扶正解毒消积方联合肝动脉化疗栓塞术对原发性肝癌气阴两虚、毒瘀蕴积证患者免疫功能及生存情况的影响  

Effect of Fuzheng Jiedu Xiaoji Formula(扶正解毒消积方)Combined with Transhepatic Arterial Chemoembolization on Immune Function and Survival Condition of Primary Hepatic Carcinoma with Qi-yin Deficiency and Toxin-stasis Accumulation Syndrome

作　　者：李斌[1] 刘遥[1] 冯颖[1] 王宪波[1] LI Bin;LIU Yao;FENG Ying;WANG Xianbo(Beijing Ditan Hospital,Capital Medical University,Beijing,100015)

机构地区：[1]首都医科大学附属北京地坛医院,北京市100015

出　　处：《中医杂志》2022年第12期1143-1148,共6页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82004153)。

摘　　要：目的观察扶正解毒消积方对行肝动脉化疗栓塞术(TACE)的原发性肝癌气阴两虚、毒瘀蕴积证患者免疫功能及生存情况的影响。方法选取120例原发性肝癌气阴两虚、毒瘀蕴积证患者作为研究对象,均为TACE初治患者,根据患者意愿分为中西医组56例和西医组64例。西医组采用TACE和对症支持治疗,每位患者行TACE治疗2~4次,每次间隔时间为6~8周。中西医组在TACE治疗同时加用扶正解毒消积方,每日1剂,3个月为1个疗程,连服3个疗程。比较两组患者治疗前后T细胞免疫功能相关指标(CD3^(+)、CD4^(+)、CD8^(+)及CD4/CD8)、血清甲胎蛋白(AFP)水平、肿瘤无进展生存期,分析患者复发时间影响因素。结果西医组患者治疗后CD3^(+)、CD4^(+)明显低于治疗前(P<0.05)。治疗后中西医组CD3^(+)、CD4^(+)水平明显高于同期西医组,而血清AFP水平明显低于同时期西医组(P<0.01)。两组患者治疗后,中西医组无进展生存期在3个月、6个月、9个月、12个月、18个月各时段病例数均明显高于同时期西医组(P<0.01)。中西医组的复发时间为8.5(4.00,12.00)个月,西医组的复发时间为2.00(1.00,3.00)个月。中西医组的复发时间长于西医组(P<0.01)。复发时间影响因素分析显示,组别和BCLC分期是复发时间的影响因素,西医组的复发风险是中西医组的3.483倍(OR=3.483,95%CI为2.272~5.340),BCLC分期每进展一期,复发风险上升1.758倍(OR=1.758,95%CI为1.104~2.800)。结论扶正解毒消积方可改善TACE初治的原发性肝癌气阴两虚、毒瘀蕴积证患者免疫功能,增强抗肿瘤能力,抑制短期复发,延长无进展生存期,从而延缓病情进展。Objective To explore the effect of Fuzheng Jiedu Xiaoji Formula(扶正解毒消积方)on immune function and survival of primary hepatic carcinoma(PHC)with qi-yin deficiency and toxin-stasis accumulation syndrome undergoing transhepatic arterial chemoembolization(TACE).Methods PHC and qi-yin deficiency and toxin-stasis accumulation syndrome were included,and they were divided into two groups according to patients’willingness,56 cases in the integration group and 64 cases in the western medicine group.The western medicine group was given 2-4 times TACE with an interval of 6 to 8 weeks as well as symptomatic and supportive treatment.The integration group was given TACE and Fuzheng Jiedu Xiaoji Formula,one dose daily,three months as a course,for three courses.The T cell immune function indicators(CD3^(+),CD4^(+),CD8^(+)and CD4/CD8),serum alpha fetoprotein(AFP),progression-free survival(PFS)were assessed before and after treatment,and factors influencing the recurrence time were analyzed.ResultsAfter treatment,the level of CD3^(+)and CD4^(+)significantly decreased in the western medicine group(P<0.05).The integration group had higher levels of CD3^(+)and CD4^(+)and lower level of serum AFP than the western medicine group(P<0.01).The number of cases with PFS at 3,6,9,12 and 18 months were higher in the integration group than in the western medicine group(P<0.01).The recurrence time in the integration group was 8.5(4.00,12.00)months,significantly longer than 2.00(1.00,3.00)months of the western medicine group(P<0.01).Group and BCLC stage were the influencing factors of recurrence time,and the recurrence risk of the western medicine group was 3.483 times that of the integration group(OR=3.483,95%CI:2.272-5.340),while the risk of recurrence increased by 1.758 times as the BCLC progressed into next stage(OR=1.758,95%CI 1.104-2.800).Conclusion Fuzheng Jiedu Xiaoji Formulacan improve the immune function,enhance anti-tumor ability,inhibit the short-term recurrence,and extend PFS in TACE-naive PHC patients with qi-yin defic

关 键 词：原发性肝癌 肝动脉化疗栓塞术 扶正解毒消积方 免疫功能 T淋巴细胞 无进展生存期 

分 类 号：R735.7[医药卫生—肿瘤]