鳖龙软肝汤联合经肝动脉化疗栓塞术治疗HBV相关原发性肝癌临床观察

摘要

目的 分别观察接受鳖龙软肝汤联合经肝动脉化疗栓塞术(TACE)治疗和单纯TACE治疗的HBV相关原发性肝癌患者临床疗效,比较2种方法疗效的差异.方法 选取2014年3月-2016年3月在湖南中医药大学第一附属医院肝病中心住院治疗的HBV相关原发性肝癌患者,随机分为试验组和对照组.试验组给予鳖龙软肝汤联合TACE治疗,对照组给予单一TACE治疗.观察2组治疗后的近期疗效、中医症候积分及血清AFP下降程度、TACE术后综合征的发生率及1年生存率.计量资料2组间比较采用t检验;计数资料2组间比较采用x2检验,等级资料组间比较Ridit分析;并用Kaplan-Meier法计算生存率,绘制生存曲线,采用log-rank检验对2组生存率进行比较.结果 研究组瘤体疗效客观反应率为77.4％,对照组56.4％,差异有统计学意义(,=9.898,P=0.020);中医症候积分下降水平两组比较,差异有统计学意义;两组治疗前后血清AFP下降程度比较,差异具有统计学意义(t=2.194,P=0.030);TACE术后2组栓塞综合征的发生率比较,研究组发热、恶心、呕吐、纳差的发生率显著降低,与对照组比较差异具有统计学意义(P值均＜0.05);试验组生活质量及体力评分高于观察组,2组比较差异有统计学意义(t值分别为-3.893、-6.187,P值均＜0.001);试验组1年生存率为77.4％(48/62),对照组1年生存率为63.6％(35/55),2组生存率差异具有统计学意义(矿=4.228,P=0.040).结论 鳖龙软肝汤联合TACE治疗HBV相关原发性肝癌,可提高患者近期疗效,改善患者生活质量.%Objective To investigate the clinical effect of Bielong Ruangan decoction combined with transcatheter arterial chemoembolization (TACE) versus TACE alone in the treatment of hepatitis B virus (HBV)-related primary liver cancer.Methods The patients with HBV-related primary liver cancer who were hospitalized in Liver Research Center in The First Affiliated Hospital of Hunan University of Chinese Medicine from March 2014 to March 2016 were enrolled and randomly divided into study group and control group.The patients in the study group were treated with Bielong Ruangan decoction combined with TACE,and those in the control group were treated with TACE alone.The two groups were observed in terms of short-term therapeutic effect,traditional Chinese medicine (TCM) syndrome score,reduction in serum alpha-fetoprotein (AFP),incidence rate of post-TACE syndrome,and 1-year survival rate.The t-test was used for comparison of continuous data between groups;the chi-square test was used for comparison of categorical data between groups;the ridit analysis was used for comparison of ranked data between groups;the Kaplan-Meier method was used to calculate survival rate and plot survival curves;the log-rank test was used to compare survival rates between groups.Results There were significant differences between the study group and the control group in objective tumor response rate (77.4％ vs 56.4％,x2 =9.898,P =0.020) and reductions in TCM syndrome score and serum AFP level (t =2.194,P =0.030).As for the incidence rate of embolism syndrome after TACE,the study group had significantly lower incidence rates of pyrexia,nausea,vomiting,and poor appetite than the control group (all P ＜ 0.05).The study group had significantly higher quality of life and physical scores than the control group (t =-3.893 and-6.187,both P ＜ 0.001).There was also a significant difference in 1-year survival rate between the study group and the control group [77.4％ (48/62) vs 63.6％ (35/55),x2 =4.228,P =0.040].Conclusion In patients with HBV-related primary liver cancer,Bielong Ruangan decoction combined with TACE can improve their short-term clinical outcome and quality of life.