疏肝健脾法对肝郁脾虚型原发性肝癌患者放疗后不良反应和生存质量的影响  

Effect of Soothing Liver and Activating Spleen Method on Adverse Reactions and Life Quality from Primary Liver Cancer Patients with Liver Depression and Spleen Deficiency After Radiotherapy

作　　者：罗双[1] 黄伟师 黄丁平[1] 谢有科[1] 白广德[1] 练祖平 LUO Shuang;HUANG Weishi;HUANG Dingping;XIE Youke;BAI Guangde;LIAN Zuping(Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning Guangxi,530011)

机构地区：[1]广西中医药大学附属瑞康医院,广西南宁530011

出　　处：《广西中医药》2020年第4期11-16,共6页Guangxi Journal of Traditional Chinese Medicine

基　　金：广西中医药大学2019—2021年广西一流学科建设开放课题(编号:2019XK178);广西中医药大学自然科学研究项目(编号:2015LX028);广西壮族自治区中医药局自筹经费科研课题(编号:GZZC2019109)。

摘　　要：目的:观察疏肝健脾法对肝郁脾虚型原发性肝癌患者放疗后不良反应和生存质量的影响。方法:将128例肝郁脾虚型原发性肝癌患者随机分为对照组64例和研究组64例。对照组接受立体定向分割放疗;研究组在立体定向分割放疗基础上,于放疗期间和放疗后4~8周予四逆散(柴胡12 g,枳实12 g,白芍9 g,甘草6 g)为基础方的加味治疗,两组患者分别于放疗前、放疗后1周和放疗后第8周进行生存质量评定、KPS评分以及血常规、肝功能等检查,比较两组患者的不良反应发生情况和生存质量。结果:放疗后1周和放疗后8周,研究组患者骨髓抑制情况明显轻于对照组(P<0.05),研究组患者的血清ALT、AST、DBIL、IBIL、TBIL水平低于对照组(P<0.05),而ALB、CHE水平高于对照组(P<0.05);生存质量量表分析显示,放疗后8周,研究组患者的KPS评分和生存质量量表得分均明显优于对照组(P<0.05)。结论:疏肝健脾法可降低肝郁脾虚型原发性肝癌患者放疗后不良反应的发生率,保护患者的肝功能,提高患者的生存质量。Objective:To observe the effect of the method of soothing liver and activating spleen on the adverse reactions and life quality of primary liver cancer patients with liver depression and spleen deficiency after radiotherapy.Methods:One hundred and twenty-eight cases of primary liver cancer patients with liver depression and spleen deficiency were randomly divided into control and study group,with 64 patients in each group. The stereotactic fractional radiotherapy was given to the control group;in the study group the modified Sinisan decoction(Bupleurum 12 g,Citrus aurantium 12 g,Peony 9 g,Licorice 6 g)on the basis of stereotactic fractional radiotherapy was added during radiotherapy and 4~8 weeks after radiotherapy. The two groups of patients were evaluated by life quality,KPS score,blood routine test,liver function and other tests separately before radiotherapy,one week after radiotherapy,and eight weeks after radiotherapy. The occurrence of adverse reactions and life quality of the two groups were compared.Results:The bone marrow suppression of patients in the study group was significantly lighter than that in the control group(P<0.05)in one week after radiotherapy and eight weeks after radiotherapy. The serum ALT,AST,DBIL,IBILand TBIL levels of the study group were lower than those in the control group(P <0.05),and the levels of ALB and CHE were higher than those of the control group(P<0.05);after analysis of the life quality showed 8 weeks after radiotherapy that the KPS score and the score of the life quality of the study group were significantly better than those of the control group(P<0.05).Conclusion:The soothing liver and activating spleen method can reduce the incidence of adverse reactions in the primary liver cancer patients with deficiency of liver and spleen after radiotherapy,it can be applied to protect the liver function and improve the quality of life of the primary liver cancer patients.

关 键 词：原发性肝癌 疏肝健脾法 放疗 肝功能 生存质量 中西医结合疗法 

分 类 号：R735.7[医药卫生—肿瘤]