氩氦刀联合华蟾素和生脉注射液治疗肝癌对机体免疫功能的影响  

Effect of argon-helium cryoablation combined with cinobufotalin and shenmai injection on the immune function in patients with primary liver cancer

作　　者：杜志强[1] 姜良进[1] 张宗城[1] 秦健勇[1] 卢集森 

机构地区：[1]广州医学院荔湾医院肿瘤科,510170 [2]广州市荔湾区中医医院中医科,510170

出　　处：《实用医学杂志》2009年第2期302-304,共3页The Journal of Practical Medicine

基　　金：广东省中医药局基金资助(编号:1050071)

摘　　要：目的:探讨氩氦刀局部消融联合华蟾素和生脉注射液治疗中晚期原发性肝癌的疗效及对机体免疫功能的影响。方法:40例拟不能手术的原发性肝癌患者分成对照组和试验组。对照组单纯氩氦刀靶向冷冻消融术,试验组在氩氦刀术后次日起静脉滴注华蟾素40mL/d,生脉注射液50mL/d,连用14d,4周为1个周期,连续治疗3周期。结果:试验组治疗后T淋巴细胞亚群CD3、CD4和CD4/CD8比例及NK细胞水平较治疗前明显增高(P<0.05);ALT、AST、总胆红素(TBIL)和血清白蛋白(ALB)无明显变化。对照组治疗后T淋巴细胞亚群CD3、CD4和CD4/CD8比例及NK细胞水平较治疗前无明显变化;ALT、AST、TBIL升高(P<0.05),ALB降低(P<0.05)。对≥3cm的肿瘤1年内随访发现,试验组的复发率为17.4%(4/23),显著低于对照组的43.5%(10/23)(P<0.05)。结论:氩氦刀局部消融联合华蟾素和生脉注射液治疗原发性肝癌可提高机体免疫力,保护肝脏功能,降低肿瘤复发率。Objective To explore the efficacy of argon-helium cryoablation plus cinobufotalin and shenmai injection and the effect of the combined therapy on the immune function in patients with advanced primary liver cancer. Methods 40 patients with unresectable liver cancer were evenly randomized to receive cryoablation alone （control group）,or cryoablation plus cinobufotalin of 40 mL and shenmai injection of 50 mL daily on days 1 to 14, with a 4-week cycle for 3 cycles （experimental group）. Results In the experimental group, T cell subsets CD3 and CD4, CD4/CD8 ratio, and NK cell level were significantly elevated, as compared with the baselines （P 〈 0.05）, while no marked changes in serum ALT, AST, TBIL, and ALB occurred （P 〉 0.05）. However, T cell subsets CD3 and CD4, CD4/CD8 and NK cell level did not differ significantly in the control group （P 〉 0.05）, but serum ALT, AST, and TBIL were increased （P 〈 0.05） and serum ALB was lower （P 〈 0.05）. During 1-year follow-up, the relapse rate for the tumor size greater than 3 cm was significantly lower in the experimental group than in the control group （ 17.4% vs 43.5%, P 〈 0.05）. Conclusions Argonhelium cryoablation combined with cinobufotalin and shenmai injection can enhance immunity, protect liver function, and decrease the recurrence rate of primary liver cancer.

关 键 词：肝肿瘤 氩氦刀消融 华蟾素 生脉注射液 免疫功能 

分 类 号：R735.7[医药卫生—肿瘤] R259.414[医药卫生—临床医学]