observed by CT or nuclear magnetic resonance imaging(MRI);Before and after treatment

score was evaluated by the European organization for cancer research and treatment of core quality of life scale-C30 (EORTCQLQ-C30)and quality of life

levels of peripheral blood T-lymphocyte subsets(CD3+

CD4+

CD4+/CD8+) and natural killer(NK) cell were detected by flow cytometry

levels of blood vessel endothelial growth factors (VEGF)

intercellular adhesion molecule-1(ICAM-1) and blood α-fetoprotein(AFP) were detected. Result: Effective rate of curative efficacy of solid tumor in the observation group was 93% superior to 77.5% in the control group(P<0.05).After treatment

levels of T-lymphocyte subsets(CD3+

CD4+

CD4+/CD8+) and NK cell in the control group showed downtrend

but those in the observation group increased(P<0.05 or P<0.01)

levels of CD3+

CD4+

CD4+/CD8+ and NK in the observation group were higher than those in the control group(P<0.01)

except cognitive function

other dimension scores in the observation group were increased(P<0.01)

which were higher than those in the control group(P<0.05 or P<0.01)

dimension scores of tired

pain

nausea and vomiting

agrypnia and appetite loss in the observation group were lower than those in the control group(P<0.01)

levels of AFP

ICAM-1 and VEGV in the observation group were lower than those in the control group(P<0.01). Conclusion: Elemene injections

Shenmai injections(intravenous infusion) and Jiedu Xiaoai decoctions(taken orally) combined with TACE could get synergism in treating primary hepatic carcinoma at middle and advanced stages

and it could improve patients' quality of life and immunity

relieve state of an illness

there may be a inhibiting effect of neoplasm metastasis.

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