摘要
目的观察加味柴芍六君子汤联合TACE治疗中晚期原发性肝癌(PHC)的临床疗效。方法将中晚期PHC患者120例随机分配入组,分为联合组和常规组各60例。治疗期间两组各剔除6例,最终各有54例患者完成临床观察。常规组采用TACE治疗,联合组在TACE基础上给予加味柴芍六君子汤,随症加减。比较两组患者肿瘤客观大小、中医症候积分、生活质量评分、免疫功能及不良反应。结果两组患者经过3个疗程观察,肿瘤客观反应率联合组为66.7%,常规组为53.7%(P<0.05)。两组患者的临床症状(腹痛、发热、呕吐、乏力)与治疗前比较都有明显改善(P<0.05),且联合组明显优于常规组(P<0.05)。两组患者治疗后KPS评分均有所提高,且联合组明显高于常规组(P<0.05)。联合组治疗后Th1/Th2比值高于治疗前(P<0.05),且治疗后Th1/Th2比值高于常规组(P<0.05)。骨髓毒性方面,联合组与常规组相比差异无统计学意义(P>0.05)。肝功能和消化道不良反应及发热、心律紊乱发生率方面,联合组明显低于常规组(P<0.05)。结论加味柴芍六君子汤具有协同增效作用,能提高对PHC控制率,缓解临床症状,减少不良反应的发生,提高中晚期PHC综合治疗效果。
Objective To evaluate the clinical efficacy of modified Chaishao Liujunzi decoction combined with transcatheter arterial chemoembolization （TACE） in treating advanced primary liver cancers. Methods One hundred twenty patients with advanced primary liver cancer were enrolled in this study. The patients were randomly assigned into combination treatment group （n = 60） and conventional treatment group （n = 60）. The clinical observation was completed only in 54 patients of each group. Patients of conventional group received TACE treatment only, while patients of combination group received modified Chaishao Liujunzi decoction as well as TACE. The objective tumor size, symptom score of traditional Chinese medicine, quality of life score, immune function and toxicity reaction of each patient were determined, and the resuhs were compared between the two groups. Results After three therapeutic courses, the objective tumor response rate of the combination group and the conventional group was 66.67% and 53.70% respectively, the difference was statistically significant （P 〈 0.05）. The clinical symptoms, such as abdominal pain, fever, vomiting, fatigue, etc. in both groups were significantly improved when compared with those observed before treatment （P 〈 0.05）. The clinical symptoms observed in the combination group were significantly better than those observed in the conventional group （P 〈 0.05）. After the treatment Karnofsky- KPS scoring were improved, and the score of combination group was significantly higher than that of the conventional treatment group （P 〈 0.05）. In combination group Thl/Th2 ratio after the treatment was better than that determined before treatment （P 〈 0.05）, and the ratio after treatment in combination group was better than that in the conventional group （P 〈 0.05）. No significant difference in bone marrow toxicity existed between the combination group and conventional group （P 〉 0.05）. The incidence of liver toxicity, gastrointestinal reaction, fever and cardiac arrhythmia in the combination group was significantly lower than that in the conventional group （P 〈 0.05）. Conclusion Modified Chaishao Liujunzi has an enhancement effect for TACE, the use of it can improve disease control rate, relieve clinical symptoms and reduce the incidence of adverse reactions, thus the therapeutic results of advanced primary liver cancer can be effectively improved. （J Intervent Radiol, 2014, 23： 163-167）
出处
《介入放射学杂志》
CSCD
北大核心
2014年第2期163-167,共5页
Journal of Interventional Radiology
基金
上海市科委中医特色专科建设项目(08ZR1419200)
关键词
加味柴芍六君子汤
原发性肝癌
经肝动脉化疗栓塞
疗效观察
modified Chaishao Liujunzi decoction
primary hepatocellular carcinoma
transcatheterarterial chemoembolization
observation of efficacy
