益脾养肝方对肝郁脾虚证原发性肝癌TACE患者bFGF、VEGF、AFP-L3及免疫功能影响  

Effect of Yipi Yanggan Decoction(益脾养肝方)on bFGF,VEGF,AFP-L3 and Immune Function in Patients Undergoing TACE Surgery for Primary Liver Cancer

作　　者：宋春荣 南然 刘永刚 李京涛 闫曙光[2] 魏海梁 席奇 寇小妮 SONG Chunrong;NAN Ran;LIU Yonggang;LI Jingtao;YAN Shuguang;WEI Hailiang;XI Qi;KOU Xiaoni(Liver Disease Hospital,Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang 712000,Shaanxi,China;Shaanxi University of Traditional Chinese Medicine,Xianyang 712000,Shaanxi,China)

机构地区：[1]陕西中医药大学附属医院肝病医院,陕西咸阳712000 [2]陕西中医药大学,陕西咸阳712000

出　　处：《辽宁中医药大学学报》2022年第1期80-84,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金(81603612);中医药防治肝病“炎-癌”转变研究创新团队(2019-VL05)。

摘　　要：目的探讨益脾养肝方在肝郁脾虚证原发性肝癌经肝动脉插管化疗栓塞术(TACE)患者治疗中的应用价值,观察其对肿瘤指标、免疫功能指标的影响,旨在为该病提供有效的治疗手段。方法将2017年4月—2019年11月因原发性肝癌于陕西中医药大学附属医院就诊行TACE且中医证型属于肝郁脾虚证的90例患者纳入研究,并用随机数字表分组。对照组45例单纯采用TACE治疗,观察组45例则联合益脾养肝方口服治疗,治疗8周后比较临床疗效。结果治疗后观察组血清甲胎蛋白异质体(AFP-L3)、甲胎蛋白(AFP)、癌胚抗原(CEA)等肿瘤指标低于对照组,差异具有统计学意义(P<0.05);治疗后观察组血清碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)低于对照组,差异具有统计学意义(P<0.05);治疗后观察组血清基质金属蛋白酶-9(MMP-9)、CC型趋化因子18(CCL18)水平低于对照组(P<0.05);治疗后观察组CD_(4)^(+)/CD_(8)^(+)、CD_(4)^(+)细胞、CD_(3)^(+)细胞等免疫功能指标均高于对照组(P<0.05);治疗后观察组总有效率为91.11%(41/45),高于对照组73.33%(33/45),差异具有统计学意义(P<0.05);治疗后观察组骨髓抑制、胃肠道反应、肝功能损伤等不良反应总发生率为33.33%(15/45),低于对照组的71.11%(32/45),差异具有统计学意义(P<0.05)。结论对于肝郁脾虚证原发性肝癌TACE患者而言,联合益脾养肝方治疗可预防血管新生及肿瘤转移,提高免疫力,降低化疗不良反应。Objective To explore the application value of Yipi Yanggan Decoction(益脾养肝方)in the treatment of patients with liver depression and spleen deficiency syndrome with primary liver cancer undergoing transcatheter arterial chemoembolization(TACE),and to observe its effect on tumor indexes and immune function indexes,in order to provide effective treatment for this disease.Methods From April 2017 to November 2019,90 patients with primary liver cancer who underwent TACE in the affiliated hospital of Shaanxi university of traditional Chinese medicine and whose TCM syndrome type belongs to liver depression and spleen deficiency syndrome were included in the study and grouped by random number table.The 45 cases in the control group were treated with TACE alone,and the 45 cases in the observation group were treated with Yipi Yanggan Decoction.The clinical effects were compared after 8 weeks of treatment.Results After treatment,serum alpha-fetoprotein heterogenes(AFP-L3),alphafetoprotein(AFP),carcino-embryonic antigen(CEA)and other tumor indicators in the observation group were lower than those in the control group.Statistically significant(P<0.05);serum basic fibroblast growth factor(b FGF)and Vascular endothelial growth factor(VEGF)in the observation group after treatment were lower than those in the control group,and the difference was Statistical significance(P<0.05);serum matrix metalloproteinase-9(MMP-9)and CC cehemokine 18(CCL18)levels in the observation group after treatment were lower than those in the control group(P<0.05);After treatment,the immune function indexes such as CD_(4)^(+)/CD_(8)^(+),CD_(4)^(+)cells and CD_(3)^(+)cells in the observation group were greater than those in the control group(P<0.05);the total effective rate of the observation group was 91.11%(41/45),which was higher than in the control group 73.33%(33/45),the difference was statistically significant(P<0.05);the total incidence of adverse reactions such as bone marrow suppression,gastrointestinal reactions,liver damage in the observ

关 键 词：益脾养肝方 原发性肝癌 经肝动脉插管化疗栓塞术 肝郁脾虚证 碱性成纤维细胞生长因子 血管内皮生长因子 免疫功能 不良反应 

分 类 号：R735.7[医药卫生—肿瘤]