经肝动脉化疗栓塞术联合中医药治疗83例中晚期肝癌患者临床观察及生存质量评介  

Transcatheter Hepatic Arterial Chemoembolization Combined with Chinese Herbal Medicine for Intermediate and Advanced Liver Cancer:Clinical Observation and Life Quality Evaluation of 83 Cases

作　　者：汪青山[1] 毛江洪[2] 张念华[3] 陈高峰[3] 田野[1] 叶振中[1] 

机构地区：[1]广东省第二中医院放射科,广州510095 [2]广东省第二中医院检验科,广州510095 [3]广东省第二中医院肿瘤科,广州510095

出　　处：《南昌大学学报（医学版）》2012年第11期28-31,42,共5页Journal of Nanchang University：Medical Sciences

基　　金：广东省中医药局科研课题(2009362)

摘　　要：目的观察经肝动脉化疗栓塞术(TACE)联合中药治疗中晚期肝癌的临床疗效及生存质量(QOL)。方法将接受TACE治疗的中晚期原发性肝癌患者83例,按治疗方式分为2组:对照组40例仅接受TACE,研究组43例在TACE的同时联合中药治疗。TACE 2个疗程完成后1个月复查CT进行临床疗效评价,并比较2组患者1年生存率、Ⅲ-Ⅳ度毒副作用的发生率及QOL评分。中位随访时间为12.5个月。结果研究组完全缓解(CR)1例,部分缓解(PR)25例,稳定(SD)11例,进展(PD)6例;对照组CR 0例,PR 18例,SD 16例,PD 6例。研究组客观反应率60.5%(26/43)明显高于对照组(45.0%,18/40)。研究组1年生存率明显高于对照组[72.1%(31/43)vs57.5%(23/40),P<0.05]。研究组Ⅲ-Ⅳ度大多数毒性反应较对照组显著降低(P<0.05)。研究组QOL总分及生理、心理、症状、社会维度4个维度得分均高于对照组(P<0.05或P<0.01))。结论 TACE联合中药治疗中晚期肝癌能降低毒副作用的发生率及程度,显著提高临床疗效和QOL。Objective To investigate the clinical efficacy of transcatheter hepatic arterial chemoembolization（TACE） combined with Chinese herbal medicine and the quality of life in patients with intermediate and advanced primary liver cancer（IALC）.Methods Eighty-three patients with IALC were assigned to receive TACE alone（control group,n=40） or in combination with traditional Chinese medicine treatment（treatment group,n=43）.CT scan was carried out to evaluate clinical efficacy 1 month after 2 courses of TACE.One-year survival rate,incidence of grade Ⅲ-Ⅳ side effects and score of quality of life（QOL） were compared between the two groups after a median follow-up of 12.5 months.Results In the treatment group,1 patients had complete remission（CR）,25 had partial remission（PR）,11 had stable disease（SD）,and 6 had progressive disease（PD）.In the control group,no patients had CR,18 had PR,16 had SD,and 6 had PD（P0.05）.The objective response rate and 1-year survival rate in treatment group were obviously higher than those in control group（60.5% vs 45.0% and 72.1% vs 57.5%,respectively;P0.05）.In addition,compared with control group,the combined treatment with TACE and traditional Chinese medicine significantly decreased grade Ⅲ-Ⅳ side effects and obviously increased total scores of QOL and scores of sychological,physical,symptomatic and social dimensions（P0.05 or P0.01）.Conclusion TACE combined with Chinese herbal medicine can decrease the incidence and degree of adverse reactions and improve clinical efficacy and QOL in patients with IALC.

关 键 词：原发性肝癌 经肝动脉化疗栓塞术 中西医结合疗法 扶正解毒方 生存质量 

分 类 号：R735.7[医药卫生—肿瘤]