分阶段中药内服外治法配合高强度聚焦超声治疗原发性肝癌的疗效观察  

Application of staged traditional chinese medicine for oral and external use combined with high-intensity focused ultrasound in patients with liver cancer

作　　者：居伟[1] 周文明[1] JU Wei;ZHOU Wen-ming(Department of gastroenterology,suzhou high-tech zone people's hospital(Suzhou Jiangsu,215129)China)

机构地区：[1]苏州高新区人民医院消化内科,江苏苏州215129

出　　处：《中西医结合肝病杂志》2022年第10期888-891,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：苏州市卫健委科研课题(No.SYSD2019231)。

摘　　要：目的:探讨分阶段中药内服外治法配合高强度聚焦超声(HIFU)治疗原发性肝癌患者的疗效。方法:选择2018年3月至2019年3月收治的100例HIFU治疗原发性肝癌(PHC)患者为研究对象,随机分为对照组和试验组,每组各50例。对照组患者采用HIFU治疗;试验组患者在对照组基础上,采用分阶段中药内服外治,即在HIFU治疗前采用泻浊护肝益气方灌肠液保留灌肠,在HIFU治疗后采用西黄胶囊口服治疗。两组患者治疗疗程均为1月。观察两组患者临床疗效、干预前后血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、T淋巴细胞亚群(CD4~+)、总胆红素(TBil)变化;并记录HIFU前的灌肠次数以及治疗过程中的各类不良反应,包括骨髓抑制、肝区不适、恶心呕吐。结果:治疗后,试验组患者总有效率为62%,优于对照组患者(18.37%),差异有统计学意义(P<0.05);两组患者治疗后ALT、AST、CD4~+、TBil均较治疗前显著改善(P<0.05),试验组患者指标改善情况均优于对照组(P<0.05);试验组患者灌肠次数少于对照组,差异有统计学意义(P<0.05);试验组患者恶心呕吐、肠道并发症和骨髓抑制等不良反应发生率均低于对照组,差异有统计学意义(P<0.05)。结论:HIFU配合分阶段中药内服外治法治疗PHC患者,可以减少灌肠次数,保护胃肠正气,改善患者生化指标,提高临床疗效,值得进一步推广和研究。Objective:To explore the application of staged Chinese medicine for oral and external use combined with high-intensity focused ultrasound(HIFU)in patients with liver cancer.Methods:A total of 100 HIFU-treated patients with primary liver cancer who were admitted from March 2018 to March 2019 were selected as the research objects,and they were randomly divided into a control group and a test group.The control group was treated with high-intensity focused ultrasound(HIFU)alone.On the basis of the control group,the experimental group adopted phased traditional Chinese medicine for internal and external use,that was,the Xihuanghuganyiqi Prescription enema was used to retain the enema before HIFU,and Xihuang Capsule was used for oral treatment after HIFU.Observation of clinical efficacy,changes in serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),T lymphocyte subsets(CD4),and total bilirubin(TBil)before and after intervention.The number of enemas before HFI and various adverse reactions in the later process,including bone marrow suppression,liver discomfort,nausea and vomiting.Results:In terms of clinical efficacy,after one month of intervention,the total effective rate of the control group was 18.37%and the observation group was 62%.The observation group was better than the control group,and the difference was statistically significant(P<0.05);In terms of inspection,the comparison of ALT,AST,CD4and TBil between the two groups before intervention was not statistically significant(P>0.05);after one month,the two groups had statistically significant differences in the above indicators compared with those before treatment(P<0.05);and the comparison between the groups,the test group was better than the control group in the results of ALT,AST,CD4,TBil(P<0.05);in the number of enema,the test group was less than the control group,the difference was statistically significant(P<0.05).In terms of adverse reactions,the three indexes of"nausea and vomiting","intestinal complication"and"bone marrow suppression"in

关 键 词：原发性肝癌 高强度聚焦超声 中医治疗 中药保留灌肠 

分 类 号：R273[医药卫生—中西医结合] R256.42[医药卫生—中医肿瘤科]