中医正肝方治疗肝癌的疗效及对患者肝功能、肠道菌群和免疫功能的影响  

Curative effect of Zhenggan Decoction on liver cancer and its influence on liver function,intestinal flora and immune function

作　　者：冉云 吕锦珍 胡世平 苏晓鹏 陈文林 李玲[2] 周怡驰 RAN Yun;LV Jin-zhen;HU Shi-ping;SU Xiao-peng;CHEN Wen-lin;LI Ling;ZHOU Yi-chi(Department of Hepatology,Shenzhen Hospital,Beijing University of Traditional Chinese Medicine,Shenzhen 518172,Guangdong,CHINA;Beijing University of Traditional Chinese Medicine,Beijing 100021,CHINA)

机构地区：[1]北京中医药大学深圳医院(龙岗)肝病科,广东深圳518172 [2]北京市北京中医药大学,北京100021

出　　处：《海南医学》2021年第14期1821-1824,共4页Hainan Medical Journal

摘　　要：目的观察中医正肝方对肝癌的疗效,并探讨其对患者肝功能、肠道菌群和免疫功能的影响。方法选择2018年8月至2020年6月北京中医药大学深圳医院门诊收治的60例肝癌患者为研究对象,根据随机数表法将患者分为观察组和对照组,每组30例。对照组患者给予保肝及对症支持治疗,观察组患者在对照组治疗的基础上联合中医正肝方治疗。治疗3个月,比较两组患者的治疗效果,以及治疗前后的总胆红素(TBIL)、天冬氨酸氨基转移酶(AST)、谷氨酸氨基转移酶(ALT)、肠道菌群和T淋巴细胞水平,并统计两组患者的不良反应发生情况。结果观察组患者的治疗总缓解率为90.00%,明显高于对照组66.67%,差异有统计学意义(P<0.05);治疗后两组患者的TBIL、AST、ALT表达水平均降低,且观察组分别为(15.31±2.11)μmol/L、(34.76±5.17)IU/L、(37.12±4.11)IU/L,明显低于对照组的(19.87±3.09)μmol/L、(50.76±6.89)IU/L、(61.32±5.67)IU/L,差异均有统计学意义(P<0.05);治疗后,两组患者的双歧杆菌、乳酸杆菌均升高,且观察组分别为(9.87±0.78)copies/g、(9.66±1.31)copies/g,明显高于对照组的(9.21±0.66)copies/g、(8.54±1.23)copies/g,而肠杆菌降低,观察组为(7.01±0.89)copies/g,明显低于对照组的(8.21±1.01)copies/g,差异均有统计学意义(P<0.05);治疗后,两组患者的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均升高,且观察组分别为(69.87±5.28)%、(38.21±4.09)%、(1.89±0.32)%,明显高于对照组的(66.12±5.61)%、(34.11±3.89)%、(1.53±0.28)%,而CD8^(+)降低,且观察组为(26.11±2.99)%,明显低于对照组的(29.87±2.18)%,差异均有统计学意义(P<0.05);观察组和对照组患者的不良反应发生率分别为10.00%、16.67%,差异无统计学意义(P>0.05)。结论中医肝正方治疗肝癌可有效改善患者的肝功能,调节肠道菌群变化,提高免疫功能,临床治疗效果显著,安全性高。Objective To observe the curative effect of Zhenggan Decoction in the treatment of liver cancer,and to explore its influence on liver function,intestinal flora,and immune function.Methods A total of 60 liver cancer patients,who treated in Outpatient Department,Shenzhen Hospital of Beijing University of Traditional Chinese Medicine from August 2018 to June 2020 were selected and divided into observation group and control group according to random number table method,with 30 patients in each group.The patients in the control group were given liver protection and symptomatic support treatment,while the patients in the observation group were treated with Zhenggan Decoction on the basis of the treatment in the control group.After 3 months of treatment,the therapeutic effect,total bilirubin(TBIL),aspartate aminotransferase(AST),glutamic acid aminotransferase(ALT),intestinal flora,and T lymphocyte levels were compared between the two groups before and after treatment,and the adverse reactions of the two groups were counted.Results The total remission rate of the observation group was 90.00%,which was significantly higher than 66.67%of the control group(P<0.05);after treatment,the expression levels of TBil,AST,and ALT of the two groups decreased,and the levels in the observation group were(15.31±2.11)μmol/L,(34.76±5.17)IU/L,(37.12±4.11)IU/L,respectively,which were significantly lower than corresponding(19.87±3.09)μmol/L,(50.76±6.89)IU/L,(61.32±5.67)IU/L in the control group(all P<0.05);the bifidobacteria and lactobacilli levels of the two groups increased,and the levels in the observation group were(9.87±0.78)copies/g and(9.66±1.31)copies/g,which were significantly higher than corresponding(9.21±0.66)copies/g,(8.54±1.23)copies/g in the control group;but enterobacteria decreased,the level in the observation group was(7.01±0.89)copies/g,which was significantly lower than(8.21±1.01)copies/g in the control group(P<0.05);after treatment,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)of the two groups of patients increased,and t

关 键 词：肝癌 中医正肝方 肝功能 肠道菌群 免疫功能 不良反应 

分 类 号：R735.7[医药卫生—肿瘤]