TACE联合扶脾调肝汤治疗中晚期肝癌68例临床观察

摘要

[Objective]To evaluate the therapeutic effects of hepatic artery chemoembolization(TACE) combined soothing liver and invigorating spleen recipes in terminal-stage liver cancer of stagnation of liver qi and spleen deficiency.[Method] 68 terminal-stage liver cancer patients were randomly divided into TACE plus Chinese medicine group(treatment group) and TACE alone group(control group) ,each group contained 34 cases. Both groups were treated with TACE once,and the treatment group were given soothing liver and invigorating spleen recipes one dose a day from one week before TACE treatment for 5 weeks. Then the tumor lesion size,liver function index,KPS score,mood scale score,TCM symptom score and toxic side effects of the two groups were compared after treatment. [Result]The tumor lesion sizes showed no difference between two groups after 4 weeks' treatment( P=0.742).However,compared with those of the control group,the ALT and TBIL of the treatment group decreased significantly(P<0.05),and the ALB of the treatment group increased significantly(P<0.05).Meanwhile,the treatment group gained a higher KPS score(P<0.05) and better mood(P<0.01) than the control group.Various TCM symptoms(P<0.05) and toxic side effects,such as bone marrow depression,liver toxicity,digestive tract toxicity and fever were also much more relieved in the treatment group than those in the control group(P<0.05).[Conclusion] It's safe and effective to treat terminal-stage liver cancer of stagnation of liver qi and spleen deficiency with TACE combined soothing liver and invigorating spleen recipes, which can attenuate toxicity ,protect liver and improve the life quality of patients.%[目的]观察肝动脉化疗栓塞术（TACE）联合扶脾调肝汤治疗肝郁脾虚型中晚期原发性肝癌的效果。[方法]将68例中晚期原发性肝癌患者随机分为TACE+术前后中药组（治疗组）和单纯TACE组（对照组）各34例。两组均进行TACE治疗1次，治疗组于TACE治疗前1周开始予以扶脾调肝汤，1剂/日，连服5周。观察治疗后两组患者在肿瘤病灶大小、肝功能指标、KPS评分、心境量表评分、中医症状评分、毒副反应等方面的变化情况。[结果] TACE治疗4周后，两组患者的肿瘤原发病灶大小变化无显著性差异（P=0．742），但治疗组血清ALT、TBIL均较对照组明显下降（P<0．05），ALB较对照组明显升高（P<0．05）。同时，治疗组患者的KPS评分明显高于对照组（P<0．05），情绪比对照组同期明显好转（P<0．01），腹胀、纳呆、胁痛、乏力、口干咽燥症状较对照组明显改善（P<0．05），且出现骨髓毒性、肝功能毒性、消化道毒性及发热等毒副反应的症状均明显轻于对照组（P<0．05）。[结论]TACE联合扶脾调肝汤治疗肝郁脾虚型中晚期原发性肝癌安全有效，能起到减毒保肝、提高患者生存质量等作用。