消积化瘀丸联合TACE治疗原发性肝癌的临床研究
本文选题:原发性肝癌 + 消积化瘀丸 ; 参考:《广西中医药大学》2017年硕士论文
【摘要】:目的:通过观察、分析消积化瘀丸联合TACE对原发性肝癌患者免疫功能、AFP、肝功能、不良反应、KPS评分、中医证候疗效等各方面的影响,评估消积化瘀丸联合介入治疗原发性肝癌的疗效及安全性。为中医、中药在原发性肝癌介入术后的临床应用上提供新的研究思路和依据。方法:将60例原发性肝癌患者按入院顺序,分为治疗组30例,对照组30例,治疗组的1例因未能遵嘱服用中药被剔除。最后纳入临床观察的病例共计59例,其中对照组30例,治疗组29例。治疗组予以消积化瘀丸联合TACE治疗,对照组则单纯TACE治疗。分别在治疗前,治疗后观察患者AFP、免疫功能指标、肝功能。治疗后评估KPS评分、中医证候疗效、术后不良反应。治疗前及治疗后复查肝脏CT评价实体瘤近期疗效。结果:1.两组实体瘤近期疗效比较,差异无统计学意义(p0.05);2.两组间KPS评分疗效比较,差异无统计学意义(p0.05);3.两组T淋巴细胞亚群指标变化比较,治疗组治疗后CD3+、CD4+、CD8+及CD4+/CD8+比值较治疗前升高,明显优于对照组,差异有统计学意义(p0.05);4.两组患者治疗后,对于AFP400 ng/m L,两组并没有统计学意义(p0.05),而AFP≥400 ng/mL中,治疗组下降水平较对照组明显(p0.05),说明差异有统计学意义;5.两组中医证候疗效比较,治疗组相比于照组改善明显,具有统计学意义(p0.05);6.两组术后1周肝功能对比没有统计学意义(p0.05);7.两组术后均出现了白细胞改变、发热、恶心呕吐、腹痛,治疗组较对照组在腹痛改善上更明显(p0.05)。结论:原发性肝癌患者TACE后联合消积化瘀丸治疗,较单纯TACE治疗可以提高机体免疫功能及中医证候疗效、改善患者腹痛症状、降低AFP水平。
[Abstract]:Objective: through observation, the effect and safety of Xiao Ji Huayu pill combined with TACE on the immune function, AFP, liver function, adverse reaction, KPS score and TCM syndrome were evaluated, and the efficacy and safety of the combined interventional therapy for primary liver cancer were evaluated. Methods: to provide new research ideas and basis. Methods: 60 cases of primary liver cancer were divided into 30 cases in the treatment group, 30 cases in the control group, and 30 cases in the control group, and 1 cases in the treatment group were excluded because of failure to take the Chinese medicine. Finally, 59 cases were included in the clinical observation, of which 30 cases in the control group and 29 cases in the treatment group. The treatment group was treated with Xiao Ji Huayu pill combined T ACE treatment, the control group was only TACE treatment. Before treatment, the patients' AFP, immune function index, liver function were observed after treatment. After treatment, the KPS scores, TCM syndromes, and postoperative adverse reactions were evaluated. Before and after treatment, the liver CT was reviewed to evaluate the short-term curative effect of solid tumor in the liver CT. Conclusion the difference was not statistically significant between the 1. groups of two groups of solid tumors. Significance (P0.05); 2. in the two groups, the effect of KPS score was not statistically significant (P0.05); 3. two groups of T lymphocyte subsets were compared, and the ratio of CD3+, CD4+, CD8+ and CD4+/CD8+ in the treatment group was higher than that before treatment, obviously superior to the control group, and the difference was statistically significant (P0.05); the 4. two groups were treated with ng/m L, two groups after treatment. There was no statistical significance (P0.05), but in AFP > 400 ng/mL, the decrease level of the treatment group was significantly higher than that of the control group (P0.05), indicating that the difference was statistically significant. 5. the two groups of TCM syndromes were compared, and the treatment group was significantly improved compared with the photo group (P0.05); 6. two groups had no statistical significance (P0.05) in the 1 weeks after operation (P0.05); 7. two. Leukocyte change, fever, nausea and vomiting, abdominal pain were found in the group after operation, and the treatment group was more obvious than the control group (P0.05). Conclusion: the treatment of primary liver cancer patients after TACE combined with the treatment of eliminating stasis and stasis can improve the immune function and the curative effect of the TCM syndrome, improve the symptoms of abdominal pain and reduce the level of AFP in the patients.
【学位授予单位】:广西中医药大学
【学位级别】:硕士
【学位授予年份】:2017
【分类号】:R735.7
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