清肝化瘀方联合射频消融术对肝癌患者生活质量、免疫功能及肿瘤转移的影响  

Effects of Qinggan Huayu Decoction Combined with Radiofrequency Ablation on Quality of Life,Immune Function and Tumor Metastasis of Hepatocellular Carcinoma Patients

作　　者：李伟良[1] 许尤琪[1] 尹会玲 王霞[1] 方祯[1] 许瑶[1] LI Weiliang;XU Youqi;YIN Huiling;WANG Xia;FANG Zhen;XU Yao(Department of Oncology,the Second Clinical Medical College Affiliated to Nanjing University of Traditional Chinese Medicine,Nanjing,Jiangsu,210000,China)

机构地区：[1]南京中医药大学附属第二临床医学院肿瘤内科,江苏南京210000

出　　处：《肿瘤药学》2020年第2期225-231,共7页Anti-Tumor Pharmacy

基　　金：江苏省基础研究计划(自然科学基金)面上研究项目(BK20161605)。

摘　　要：目的观察清肝化瘀方联合射频消融术对肝癌患者生活质量、免疫功能及肿瘤转移的影响。方法选择2015年12月—2018年12月我院收治的原发性肝癌患者94例为研究对象,按照随机数字表法分为对照组(n=45)和观察组(n=49)。对照组采用射频消融术治疗,观察组在对照组的基础上于手术当日给予清肝化瘀方治疗,每日1剂,水煎服,早晚餐后各1次,连续服用30 d为1个疗程,共治疗3个疗程。对比两组患者的治疗缓解率、生活质量(KPS评分)、丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、免疫功能(NK细胞、CD4^+、CD8^+、IL-2、TNF-α、INF-γ)、肿瘤转移相关蛋白(VEGF、COX-2)水平。结果观察组患者总缓解率(36.73%)显著高于对照组(17.78%)(P<0.05)。治疗1、2、3个月,观察组患者血清ALT、AST水平与治疗前相比,差异无统计学意义(P>0.05);对照组患者血清ALT、AST水平均显著高于治疗前,且明显高于观察组(P<0.05)。治疗前,两组患者KPS评分、CD4^+、CD8^+、NK细胞、TNF-α、IFN-γ、IL-2、VEGF及外周血有核细胞中COX-2水平均无明显差异(P>0.05);治疗后,两组患者KPS评分均明显升高,TNF-α、IFN-γ、IL-2、VEGF水平均明显下降(P<0.05)。治疗前后对照组患者CD4^+、CD8^+、NK细胞、外周血有核细胞中COX-2水平均无明显变化(P>0.05);治疗后,观察组患者KPS评分、CD4^+和NK细胞水平均明显高于对照组(P<0.05),CD8^+、TNF-α、IFN-γ、IL-2、VEGF、外周血有核细胞中COX-2水平均明显低于对照组(P<0.05)。结论清肝化瘀方联合射频消融术可抑制肝癌患者的肿瘤生长,提高患者的生活质量和免疫功能,其抑制肿瘤转移的作用可能与VEGF、COX-2有关。Objective To observe the effects of Qinggan Huayu decoction combined with radiofrequency ablation on the quality of life,immune function and tumor metastasis of liver cancer patients.Methods Ninety-four patients with primary liver cancer in our hospital between December 2015 and December 2018 were selected as the research objects.They were divided into the control group(n=45)and the observation group(n=49)according to the random number table method.Patients in control group were treated with radiofrequency ablation,and those in observation group were treated with Qinggan Huayu decoction on the day of surgery on the base of radiofrequency ablation.Patients had it decocted with water,one dose per day,and took the decoction after breakfast and dinner,30 days as one course of treatment,continuously for three courses.Then the remission rate,quality of life(KPS score),alanine transaminase(ALT)level,aspartate transaminase(AST)level,immune function(NK cells,CD4^+,CD8^+,IL-2,TNF-α,INF-γ)and levels of tumor metastasis related proteins(VEGF and COX-2)were compared between the two groups.Results The total remission rate of the observation group(36.73%)was significantly higher than that of the control group(17.78%)(P<0.05).After 1,2 and 3 months of treatment,the serum levels of ALT and AST of the observation group were not significantly different from those before treatment(P>0.05),but those of the control group were significantly higher than those before treatment and those of the observation at the same time point(P<0.05).Before treatment,the KPS scores,CD4^+,CD8^+,NK cells,TNF-α,IFN-γ,IL-2,VEGF and COX-2 levels of the two groups had no statistical differences(P>0.05).After treatment,the KPS scores of the two groups of patients increased significantly,and the levels of TNF-α,IFN-γ,IL-2,and VEGF decreased significantly in the two groups,when compared with before treatment(P<0.05).In the control group,no significant changes were found before and after treatment in the levels of CD4^+,CD8^+,NK cells and COX-2(P>0.05).Aft

关 键 词：清肝化瘀方 射频消融术 肝癌 生活质量 免疫功能 肿瘤转移 

分 类 号：R735.7[医药卫生—肿瘤]