中药预防肝癌早期消融术后复发的疗效评价  

Evaluation of the efficacy of traditional Chinese medicine in preventing recurrence after ablation of early-stage liver cancer

作　　者：张晶晶 周双男 付双楠 王宣 张宁 ZHANG Jing-jing;ZHOU Shuang-nan;FU Shuang-nan;ZHANG Ning(Department of Liver Disease,the Fifth Medical Center of Chinese PLA General Hospital(Beijing 100039),China;不详)

机构地区：[1]解放军总医院第五医学中心肝病医学部中医肝病科,北京100039 [2]解放军总医院第五医学中心感染病医学部生物损伤救治科

出　　处：《中西医结合肝病杂志》2023年第1期15-18,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：首都临床特色研究(No.Z181100001718075);艾滋病和病毒性肝炎等重大传染病防治(No,2018ZX10303502)。

摘　　要：目的:评估中药治疗预防肝癌早期消融术后复发的疗效并初步比较不同类别中药的疗效差异。方法:回顾性分析符合纳排标准的215例肝癌患者,根据消融术后是否使用中药及中药处方内是否含有虫类药物分为3组。采用Log-rank检验比较各组消融术后无复发生存时间的差异,采用Cox比例风险模型进行多因素分析评价中药作用的独立效果。结果:中药治疗能有效延长肝癌消融术后无复发生存时间(未服中药组13.8月,不含虫类中药组29.6月,含虫类中药组38.5月);中药治疗是肝癌消融术后无复发生存的独立保护因素(不含虫类组中药HR=0.58[0.35~0.94],含虫类组中药HR=0.47[0.31~0.72])。结论:肝癌消融术后使用扶正化瘀、清热解毒类中药治疗能有效延长无复发生存时间,加入含虫类抗肿瘤药物作用更为显著。Objective:To evaluate the efficacy of traditional Chinese medicine(TCM)in preventing recurrence after ablation of early-stage liver cancer and compare the effectiveness of different types of TCM.Methods:A retrospective analysis of 215 liver cancer patients who met the criteria for inclusion and exclusion were retrospectively divided into three groups according to whether TCM was used after ablation and whether the prescription contained insect drugs.Log-rank test was used to compare the difference in recurrence-free survival(RFS)after ablation in each group,and the Cox proportional hazard model was used to perform multivariate analysis to evaluate the independent effect of TCM.Results:TCM can effectively prolong the RFS after liver cancer ablation(13.8 months for the non-taking Chinese medicine group,29.6 months for the insect-free Chinese medicine group,and 38.5 months for the insect-containing Chinese medicine group);TCM treatment is an independent protective factor for RFS(HR=0.58[0.35~0.94]for the insect-free Chinese medicine group,HR=0.47[0.31~0.72]for the insect-containing Chinese medicine group).Conclusion:After liver cancer ablation,the use of TCM by methods of clearing away heat and detoxification,health-strengthening,and removing blood stasis can effectively prolong the RFS,and adding insect-containing anti-tumor herbs can achieve more significant efficacy.

关 键 词：肝癌 消融 中药 复发 

分 类 号：R735.7[医药卫生—肿瘤]