清热利胆自拟方对仑伐替尼联合卡瑞丽珠单抗治疗晚期原发性肝癌患者炎症因子、免疫细胞水平和生活质量的影响  

Effect of self-made Qingre Lidan decoction on inflammatory factors,immune cell levels and quality of life in patients with advanced primary liver cancer treated with lenvatinib combined with carrelizumab

作　　者：王瑛[1] 袁鹤立 赵利[1] 马向明[1] 袁楠[1] 王清贤[3] WANG Ying;YUAN Heli;ZHAO Li;MA Xiangming;YUAN Nan;WANG Qingxian(Kailuan General Hospital (Hebei Hepatobiliary Diseases Institute of Integrated Traditional Chinese and Western Medicine ),Tangshan 063000, Hebei,China;The Affiliated Hospital of North China University of Science and Technology, Tangshan 063000, Hebei, China;Tangshan Hospital of Traditional Chinese Medicine, Tangshan 063000, Hebei, China)

机构地区：[1]开滦总医院(河北省中西医结合肝胆病研究所),河北唐山063000 [2]华北理工大学附属医院,河北唐山063000 [3]唐山市中医医院,河北唐山063000

出　　处：《现代中西医结合杂志》2021年第24期2664-2669,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2020425)。

摘　　要：目的评价清热利胆自拟方对仑伐替尼联合卡瑞丽珠单抗治疗晚期原发性肝癌患者的炎症因子、免疫细胞水平、生活质量的影响。方法选取2018年12月—2020年5月在开滦总医院住院确诊为晚期原发性肝癌患者90例,根据患者自己及家属是否愿意行清热利胆汤自拟方治疗分为中药组42例和对照组48例,2组均给予仑伐替尼联合卡瑞丽珠单抗治疗,2周为1个疗程,共治疗4个疗程,中药组同时给予清热利胆自拟方口服。分别在治疗前及治疗后15 d、30 d检测2组患者血清白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)及CD3^(+)、CD4^(+)、CD8^(+),比较2组患者临床疗效、不良反应发生情况及生活质量。结果中药组患者治疗后30 d的血清IL-1、IL-6、TNF-α、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平与对照组比较差异均具有统计学意义(P均<0.05)。中药组有效率为40.48%(17/42)、疾病控制率为83.33%(35/42),对照组有效率为41.67%(20/48)、疾病控制率为81.25%(39/48),2组有效率及疾病控制率比较差异均无统计学意义(P均>0.05)。中药组患者手足感觉异常、发声困难、高血压、恶心呕吐、腹泻、食欲减退发生率均明显低于对照组(P均<0.05)。治疗后2组患者社会功能、生理功能、躯体疼痛、生理职能、总体健康、活力、情感职能、精神健康评分及生理健康评分、心理健康评分、总评分均升高(P均<0.05),且中药组均明显高于对照组(P均<0.05)。结论清热利胆自拟方用于仑伐替尼联合卡瑞丽珠单抗治疗晚期原发性肝癌患者不影响有效率及疾病控制率,可以抑制炎症反应,提高免疫细胞水平,控制药物不良反应的发生,并提高生活质量。Objective It is to evaluate the effect of self-made Qingre Lidan decoction on inflammatory factors,immune cell levels and quality of life in patients with advanced primary liver cancer treated with lenvatinib combined with carrelizumab.Methods A total of 90 patients with advanced primary liver cancer diagnosed in Kailuan General Hospital from December 2018 to May 2020 were selected.According to whether the patients and their family members were willing to treat with self-made Qingre Lidan decoction,they were divided into 42 cases in the traditional Chinese medicine group,48 cases in the control group,both groups were treated with lenvatinib combined with carrelizumab.2 weeks was a course of treatment,totally treated for 4 courses.The Chinese medicine group was also treated with self-made Qingre Lidan decoction orally.The levels of serum interleukin-1(IL-1),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and CD3^(+),CD4^(+),CD8^(+)were detected in the two groups before treatment and after treatment for 15 d and 30 d,the clinical efficacy,adverse reactions and quality of life of the two groups were compared.Results The levels of serum IL-1,IL-6,TNF-α,CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)of patients in the traditional Chinese medicine group were significantly different from those in the control group after treatment for 30 days(all P<0.05).The effective rate was 40.48%(17/42)and the disease control rate was 83.33%(35/42)in the traditional Chinese medicine group,and the effective rate was 41.67%(20/48)and the disease control rate was 81.25%(39/48)in the control group,there was no significant difference in the effective rate and disease control rate between the two groups(P>0.05).The incidence of hand and foot paresthesia,dysphonia,hypertension,nausea and vomiting,diarrhea,and loss of appetite in the Chinese medicine group were significantly lower than those in the control group(all P<0.05).After treatment,the scores of social function,physiological function,physical pain,physiological f

关 键 词：清热利胆自拟方 仑伐替尼 原发性肝癌 炎症因子 生活质量 

分 类 号：R735.7[医药卫生—肿瘤]