健脾补肾方联合微波消融治疗对原发性肝癌患者T淋巴细胞亚群的影响

发布时间：2018-04-27 19:07

本文选题：原发性肝癌 + 健脾补肾方　；参考：《河南中医学院》2015年硕士论文

【摘要】：目的:通过运用健脾补肾方联合水冷微波消融术治疗原发性肝癌(PLC)患者,观察两组受试者处理前后T淋巴细胞亚群的变化,探讨健脾补肾方对PLC患者细胞免疫功能的影响,并比较治疗前后患者AFP水平变化、症状及生存质量改善情况,探讨健脾补肾方结合水冷微波消融治疗PLC的优势。方法:收取40例符合本次研究入选标准的PLC患者为观察病例,并随机归入试验组和对照组,各20例,两组患者均给予水冷微波消融术及抗病毒、保肝降酶等对症基础治疗,试验组在此基础上服用健脾补肾方并随症加减,疗程为2个月。治疗结束后,分别比较两组治疗前后CD3+、CD4+及CD8+T细胞绝对值、CD4+/CD8+比值、AFP水平、临床症状及生存质量改善情况,并进行统计学分析。结果:1、两组患者治疗后CD3+、CD4+T淋巴细胞水平及CD4+/CD8+比值较治疗前均有所升高,试验组差异明显(P0.05),对照组无明显差异(P0.05)。两组患者治疗后CD3+、CD4+T淋巴细胞水平及CD4+/CD8+比值比较有明显差异(P0.05)。2、两组患者治疗后CD8+T淋巴细胞水平较治疗前均有所下降,组内治疗前后比较无显著差异(P0.05),两组患者治疗后CD8+T淋巴细胞水平相比无显著差异(P0.05)。3、两组患者治疗后AFP水平较治疗前均有不同程度的下降,差异明显(P0.05),两组患者治疗后AFP水平相比无明显差异(P0.05)。4、两组患者治疗后胁痛、纳呆、腹胀、乏力症状较治疗前均有所改善,但试验组症状积分情况较治疗前显著改善,差异明显(P0.05),对照组各症状积分情况较治疗前改善不明显,无显著差异(P0.05)。两组患者治疗后各症状积分情况相比,存在明显差异(P0.05)。两组患者治疗后总体症状改善情况相比,试验组较治疗组显著改善,差异明显(P0.05)。5、两组患者治疗后生存质量提高方面相比,试验组较对照组生存质量提高显著,差异明显(P0.05)。结论:1、健脾补肾方联合水冷微波消融术可提高PLC患者CD3+、CD4+T细胞水平及CD4+/CD8+比值,从扶正祛邪角度阐明了健脾补肾方在一定程度上可改善PLC水冷微波消融术后患者的细胞免疫功能。2、健脾补肾方可改善PLC微波消融术后患者的部分临床症状,提高患者的生存质量。3、微波消融治疗对PLC患者细胞免疫情况及临床症状有所改善,但改善不明显。
[Abstract]:Objective: to observe the changes of T lymphocyte subsets in patients with primary liver cancer (PLC) treated with Jianpi Bushen recipe and water-cooled microwave ablation, and to explore the effect of Jianpi Bushen recipe on cellular immune function of PLC patients. The changes of AFP level, symptoms and quality of life were compared before and after treatment, and the advantages of Jianpi Bushen recipe combined with water-cooled microwave ablation in the treatment of PLC were discussed. Methods: 40 patients with PLC who met the criteria of this study were selected as observation cases and randomly divided into two groups: experimental group and control group, 20 cases each. The two groups were treated with water-cooled microwave ablation and basic therapy of anti-virus, anti-liver enzyme and so on, and the patients in the two groups were divided into two groups: control group (n = 20) and control group (n = 20). The experimental group was treated with Jianpi Bushen recipe for 2 months. After treatment, the CD3 levels, clinical symptoms and quality of life (QOL) were compared between the two groups before and after treatment. Results the levels of CD4 T lymphocytes and the ratio of CD4 / CD8 in CD3 were increased in both groups after treatment. The difference was significant in the trial group (P 0.05), but not in the control group (P 0.05). There were significant differences in the levels of CD3 T lymphocytes and CD4 / CD8 ratio between the two groups after treatment. The levels of CD8 T lymphocytes in the two groups were lower than those before treatment. There was no significant difference between the two groups before and after treatment, and there was no significant difference in the levels of CD8 T lymphocytes between the two groups after treatment. The levels of AFP in the two groups were lower than those before and after treatment. There was no significant difference in AFP level between the two groups after treatment. The symptoms of hypochondriac pain, anorexia, abdominal distension and fatigue were improved after treatment in the two groups, but the symptom scores in the test group were significantly improved compared with those before treatment. The difference was significant (P0.05). The scores of symptoms in the control group were not significantly improved compared with those before treatment, but there was no significant difference between the two groups. There was a significant difference between the two groups in the scores of symptoms after treatment (P 0.05). Compared with the treatment group, the overall symptoms of the two groups were improved significantly, the difference was significant (P0.05N. 5). Compared with the two groups, the quality of life in the experimental group was significantly higher than that in the control group, and the difference was significant (P 0.05). Conclusion: 1. The combination of Jianpi Bushen decoction and water-cooled microwave ablation can increase the level of CD3 CD4 T cells and the ratio of CD4 / CD8 in patients with PLC. From the point of view of nourishing qi and dispelling evil, it is expounded that Jianpi Bushen prescription can improve the cellular immune function of patients after PLC water cooling microwave ablation to a certain extent, and Jianpi Bushen decoction can improve some clinical symptoms of patients after PLC microwave ablation. The cell immunity and clinical symptoms of patients with PLC were improved by microwave ablation, but the improvement was not obvious.
【学位授予单位】：河南中医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.7

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