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纸质出版日期:2015
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李霞, 孙莉. 中药辨证维持治疗对晚期原发性肝癌患者生存质量和生存率的影响[J]. 中国实验方剂学杂志, 2015,21(10):207-211.
LI Xia, SUN Li. Influence of Maintenance Treatment of Traditional Chinese Medicine on Quality of Life and Survival Rate in Patients with Advanced Primary Hepatocarcinoma[J]. Chinese journal of experimental traditional medical formulae, 2015, 21(10): 207-211.
李霞, 孙莉. 中药辨证维持治疗对晚期原发性肝癌患者生存质量和生存率的影响[J]. 中国实验方剂学杂志, 2015,21(10):207-211. DOI: 10.13422/j.cnki.syfjx.2015100207.
LI Xia, SUN Li. Influence of Maintenance Treatment of Traditional Chinese Medicine on Quality of Life and Survival Rate in Patients with Advanced Primary Hepatocarcinoma[J]. Chinese journal of experimental traditional medical formulae, 2015, 21(10): 207-211. DOI: 10.13422/j.cnki.syfjx.2015100207.
目的: 探讨中药辨证维持治疗对晚期原发性肝癌患者生存质量的改善作用和对生存率的影响. 方法: 85例晚期肝癌患者根据不同的治疗方式分为对照组34例和观察组51例.对照组给予对症支持处理.观察组在对照组治疗的基础上根据患者不同情况给予①气虚采用参芪扶正注射液
250 mL/次
静脉滴注;或②气阴两虚采用参麦注射液
20~100 mL/次
静脉滴注;1个疗程为2周
间隔1周后进行下1个疗程;和③艾迪注射液
50~100 mL/次
静脉滴注;和④口服鸦胆子油软胶囊
4粒/次
3次/d.1个疗程均为4周
间隔1周后进行下1个疗程.和⑤中药内服.两组疗程均为6个月或至患者死亡.每月进行生活质量KPS评分和主要症状体征评分;于治疗前及治疗后3
6个月各进行1次肝脏储备功能进行量化评估(Child-Pugh)分级标准和体力状态ECOG评分标准
并进行肝功能丙氨酸氨基转移酶(ALT)
天门冬氨酸氨基转移酶(AST)
总胆红素(TBil)和血清甲胎蛋白(AFP)水平检测
评价患者中位生存时间和半年生存率. 结果: 观察组在治疗后4
6个月KPS评分高于同期对照组(P<0.01);观察组在治疗后2
4
6个月主要症状、体征评分低于对照组(P<0.01);观察组在治疗后第3
6个月Child-Pugh评分和ECOG评分均低于对照组(P<0.01);治疗后3个月
观察组ALT
AST低于对照组(P<0.01);治疗后6个月
观察组ALT
AST
TBil低于对照组(P<0.01);治疗后第3
6个月
观察组AFP均低于对照组(P<0.01);观察组半年生存率为50.98%
高于对照组的37.14%(P<0.05);观察组中位生存期为132 d
高于对照组的86 d(P<0.01). 结论: 中医药辨证维持治疗晚期原发性肝癌能减轻患者临床症状和体征
改善患者生存质量和体力状况
能延长患者半年生存率和中位生存期.
Objective: To discuss the amelioration effect of maintenance treatment of traditional Chinese medicine on quality of life and survival rate in treating patients with advanced primary hepatocarcinoma (APH). Method: Eighty-five patients with APH were randomly divided into the control group (34 cases) and the observation group (51 cases) according to the different therapy methods. Patients in the control group received symptomatic relief and supportive treatment. Based on the treatment of the control group
patients in observation group received ① 250 mL Shenqi Fuzheng injection
②20-100 mL Shenmai injection for 2 weeks separated a week
③ 50-100 mL aidi injection
④ 4 brucea javanica oil soft capsules thrice daily for 4-weeks period separated a week between two weeks
⑤ Traditional Chinese medicine for oral administration according to their different condition. All patients in both two groups received 6 months of treatment until their deaths. Karnofsky (KPS) grades of quality of life and grades of the main symptoms and signs were evaluated every month. Child-pugh classification scores of liver function and ECOG scores of physical condition were made before treatment and after 3-
6-month treatment. Levels of liver function including alanine aminotransferase (ALT) and aspartate aminotransferase (AST)
total bilirubin (TBil) and serum alpha-fetoprotein (AFP) were detected. Patients' medium survival time and survival rate of half a year were evaluated. Result: KPS grades were higher after 4-
5-and 6-month treatment in the observation group than those in the control group (P<0.05). Scores of the main symptoms and signs increased
while the results were lower after 2-
4-and 6-month treatment as compared to the control group (P<0.01). Scores of Child-Pugh and ECOG were lower after 3-and 6-month treatment in the observation group than those in the control group (P<0.01). Levels of ALT and AST were lower after 3-month treatment in the observation group than those in the control group (P<0.01). Levels of ALT
AST and TBil were lower after 6-month treatment in the observation group than those in the control group (P<0.01). Level of AFP after 3-and 6-month treatment in the observation group was lower than that in the control group (P<0.01). Survival rate of half a year in the observation group was 50.98%
which was higher than that of 37.14% in the control group (P<0.05). The medium survival time in observation group was 132 days
which was higher than that of 86 days in the control group (P<0.01). Conclusion: Maintenance treatment of traditional Chinese medicine could relieve clinical symptoms and signs
ameliorate patients' quality of life and physical condition in treating APH. Moreover
it could prolong patients' medium survival time and survival rate of half a year.
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