解表剂桂枝汤加味治疗晚期肝癌合并腹水的临床疗效及对血清炎症因子影响分析  

Clinical Efficacy of Diaphoretic Recipe Modified Guizhi Decoction for the Treatment of Advanced Hepatocellular Carcinoma Complicated with Ascites and Its Effect on Serum Inflammatory Factors

作　　者：任素华 杨春旭 魏晓 REN Su-Hua;YANG Chun-Xu;WEI Xiao(The Fourth Clinical Medical School of Xinxiang Medical University,Xinxiang Central Hospital,Xinxiang 453000 Henan,China)

机构地区：[1]新乡医学院第四临床学院,新乡市中心医院,河南新乡453000

出　　处：《广州中医药大学学报》2023年第5期1096-1103,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:8180140119)。

摘　　要：【目的】分析解表剂桂枝汤加味治疗晚期肝癌合并腹水的临床疗效及对血清炎症因子的影响。【方法】通过便利抽样、对照原则回顾性收集2020年1月至2022年1月期间在新乡市中心医院住院治疗的100例晚期肝癌合并腹水患者,根据治疗方法的不同分为观察组和对照组,每组各50例。对照组给予常规西药治疗,观察组在对照组的基础上给予解表剂桂枝汤加味治疗,疗程为21 d。观察2组患者治疗前后腹围、Karnofsky功能状态(KPS)评分、血清炎症因子、肝功能、血清肿瘤标志物的变化情况,并评价2组患者的临床疗效。【结果】(1)治疗21 d后,观察组的总有效率为84.00%(42/50),对照组为60.00%(30/50),组间比较,观察组的疗效明显优于对照组(P<0.01)。(2)观察组治疗1周、2周、3周后及对照组治疗2周、3周后的腹围均较治疗前降低(P<0.05),KPS评分均较治疗前升高(P<0.05),且治疗组在治疗1周、2周、3周后对腹围的降低作用及对KPS评分的升高作用均明显优于对照组(P<0.01)。(3)观察组治疗1周、2周、3周后及对照组治疗2周、3周后的血清白细胞介素1β(IL-1β)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、癌胚抗原125(CA125)、甲胎蛋白(AFP)水平均较治疗前明显降低(P<0.05),且观察组在治疗1周、2周、3周后对上述指标的降低作用均明显优于对照组(P<0.05或P<0.01)。【结论】在常规西药治疗基础上配合解表剂桂枝汤加味治疗,可有效减少腹水量,缩小腹围,提高治疗效果,减轻炎症反应,降低血清肿瘤标志物水平,改善患者肝功能及生存状况,具有一定的临床价值。Objective To investigate the clinical efficacy of diaphoretic recipe modified Guizhi Decoction for the treatment of advanced hepatocellular carcinoma complicated with ascites and to observe its effect on serum inflammatory factors.Methods A total of 100 patients with advanced hepatocellular carcinoma complicated with ascites who were hospitalized in Xinxiang Central Hospital from January 2020 to January 2022 was retrospectively collected by blinding method,convenience sampling and control principle.The patients were divided into observation group and control groups according to the treatment methods,with 50 cases in each group.The control group was treated with conventional western medicine,while the observation group was treated with the diaphoretic recipe modified Guizhi Decoction on the basis of treatment for the control group.The course of treatment for the two groups lasted for 21 days.The pre-and post-treatment changes in abdominal circumference,Karnofsky performance status(KPS)scores,serum inflammatory factors,liver function and serum tumor markers in the two groups were observed.Moreover,the clinical efficacy of the patients in the two groups was evaluated.Results(1)After 21 days of treatment,the total effective rate of the observation group was 84.00%(42/50)and that of the control group was 60.00%(30/50),and the efficacy of the observation group was significantly superior to that of the control group when compared between the two groups(P<0.01).(2)The abdominal circumference in the observation group after one,2 and 3 week(s)of treatment and in the control group after 2 and 3 weeks was decreased,and the KPS scores in both groups were increased compared with those before treatment(P<0.05).The effect on reducing abdominal circumference and increasing KPS scores in the treatment group after one,2 and 3 week(s)of treatment was significantly superior to that in the control group(P<0.01).(3)The serum levels of interleukin 1β(IL-1β),C-reactive protein(CRP),tumor necrosis factorα(TNF-α),aspartate transaminase

关 键 词：桂枝汤 晚期肝癌 腹水 炎症反应 肝功能 血清肿瘤标志物 临床疗效 

分 类 号：R273.57[医药卫生—中西医结合]