“补肾生髓成肝”改善肝癌肝再生微环境治疗晚期肝癌的临床疗效观察及机制研究  

Clinical observation and mechanism study of"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"improving the microenvironment of liver regeneration in the treatment of advanced liver cancer

作　　者：刘皎皎 李瀚旻 高翔 叶之华 戴玲 陈乞 LIU Jiao-jiao;LI Han-min;GAO Xiang(Shanxi Provincial Hospital of Traditional Chinese Medicine(Xi'an Shaanxi,710000)China;不详)

机构地区：[1]陕西省中医医院,陕西西安710003 [2]湖北省中医院肝病研究所、湖北中医药大学附属医院、湖北省中医药研究院中医基础理论研究所、中医肝肾研究及应用湖北省重点实验室、国家中医药管理局中医药科研三级实验室细胞分子生物学实验室、国家中医药管理局慢性肝病肝肾论治重点研究室

出　　处：《中西医结合肝病杂志》2022年第8期683-688,共6页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：国家自然科学基金(No.81973669,No.81703912,No.81603484,No.81373513);国家中医临床研究基地(湖北)重点病种研究项目(No.JDZX2015172);李瀚旻名老中医传承工作室项目。

摘　　要：目的:对比观察“补肾生髓成肝”治疗法则改善肝再生微环境治疗晚期肝癌的临床疗效及其机制。方法:将2017年1月至2020年6月收治的126例晚期肝癌患者采用随机数字表法分为3组,每组42例,西医对照组患者(简称西医组)采用西医综合治疗方案,“补肾生髓成肝”单独治疗组患者(简称中医组)采用地五养肝方、抗毒软坚方、左归饮合方化裁,辨证加减治疗方案,“补肾生髓成肝”综合治疗组患者(简称中西医组)在西医治疗组方案基础上联合地五养肝方、抗毒软坚方、左归饮合方化裁,辨证加减。比较3组患者治疗3个月及治疗6个月的生存率及生存期、治疗后3个月血常规及相关生化指标、中医证候评分、生存质量评分,并检测患者血清肝再生相关细胞因子(G-CSF、HGF、IFN-γ、IL-6、IL-8、IL-18、PDGF-BB、SCF、TNF-α)水平。结果:治疗3个月后,中西医组和中医组患者生存率(88.10%、72.22%)较西医组(52.63%)明显升高,差异有统计学意义(P<0.05)。治疗6个月后,中西医组和中医组患者生存率(71.43%、58.33%)显著高于西医组(34.21%),差异具有统计学意义(P<0.05)。治疗后中西医组患者生存期平均为(23.88±17.52)个月,中医组患者生存期平均为(20.08±19.86)个月,西医组患者生存期平均为(15.95±16.44)个月,差异具有统计学意义(P<0.05)。3组患者治疗前后白蛋白水平比较,具有统计学意义(P<0.05);白细胞水平、中性粒细胞/淋巴细胞比值、血小板和肌酐水平比较,差异均具有统计学意义(P<0.05)。治疗后中西医组和中医组患者HGF、G-CSF、IL-6、IL-8、IL-18和SCF的表达水平较西医对照组下降,其中与西医对照组比较,HGF在中西医组和中医组患者的表达明显下降,差异有统计学意义(P<0.05)。结论:“补肾生髓成肝”治疗法则能够显著提高晚期肝癌患者3个月及6个月的生存率及生存期,改善晚期肝癌患者临床症状和生化指标,提�Objective:To compare and observe the clinical efficacy and mechanism of"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"in improving the microenvironment of liver regeneration in the treatment of advanced liver cancer.Methods:A total of 126 patients with advanced liver cancer who were treated from January 2017 to June 2020 were divided into 3 groups by random number table method.The western medicine control group(referred to as the western medicine group)was treated with a comprehensive treatment plan of western medicine.The single treatment group of"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"(referred to as the traditional Chinese medicine group)adopted the combination of Diwu Yanggan Decoction,Kangdu Ruanjian Decoction,and Zuogui Pill,and add and subtract according to syndrome differentiation.The comprehensive treatment group of"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"(referred to as the Chinese and Western medicine group)adopted the Western medicine treatment group's plan combined with Diwuyanggan Decoction,Antidu Ruanjian Decoction,and Zuogui Pill,and added and subtracted according to syndrome differentiation.The survival rate and survival time of the three groups after 3 month treatment and 6 month treatment were compared.The blood routine and related biochemical indexes,TCM syndrome scores,quality of life scores,and serum liver regeneration-related cytokines(G-CSF,HGF,IFN-γ,IL-6,IL-8,IL-18,PDGF-BB,SCF,TNF-α)expression were compared 3 months after treatment.Results:After 3 months of treatment,the survival rates of patients in the TCM and western medicine groups(88.10%,72.22%)were significantly higher than those in the western medicine group(52.63%),and the difference was statistically significant(P<0.05).After 6 months of treatment,the survival rate of patients in Chinese and western medicine group(71.

关 键 词：“补肾生髓成肝” 肝癌 肝再生微环境 

分 类 号：R256.42[医药卫生—中医内科学]