桂枝汤加味对中老年晚期肝癌合并腹水患者的免疫指标和血清肿瘤标志物及生活质量的影响  

Effects of modified Guizhi decoction on immune indicators,serum tumor markers and quality of life in middle-aged and elderly patients with advanced liver cancer complicated by ascites

作　　者：刘位坤 赵亚博 胡景景 王春霞 王英强[1] LIU Weikun;ZHAO Yabo;HU Jingjing;WANG Chunxia;WANG Yingqiang(Department of Hepatology,Handan Infectious Disease Hospital,Handan,Hebei,056001,China)

机构地区：[1]邯郸市传染病医院肝四科,河北邯郸056001

出　　处：《中国中西医结合消化杂志》2024年第9期790-795,共6页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：邯郸市科学技术研究与发展计划项目(No:21422083035)。

摘　　要：目的:探讨桂枝汤加味对中老年晚期肝癌合并腹水患者的免疫指标、血清肿瘤标志物及生活质量的影响。方法:收集2022年1月—2023年9月收治的103例中老年晚期肝癌合并腹水患者的资料,按照随机分组的方法将患者分为观察组(51例,常规西药治疗结合桂枝汤加味)与对照组(52例,常规西药治疗)。对比两组患者的肿瘤疗效、腹水疗效、免疫指标、血清肿瘤标志物、中医症状积分改善情况、生活质量及不良反应。结果:与对照组比较,观察组的疾病控制率更高(80.4%vs 57.7%),差异有统计学意义(P<0.05)。治疗后,与对照组比较,观察组的腹围、体重更低,24 h尿量更高(P<0.05);CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)更高,CD8^(+)更低(P<0.05);血清AFP、AFP-L3、GP73水平更低(P<0.001)。治疗后,与对照组比较,观察组的总有效率更高(90.2%vs 36.5%,P<0.001),KPS评分也更高(P<0.001)。两组患者均未出现明显不良反应。结论:在常规治疗基础上加用桂枝汤加味能明显减少中老年晚期肝癌患者的腹水量,提升免疫功能,降低肿瘤标志物水平,改善生活质量。Objective:To investigate the effects of modified Guizhi decoction on immune indicators,serum tumor markers and quality of life in middle-aged and elderly patients with advanced liver cancer complicated by ascites.Methods:Data were collected from 103 middle-aged and elderly patients with advanced liver cancer complicated by ascites who were treated from January 2022 to September 2023.According to the method of randomization,the patients were divided into observation group(conventional Western medicine treatment combined with modified Guizhi decoction,51 cases)and control group(conventional Western medicine treatment,52 cases).Tumor efficacy,ascites efficacy,immune indicators,serum tumor markers,quality of life and adverse reactions were compared between the two groups.Results:Compared with the control group,the disease control rate in the observation group was higher(80.4%vs 57.7%,P<0.05).After treatment,compared with the control group,abdominal circumference,body weight in observation group were lower,24 h urine volume was higher(P<0.05).Compared with the control group,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were higher and CD8^(+)were lower in the observation group(P<0.05).Compared with the control group,the serum levels of AFP,AFP-L3 and GP73 in the observation group were lower(P<0.001).Compared with the control group,the total effective rate of traditional Chinese medicine symptom score in the observation group was higher(90.2%vs 36.5%,P<0.001).Compared with the control group,the KPS score of the observation group was higher(P<0.001).No significant adverse reactions were reported in both groups.Conclusion:The addition of modified Guizhi decoction on the basis of conventional treatment can significantly reduce the amount of ascites in middle-aged and elderly patients with advanced liver cancer,improve their immune function,lower tumor marker levels,and enhance quality of life.

关 键 词：桂枝汤加味 晚期肝癌 腹水 免疫指标 肿瘤标志物 生活质量 

分 类 号：R256.3[医药卫生—中医内科学]