经肝动脉化疗栓塞术对不同中医症型原发性肝癌患者细胞免疫功能影响的研究  

Influence of Transcatheter Arterial Chemoembolization on Cellular Immune Function of Patients with Different TCM Syndrome Types of Primary Hepatocellular Carcinoma

作　　者：蔡恒毅[1,2] 郭贵海[1] 

机构地区：[1]南昌大学第一附属医院消化内科,江西省南昌市330006 [2]江西省九江县血防站

出　　处：《中国全科医学》2011年第19期2218-2221,2224,共5页Chinese General Practice

基　　金：江西省卫生厅中医药科研基金(2005B02)

摘　　要：目的观察经肝动脉化疗栓塞术(TACE)对不同中医症型原发性肝癌患者细胞免疫功能的影响。方法采用前瞻性对照研究,将92例接受TACE治疗的原发性肝癌患者按入院时中医征象分为:第1组:肝郁脾虚型12例;第2组:气滞血瘀型30例;第3组:湿热毒瘀型32例;第4组:肝肾阴虚型18例,观察患者细胞免疫功能在TACE治疗前后的变化及与中医分型的关系。结果 92例患者共接受219次TACE治疗。前3组患者细胞免疫功能治疗前后组内比较差异均无统计学意义(P>0.05);第4组患者TACE治疗前CD3、CD4、CD8、NK细胞水平分别是(52.1±5.5)、(33.9±5.7)、(49.8±7.3)、(5.8±2.9),治疗后分别为(46.6±6.7)、(28.9±6.8)、(55.9±4.9)、(4.5±2.1),治疗后细胞免疫功能下降,治疗前后组内比较差异有统计学意义(P<0.05)。第2组有4人中医症型加重,由气滞血瘀型转化为湿热毒瘀型,TACE治疗前CD3、CD4、CD8、NK细胞水平分别是(60.1±1.3)、(41.1±2.2)、(39.9±2.9)、(11.9±1.3),治疗后分别为(56.2±2.5)、(37.8±2.4)、(43.9±2.2)、(9.8±1.1);第3组有6人由湿热毒瘀型转化为肝肾阴虚型,TACE治疗前CD3、CD4、CD8、NK细胞水平分别是(56.1±2.4)、(36.8±2.7)、(44.9±2.1)、(9.0±1.3),治疗后分别为(51.3±3.2)、(33.1±1.9)、(49.8±2.1)、(5.5±1.7),细胞免疫功能下降,差异有统计学意义(P<0.05)。结论 TACE治疗对不同中医症型原发性肝癌患者细胞免疫功能的影响随中医症型的加重而加重,原发性肝癌患者细胞免疫功能在TACE治疗后随中医症型的加重而下降。Objective To observe the influence of transcatheter arterial chemoembolization（TACE） on cellular immune function of patients with different syndrome types in traditional Chinese medicine（TCM） of primary hepatocellular carcinoma（PHC）.Methods A prospective controlled study was applied,a total of 92 PHC patients who received TACE treatments were divided into 4 groups according to the type of Chinese clinical sign at the time of admission：Group 1,liver and spleen deficiency type（n=12）;Group 2,blood stasis type（n=30）;Group 3,damp heat toxin stasis type（n=32）;and Group 4,liver-kidney week type（n=18）.Immune function of the patients and its′ relationship with TCM syndrome type were studied before and after TACE the treatment.Results All the 92 patients received a total of 219 times of TACE treatment.No statistic difference was found in group 1;group 2 and group 3 of cellular immune function before and after treatment（P0.05）,The numbers of CD3,CD4,CD8,NK cells of group 4 were（52.1±5.5）,（33.9±5.7）,（49.8±7.3）,（5.8±2.9）,respectively before TACE treatment,and（46.6±6.7）,（28.9±6.8）,（55.9±4.9）,（4.5±2.1） respectively after the treatment.There was a statistically significant difference of immune function before and after treatment in group 4（P0.05）,indicating a decreased cellular immune function after the treatment.Four patients in group 2 got more serious after TACE treatment in condition of syndrome transformation from blood stasis type to damp heat toxin stasis type.The numbers of CD3,CD4,CD8,NK cells were（60.1 ±1.3）,（41.1±2.2）,（39.9±2.9）,（11.9±1.3） respectively before TACE treatment,and（56.2±2.5）,（37.8±2.4）,（43.9± 2.2）,（9.8±1.1） respectively after the treatment.Six patients in group 3 had a syndrome transformation from damp heat toxin stasis type to liver-kidney week type.The numbers of CD3,CD4,CD8,NK cells were（56.1±2.4）,（36.8±2.7）,（44.9±2.1）,（9.0±1.3） respectively before TACE treatment,a

关 键 词：肝肿瘤 中医分型 经肝动脉化疗栓塞术 细胞免疫 

分 类 号：R735.7[医药卫生—肿瘤]