参芪消积方联合替雷丽珠单抗及仑伐替尼治疗正虚瘀结型中晚期肝细胞癌的临床观察  

Clinical Observation of Shenqi Xiaoji Prescription Combined with Tislelizumab and Lenvatinib in the Treatment of Advanced Hepatocellular Carcinoma of Deficiency of Vital Energy and Stasis Type

作　　者：汪夏 夏黎明[2] WANG Xia;XIA Liming(Anhui University of Chinese Medicine,Anhui Hefei 230022,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China)

机构地区：[1]安徽中医药大学第一临床医学院,安徽合肥230022 [2]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《中医药临床杂志》2025年第1期146-152,共7页Clinical Journal of Traditional Chinese Medicine

基　　金：省十三五重点专科(肿瘤科)(项目编号:zlk20190054)。

摘　　要：目的:观察参芪消积方联合雷丽珠单抗及仑伐替尼治疗正虚瘀结型中晚期肝细胞癌的临床效果。方法:筛选符合标准的正虚瘀结型中晚期肝细胞癌患者54例,将筛选出的患者按照随机数字表法,以1∶1的比例随机分为实验组和对照组2组各27例。实验组给予参芪消积方与替雷丽珠单抗、仑伐替尼联合治疗;对照组给予替雷丽珠单抗、仑伐替尼靶免联合治疗。治疗4个疗程后比较实验组及对照组的临床疗效。结果:在完成治疗后,根据实体瘤反应评估标准(RECIST1.1),接受中西医结合治疗的患者和仅接受西医治疗的患者的疾病控制率分别为80.77%和53.85%,差异具有统计学意义(P<0.05);观察2组治疗前后中医证候积分变化,通过比较,实验组的总有效率更高(69.23%vs38.46%),差异具有统计学意义(P<0.05);2组患者治疗后卡式评分对比治疗前均有所升高(P<0.05),而实验组改善更显著(P<0.01);相较治疗前,治疗后2组患者甲胎蛋白及癌因性疲乏水平均显著降低(P<0.01),且实验组比对照组降幅更大(P<0.05)。在安全性评价方面,实验组胃肠道反应及手足综合征的不良反应发生率更低(P<0.05)。结论:参芪消积方联合替雷丽珠单抗、仑伐替尼治疗正虚瘀结型中晚期肝细胞癌具有良好的临床疗效,能有效改善患者的临床表现,抑制肿瘤细胞的增长,减小肿瘤病灶,降低某些不良反应的发生率,改善患者生活质量。Objective:To observe the clinical effect of Shenqi Xiaoji Recipe combined with retezumab and lenvatinib in the treatment of advanced hepatocellular carcinoma of deficiency of vital energy and stasis type.Methods:A total of 54 patients with advanced hepatocellular carcinoma of deficiency of vital energy and stasis type who met the criteria were screened and randomly divided into an experimental group and a control group at a ratio of 1:1,with 27 cases in each group.The experimental group was treated with Shenqi Xiaoji Recipe combined with retezumab and lenvatinib;the control group was treated with retezumab and lenvatinib combined with target immunity.The clinical efficacy of the experimental group and the control group was compared after 4 courses of treatment.Results:After the completion of treatment,according to the solid tumor response evaluation criteria(RECIST1.1),the disease control rates of patients receiving integrated Chinese and Western medicine treatment and those receiving only Western medicine treatment were 80.77%and 53.85%,respectively,with a statistically significant difference(P<0.05).The changes in TCM syndrome scores before and after treatment were observed in the two groups.By comparison,the total effective rate of the experimental group was higher(69.23%vs 38.46%),with a statistically significant difference(P<0.05).The Karnofsky scores of the two groups of patients increased after treatment compared with those before treatment(P<0.05),and the improvement in the experimental group was more significant(P<0.01).Compared with before treatment,the levels of alpha-fetoprotein and cancer-related fatigue in the two groups of patients after treatment were significantly reduced(P<0.01),and the reduction in the experimental group was greater than that in the control group(P<0.05).In terms of safety evaluation,the incidence of adverse reactions of gastrointestinal reactions and hand-foot syndrome was lower in the experimental group(P<0.05).Conclusion:Shenqi Xiaoji prescription combined with tislelizumab

关 键 词：肝细胞癌 正虚瘀结型 参芪消积方 替雷丽珠单抗 仑伐替尼 

分 类 号：R273[医药卫生—中西医结合]