参麦散结胶囊联合微波消融治疗老年小肝癌患者的疗效  

Efficacy of Shenmai Sanjie capsule combined with microwave ablation in the treatment of senile small liver cancer and its influence on tumor markers,functional status and survival rate

作　　者：郭玺 汤晓青 王洁 万焱 陈瑾 党富涛 徐斌 付海艳 罗煜 GUO Xi;TANG Xiao-qing;WANG Jie(Care/Oncology Department of Yunnan Infectious Disease Clinical Medical Center,Kunming Third People's Hospital,Kunming,650041,China.)

机构地区：[1]昆明市第三人民医院云南省传染性疾病临床医学中心关怀/肿瘤科,云南昆明650041

出　　处：《中西医结合肝病杂志》2025年第3期305-309,共5页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：昆明市官渡区科技创新团队培养(No.202004)。

摘　　要：目的:探讨参麦散结胶囊联合微波消融治疗老年小肝癌的疗效,并分析其对肿瘤标志物、功能状态及生存率的影响。方法:选取98例老年小肝癌患者,随机分为对照组、研究组,每组各49例。对照组患者采用微波消融治疗,研究组患者采用参麦散结胶囊联合微波消融治疗。比较两组患者近期疗效、中医证候积分、血清肿瘤标志物[异常凝血酶原Ⅱ(PIVKA-Ⅱ)、甲胎蛋白(AFP)、磷脂酰肌醇蛋白聚糖3(CPC3)]、炎性因子[C反应蛋白/白蛋白比值(CAR)、肿瘤坏死因子α(TNF-α)、白介素-10(IL-10)]、功能状态、肝区疼痛及生存率。结果:研究组患者治疗总有效率高于对照组(83.67%vs 61.22%,P<0.05)。研究组患者治疗后中医证候积分低于对照组(P<0.05)。研究组患者治疗后血清PIVKA-Ⅱ、AFP、CPC3水平分别为(285.76±55.18)U/L、(539.64±75.23)μg/L、(2.90±0.86)μg/L,低于对照组的(359.81±67.24)U/L、(608.41±87.54)μg/L、(3.85±1.04)μg/L(P<0.05)。研究组患者治疗后血清CAR、TNF-α、IL-10水平分别为(0.18±0.05)、(0.71±0.19)ng/ml、(55.91±16.20)pg/ml,低于对照组的(0.25±0.07)、(0.83±0.21)ng/ml、(70.84±18.41)pg/ml(P<0.05)。研究组患者治疗后KPS评分高于对照组[(81.46±4.29)分vs(75.31±4.70)分],VAS评分低于对照组[(2.41±0.73)分vs(2.95±0.81)分,(P<0.05)]。研究组患者术后12个月生存率高于对照组(100.00%vs 86.67%,P<0.05)。结论:参麦散结胶囊联合微波消融治疗老年小肝癌患者的疗效确切,可改善临床症状,控制肿瘤进展,抑制炎症反应,并可改善功能状态,减轻肝区疼痛程度,提高生存率。Objective:To explore the efficacy of Shenmai Sanjie capsule combined with microwave ablation in the treatment of senile small liver cancer and analyze its effects on tumor markers,functional status,and survival rate.Methods:A total of 98 elderly patients with small liver cancer treated in Kunming Third People's Hospital from January 2021 to January 2023 were selected and divided into control group and study group with 49 cases each by random number table method.The control group was treated with microwave ablation,and the study group was treated with Shenmai Sanjie capsule combined with microwave ablation.The short-term efficacy,TCM syndrome scores,serum tumor markers[abnormal prothrombinⅡ(PIVKA-Ⅱ),alpha-fetoprotein(AFP),phosphatidylinositol proteoglycan 3(CPC3)],inflammatory factors[C-reactive protein/albumin ratio(CAR),tumor necrosis factorα(TNF-α),interleukin-10(IL-10)],Functional status,hepatic pain and survival rate were compared between the two groups.Results:The total effective rate of the study group was higher than that of the control group(83.67%vs.61.22%,P<0.05).The TCM syndrome score of the study group was lower than that of the control group(P<0.05).The levels of PIVKA-Ⅱ,AFP and CPC3 after treatment were(285.76±55.18)U/L,(539.64±75.23)μg/L and(2.90±0.86)μg/L,respectively.Lower than that of control group(359.81±67.24)U/L,(608.41±87.54)μg/L,(3.85±1.04)μg/L(P<0.05);The levels of CAR,TNF-αand IL-10 in serum after treatment were(0.18±0.05),(0.71±0.19)ng/ml and(55.91±16.20)pg/ml,respectively.It was lower than that of control group(0.25±0.07),(0.83±0.21)ng/ml,(70.84±18.41)pg/ml(P<0.05).After treatment,the KPS score of the study group was higher than that of the control group[(81.46±4.29)points vs.(75.31±4.70)points],and the VAS score was lower than that of the control group[(2.41±0.73)points vs.(2.95±0.81)points,(P<0.05)].The 12-month survival rate of the study group was higher than that of the control group(100.00%vs.86.67%,P<0.05).Conclusion:Shenmai Sanjie capsule combined wit

关 键 词：小肝癌 老年 参麦散结胶囊 微波消融 疗效 功能状态 生存率 

分 类 号：R735.7[医药卫生—肿瘤]