摘要
[目的]观察四君子汤联合西药治疗原发性肝癌导管动脉内化疗栓塞术后综合征疗效。[方法]使用随机平行对照方法,将64例住院及门诊患者按掷骰子方法简单随机分为两组。对照组32例术后补液、止吐、退热、止痛、保肝等,复方甘草酸苷40-60m L/次,0.9%氯化钠或5%葡萄糖适量溶解,1次/d,静脉注射;维生素C1-2片/次,1次/d,口服;曲马多50-100mg/次,日剂量≤400mg;胃复安5-10mg/次,3次/d,口服;地塞米松2-20mg/次,5%葡萄糖注射液稀释,静滴。治疗组32例四君子汤（人参、白术各15g,茯苓25g,甘草10g,胃虚加青蒿15g;肝区肿痛加绿梅花、白花蛇舌草各12g;痛甚加八月札、苏梗各15g;呕吐加生姜、姜半夏各12g,热甚加栀子、柴胡各10g;黄疸加茵陈、虎杖各18g）,1剂/d,水煎400m L,早晚口服;西药治疗同对照组。连续治疗15d为1疗程。观测临床症状、门冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、总胆红素（T-Bil）、碱性磷酸酶（ALP）、不良反应。连续治疗2疗程（15d）,判定疗效。[结果]治疗组显效12例,有效17例,无效3例,总有效率90.63%;对照组显效7例,有效13例,无效12例,总有效率62.50%;治疗组疗效优于对照组（P〈0.01）。AST、ALT两组均有改善（P〈0.01）,治疗组改善优于对照组（P〈0.01）,TBIL两组均有改善（P〈0.01）,两组间无明显差异（P〉0.05）,ALP对照组明显改善（P〈0.05）。[结论]四君子汤联合西医常规治疗原发性肝癌导管动脉内化疗栓塞术后综合征,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of Four Gentlemen Decoction Combined with western medicine in the treatment of primary hepatic carcinoma after transeatheter arterial chemoembolization. [Methods] 64 patients were randomly divided into two groups according to the method of random parallel control. The control group of 32 cases of postoperative fluid, antiemetic, antipyretic, analgesic, hepatoprotective, compound glycyrrhizin in 40-60mL, 0.9% sodium chloride or 5% glucose dissolved amount, l/d, intravenous injection of vitamin C 1 to 2 tablets each time, 1 times/d, oral tramadol; 50-100 mg/times a day the dose is less than or equal to 400mg; metoclopramide 5-10 mg/times, 3 times/d, oral; dexamethasone 2-20 mg/times, 5% Glucose Injection diluted intravenous drip. The treatment group of 32 cases of Four Gentlemen Decoction （ginseng, Atractylodes, 15g Poria, 25g, licorice 10g, stomach deficiency plus Artemisia 15g; liver gall and green plum, Hedyotis diffusa, 12g; and in August, Su Zagreb very pain stems 15g; vomiting with ginger and Jiang Banxia each 12g, very hot add Gardenia, bupleurnm 10g; jaundice capillaris, Polygonum 18g） plus 1 doses of/d, water decoction, 400mL, and oral administration of Western medicine with the control group. Continuous treatment for 1 courses of 15d. Observation of clinical symptoms, aspartate aminotransferase （AST）, alanine aminotransferase （ALT）, total bilirubin （T-Bil）, alkaline phosphatase （ALP）, adverse reaction. Continuous treatment for 2 course of treatment （15d）, to determine the efficacy. [Result] 12 cases were markedly effective, 17 cases were effective, 3 cases were ineffective, the total effective rate was 90.63%; the control group was 7 cases, 13 cases were effective, 12 cases ineffective, the total effective rate was 62.50%. The treatment group was better than the control group （P〈0.01）. AST, ALT two groups were improved （P〈0.01）, the treatment group improved better than the control group （P 〈~0.01）, TBIL two groups were improved （P〈0.01）, there was no significant difference between the two groups （P〉0.05）, ALP control group was significantly improved （P〈0.05）. [Conclusion] Sijunzi decoction combined with western medicine routine treatment of primary liver cancer after transcatheter arterial chemoembolization syndrome, curative effect satisfaction, no serious adverse reactions, it is worth promoting.
出处
《实用中医内科杂志》
2016年第12期64-66,共3页
Journal of Practical Traditional Chinese Internal Medicine
