敷和备化方联合经肝动脉化疗栓塞术治疗218例肝郁脾虚型原发性肝癌患者的临床效果  

Clinical effect of Fuhe Beihua prescription combined with transcatheter arterial chemoembolization in treatment of primary liver cancer patients with liver depression and spleen deficiency:An analysis of 218 cases

作　　者：蒋锐沅 荣震[2] 满婷婷 覃艳春 刘秋月 莫春梅[3] JIANG Ruiyuan;RONG Zhen;MAN Tingting;QIN Yanchun;LIU Qiuyue;MO Chunmei(Graduate School,Guangxi University of Chinese Medicine,Nanning 530000,China;Department of Oncology,The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530000,China;Second Inpatient Area,Department of Hepatology,The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530000,China)

机构地区：[1]广西中医药大学研究生院,南宁530000 [2]广西中医药大学第一附属医院肿瘤科,南宁530000 [3]广西中医药大学第一附属医院肝病科二病区,南宁530000

出　　处：《临床肝胆病杂志》2020年第10期2219-2225,共7页Journal of Clinical Hepatology

基　　金：国家自然科学基金项目(81760850);国家传染病防治重大专项课题(2018ZX10303502-001,2018ZX10303502-002);广西医疗卫生适宜技术开发与推广应用项目(S2018046);广西壮族自治区科技厅科技基地和人才专项建设项目(桂科AD17129001);广西中医药大学第一附属医院院内制剂研究与开发(2018ZJ004)。

摘　　要：目的探究敷和备化方联合肝动脉化疗栓塞术(TACE)对肝郁脾虚型原发性肝癌患者的治疗效果和对T淋巴细胞亚群水平的影响作用。方法采用回顾性研究的方法收集2018年1月-2020年1月在广西中医药大学第一附属医院肿瘤科、肝病科和介入科接受治疗的肝郁脾虚型Ⅲ期原发性肝癌患者资料。按患者是否服用中药敷和备化方分为治疗组与对照组,两组均行常规TACE治疗,治疗组加用敷和备化方内服。两组疗程均为16周。比较两组患者的近期有效率、生存质量评分、血清AFP水平、肝纤维化四项水平、凝血功能指标、外周血T淋巴细胞亚群水平,肝功能指标情况。计量资料两组间比较采用独立样本t检验;计数资料两组间比较采用χ^2检验。计量资料不同时间不同组间比较采用重复测量资料的方差分析。结果最终整理出患者218例,其中对照组患者118例,治疗组患者100例。治疗组治疗8周的客观缓解率和疾病控制率分别为33%、66%,16周的客观缓解率和疾病控制率分别为34%、69%;对照组疗8周的客观缓解率和疾病控制率分别为26.27%、68.64%,16周的客观缓解率和疾病控制率分别为30.51%、68.64%,两组患者8周及16周客观缓解率差异具有统计学意义(P值均<0.05)。与同组治疗前比较,治疗组和对照组在8周与16周的KPS评分、纤维蛋白原、Alb较前均显著升高(P值均<0.05);两组间治疗8周及16周比较,KPS评分、纤维蛋白原、Alb差异均具有统计学意义(P值均<0.05)。与同组治疗前比较,治疗组和对照组的AFP、肝纤维化四项指标、ALT、AST、PT、中医症候积分较前显著降低(P值均<0.05);两组间治疗8周及16周后比较AFP、肝纤维化四项指标、ALT、AST、PT、中医症候积分差异具有统计学意义(P值均<0.05)。与同组治疗前相比,治疗组在8周时间与16周CD3^+、CD4^+、CD4^+/CD8^+水平较前显著升高(P值均<0.05),CD8+水平较前显著降低(P<0Objective To investigate the clinical effect of Fuhe Beihua prescription combined with transcatheter arterial chemoembolization(TACE)in the treatment of primary liver cancer patients with liver depression and spleen deficiency and its effect on T lymphocyte subsets.Methods A retrospective analysis was performed for the clinical data of stageⅢprimary liver cancer patients with liver depression and spleen deficiency who were treated in Department of Hepatology and Department of Oncology in The First Affiliated Hospital of Guangxi University of Chinese Medicine from January 2018 to January 2020.According to whether the traditional Chinese medicine Fuhe Beihua prescription was used,the patients were divided into treatment group(treated with routine TACE and oral administration of Fuhe Beihua prescription)and control group(treated with routine TACE alone),and the course of treatment was 16 weeks for both groups.The two groups were compared in terms of short-term response rate,quality-of-life score,serum alpha-fetoprotein(AFP)level,four indicators of liver fibrosis,coagulation function parameters,peripheral blood T lymphocyte subsets,and liver function parameters.The independent samples t-test was used for comparison of continuous data between two groups,and the chi-square test was used for comparison of categorical data between two groups.A repeated-measures analysis of variance was used for comparison of continuous data between different groups at different time points.Results A total of 218 patients were selected,with 118 in the control group and 100 in the treatment group.The treatment group had an objective response rate of 33%and a disease control rate of 66%at week 8 of treatment and an objective response rate of 34%and a disease control rate of 69%at week 16 of treatment,and the control group had an objective response rate of 26.27%and a disease control rate of 68.64%at week 8 of treatment and an objective response rate of 30.51%and a disease control rate of 68.64%at week 16 of treatment;there was a significa

关 键 词：肝肿瘤 化学栓塞 治疗性 敷和备化方 回顾性研究 

分 类 号：R735.7[医药卫生—肿瘤]