益气解毒方治疗原发性肝癌临床研究  

Clinical Study on Qi⁃Replenishing and Detoxification Decoction in the Treatment of Primary Liver Cancer

作　　者：任娟 刘海军 沈莉莉 曹振健 翟笑枫[3] 王祥麒[4] 殷晓聆[1] 侯风刚[1] REN Juan;LIU Haijun;SHEN Lili;CAO Zhenjian;ZHAI Xiaofeng;WANG Xiangqi;YIN Xiaoling;HOU Fenggang(Shanghai Hospital of Traditional Chinese Medicine,Shanghai,China,200071;Jiading District Nanxiang Hospital of Shanghai,Shanghai,China,201802;Changhai Hospital Affiliated to Naval Medical University,Shanghai,China,200433;Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou,Henan,China,450008)

机构地区：[1]上海市中医医院,上海200071 [2]上海市嘉定区南翔医院,上海201802 [3]第二军医大学附属长海医院,上海200433 [4]河南中医药大学第三附属医院,河南郑州450008

出　　处：《河南中医》2024年第5期744-748,共5页Henan Traditional Chinese Medicine

基　　金：上海市中医药管理局——中医非药物疗法示范中心建设子项目[ZY(2021-2023)-0204-05];上海市嘉定区卫生和计划生育委员会中医药科研项目(2019-KY-ZYY-06)。

摘　　要：目的:观察益气解毒方治疗原发性肝癌的临床疗效及其对患者血清中缺氧诱导因子-1α(Hypoxia inducible factor-1α,HIF-1α)及相关细胞因子表达的影响。方法:将80例原发性肝癌患者按照随机数字表法分为对照组和试验组,每组各40例。对照组给予甲磺酸阿帕替尼治疗,试验组在对照组治疗的基础上给予益气解毒方。ELISA定量检测两组患者治疗前及治疗8周后血清HIF-1α、内皮生长因子(endothelial growth factor,VEGF)、基质金属蛋白酶(matrix metalloproteinase,MMP)-2、MMP-9水平,比较两组患者临床疗效及不良反应发生率。结果:试验组有效率为37.5%,高于对照组的20.0%,差异有统计学意义(P<0.05)。两组患者治疗后MMP-2、MMP-9、VEGF、HIF-1α水平低于本组治疗前,治疗后试验组MMP-2、HIF-1α水平均低于对照组,差异有统计学意义(P<0.05)。试验组高血压、乏力发生率低于对照组,差异有统计学意义(P<0.05),但两组患者皮疹、手足综合征发生率、发热、腹泻、蛋白尿发生率比较,差异无统计学意义(P>0.05)。结论:益气解毒方治疗原发性肝癌,可缓解患者的临床症状,降低HIF-1α、MMP-2水平,抑制肿瘤血管生成。Objective:To observe the clinical efficacy of Qi⁃Replenishing and Detoxification Decoction on primary liver cancer and its in⁃fluence on the expression of hypoxia inducible factor⁃1α(HIF⁃1α)and related cytokines in patients′serum.Methods:A total of 80 pa⁃tients with primary liver cancer were divided into the control group and the experimental group according to the random number table method,with 40 cases in each group.The control group was given apatinib mesylate for oral treatment,while the experimental group was given Qi⁃Replenishing and Detoxification Decoction on the basis of the control group.The levels of serum HIF⁃1α,endothelial growth factor(VEGF),matrix metalloproteinase(MMP)⁃2,and MMP⁃9 in the two groups were quantitatively detected by ELISA before treat⁃ment and after 8 weeks of treatment respectively,and the clinical efficacy and incidence of adverse reactions in the two groups were compared.Results:The remission rate of the experimental group was 37.5%,which was higher than that of the control group:20%,and the difference was statistically significant(P<0.05).After treatment,the levels of MMP⁃2,MMP⁃9,VEGF,and HIF⁃1αin the two groups were lower than those before treatment,while the levels of MMP⁃2 and HIF⁃1αin the experimental group were lower than those in the control group,and all the differences were statistically significant(P<0.05).The incidence of hypertension and fatigue in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05),but there was no statistically significant difference in the incidence of rash,hand⁃foot syndrome,fever,diarrhea,and proteinuria between the two groups(P>0.05).Conclusion:Qi⁃Replenishing and Detoxification Decoction for the treatment of primary liver cancer can relieve the clinical efficacy of patients,reduce the levels of HIF⁃1αand MMP⁃2,and inhibit tumor angiogenesis.

关 键 词：原发性肝癌 益气解毒方 甲磺酸阿帕替尼 中西医结合疗法 缺氧诱导因子-1Α 内皮生长因子 基质金属蛋白酶-2 基质金属蛋白酶-9 

分 类 号：R273.357[医药卫生—中西医结合]