加味玉屏风散治疗气虚毒瘀型晚期肝癌的临床研究  

Clinical Study on the Treatment of Advanced Liver Cancer of Qi Deficiency and Toxic Stasis Type by Jiawei Yupingfeng San

作　　者：王宗傲 张明慧 孙华 欧阳依然 赵兰美 张婷[2] 姚霏[3] 袁琴[3] 江国荣[3] 张露蓉[3] 刘敏[1] WANG Zongao;ZHANG Minghui;SUN Hua;OUYANG Yiran;ZHAO Lanmei;ZHANG Ting;YAO Fei;YUAN Qin;JIANG Guorong;ZHANG Lurong;LIU Min(Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine,Suzhou 215009,China;Department of Oncology,Suzhou Hospital of Traditional Chinese Medicine,Suzhou 215009,China;Central Laboratory of Suzhou Hospital of Traditional Chinese Medicine,Suzhou 215009,China)

机构地区：[1]南京中医药大学附属苏州市中医医院,江苏苏州215009 [2]苏州市中医医院肿瘤科,江苏苏州215009 [3]苏州市中医医院中心实验室,江苏苏州215009

出　　处：《南京中医药大学学报》2024年第4期413-418,共6页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：苏州市科技计划项目(SS202083);国家自然科学基金青年科学基金项目(81303276)。

摘　　要：目的观察加味玉屏风散治疗气虚毒瘀型晚期肝癌的临床疗效及对患者血清胸腺基质淋巴细胞生成素(TSLP)水平的影响。方法采用随机双盲法将120例气虚毒瘀型晚期肝癌患者分为加味玉屏风散组、玉屏风散组和安慰剂组各40例,3组患者均给予放疗、化疗、介入或靶向治疗等常规治疗,加味玉屏风散组加服加味玉屏风散颗粒,玉屏风散组加服玉屏风散颗粒,安慰剂组加服安慰剂,疗程均为2个月。治疗前后观察3组患者Karnofsky功能状态评分(KPS评分)、中医证候积分、瘤体大小及血清TSLP水平变化情况,并将肿瘤大小变化与TSLP变化进行相关性分析。结果治疗后,玉屏风散组及加味玉屏风散KPS评分均显著提高(P<0.05,P<0.01),中医证候总积分显著降低(P<0.01),同时明显延缓肿瘤的生长(P<0.05,P<0.01),显著降低血清中TSLP水平(P<0.05,P<0.01)。此外,肿瘤大小变化与TSLP变化呈轻度正相关(P<0.05)。在改善瘤体大小方面,加味玉屏风散组疗效优于玉屏风散组(P<0.05)。治疗期间,3组患者均未见明显不良反应。结论加味玉屏风散联合常规治疗可显著延缓气虚毒瘀型晚期肝癌患者的肿瘤生长,改善患者中医症状同时显著提高患者生存质量,其疗效机制可能为通过降低患者血清TSLP表达,改善机体免疫状态有关。OBJECTIVE To observe the clinical efficacy and effect on serum thymic stromal lymphopoietin(TSLP)levels of patients with advanced liver cancer of qi deficiency and toxic stasis type by Jiawei Yupingfeng San.METHODS Using random double blind method,120 patients with advanced liver cancer of qi deficiency and toxic stasis type were randomly divided into 3 groups:Jiawei Yupingfeng San group,Yupingfeng San group,and placebo group,each consisting of 40 cases.All patients in the 3 groups were given conventional treatment such as radiotherapy,chemotherapy,interventional or targeted therapy;Jiawei Yupingfeng San group was given Jiawei Yupingfeng San granules,Yupingfeng San group was given Yupingfeng San granules,and placebo group was given placebo.The course of treatment was 2 months.The changes of Karnofsky functional status score(KPS score),TCM syndrome score,tumor size and serum TSLP level in the 3 groups were observed before and after treatment,and the correlation between the changes of tumor size and TSLP was analyzed.RESULTS After treatment,the KPS scores of Yupingfeng San group and Jiawei Yupingfeng San group were significantly increased(P<0.05,P<0.01),TCM syndrome score were decreased(P<0.01),tumor growth(P<0.05,P<0.01)was delayed,and serum TSLP levels(P<0.05,P<0.01)were decreased.Furthermore,there was a slight positive correlation between changes in tumor size and changes in TSLP(P<0.05).In terms of improving tumor size,the curative effect of Jiawei Yupingfeng San group was better than that of Yupingfeng San group(P<0.05).During the treatment period,no obvious adverse reactions were observed in the 3 groups of patients.CONCLUSION Combined with conventional treatment,Jiawei Yupingfeng San can significantly delay tumor growth in patients with advanced liver cancer of qi deficiency and toxic stasis type and improve patients'TCM syndromes and their quality of survival.The therapeutic mechanism is related to reducing the expression of serum TSLP and improving the immune status of patients,thereby delaying the growth

关 键 词：晚期肝癌 胸腺基质淋巴细胞生成素 加味玉屏风散 玉屏风散 生存质量 肿瘤生长 气虚毒瘀 

分 类 号：R285.5[医药卫生—中药学]