基于“补肾生髓成肝”的肝癌第三级预防方案的真实世界研究  

A real world study on tertiary prevention program for liver cancer based on tonifying the kidney to promote liver regeneration and repair by effecting stem cells and their microenvironment

作　　者：戴玲[1] 倪颖 姚欣[2] 高翔[2] 叶之华[2] 李瀚旻[2] DAI Ling;NI Ying;YAO Xin;LI Hanmin(Ph. D. Grade 2016, Hubei University of Traditional Chinese Medicine (Wuhan, Hu-bei, 430061)China)

机构地区：[1]湖北中医药大学 [2]湖北省中医院

出　　处：《中西医结合肝病杂志》2019年第2期118-120,136,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：国家自然科学基金(No.81373513);国家中医临床研究基地(湖北)重点病种研究项目(No.JDZX2012054;JDZX2015172)

摘　　要：目的:基于真实世界临床数据,探讨基于"补肾生髓成肝"的肝癌第三级预防方案(简称:补肾生髓成肝方案)治疗晚期肝癌的临床疗效,为临床推广应用提供循证医学证据。方法:采用真实世界研究方法收集2012年7月～2018年5月在湖北省中医院住院治疗的肝癌晚期患者的临床资料330份。根据患者的治疗方案分为常规综合治疗组150例和补肾生髓成肝方案治疗组180例,比较患者治疗3个月和6个月后的生存率,并观察患者治疗12周后临床生化指标(ALT、AST、 TBil、Alb、WBC、PLT、NLR、PT、 PTA)的改善情况。结果:治疗12周后补肾生髓成肝治疗组生存率(3个月82.78%,6个月37.22%)显著高于常规综合治疗组生存率(3个月70.67%,6个月21.33%),两组比较有统计学差异(P<0.05);补肾生髓成肝治疗组患者Alb(37.17±7.72 g/L)及PLT(161.23±75.67 g/L)显著高于常规综合治疗组患者Alb(34.57±5.98 g/L)及PLT(137.44±97.74 g/L),组间比较有统计学意义(P<0.05);补肾生髓成肝组患者TBil(50.11±86.96μmol/L)、NLR(4.44±3.69)显著低于常规综合治疗组患者TBil(81.59±125.83μmol/L)、NLR(6.63±5.64),组间比较有统计学差异(P<0.05)。结论:基于"补肾生髓成肝"的肝癌第三级预防方案能显著提高患者3个月及6个月的生存率,改善肝功能,其疗效机制之一可能是通过改善患者的肝再生微环境从而延缓了肝癌的发生发展。Objective:To study the curative efficacy of “tonifying the kidney to promote liver regeneration and repair by affecting stem cells” treatment the tertiary prevention program for liver cancer based on the real world clinical data. Methods: A total of 330 clinical data of patients who were liver cancer were enrolled in this study. The data of patients were divided into integrated traditional Chinese and Western medicine control group and tonifying the kidney to promote liver regeneration and repair by affecting stem cells treatment group according to the clinical treatment plan. After 12 weeks of treatment,the patients survival rates of 3 months and 6 months and clinical biochemical indexes (ALT,AST, TBil,ALB,WBC,PLT,NLR,PT and PTA) were observed. Results: At the 12wk posttreatment time point,the patient survival rates of 3 months and 6 month in the “TTK”groups were 82. 78%,37. 22%;the patient survival rates of 3 months and 6 month in the “ CWM” groups were 70. 67%、21. 33%;and the differences between groups were statistically significant(P < 0. 05). Patients in the “TTK” group had significantly low levels of serum total bilirubin (50. 11 ± 86. 96μmol /L)compared to the “CWM”group(81. 59 ± 125. 83μmol /L);NLR in the “TTK” group(4. 44 ± 3. 69)were significantly lower than in the “CWM” group(6. 63 ± 5. 64);the differences between groups were statistically significant(P < 0. 05). Serum albumin levels in the “TTK” group(37. 17 g/L ± 7. 72g/L)and platelet level(161. 23 g/L ± 75. 67g/L)were significantly higher than in the “CWM” group(34. 57 g/L ± 5. 98 g/L),(137. 44 g/L ± 97. 74 g/L)and the differences between groups were statistically significant (P < 0. 05). Conclusion:Tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment treat ment for tertiary prevention program for liver cancer can significantly increasing the patients survival rates of 3 months and 6 month and impro ving liver function,one of the m

关 键 词：补肾生髓成肝 肝癌 肝再生 中西医结合治疗 

分 类 号：R273[医药卫生—中西医结合]