中药内外合治配合肝动脉化疗栓塞治疗中晚期原发性肝癌32例

目的观察护肝消癥汤、散结消痛膏配合肝动脉化疗栓塞治疗中晚期原发性肝癌的临床疗效。方法将62例中晚期原发性肝癌病例随机分为治疗组（32例）和对照组（30例）。两组均给予肝动脉化疗栓塞,每4-6周1次,均治疗3次,并配合对症治疗;治疗组同时口服护肝消癥汤、外敷散结消痛膏。两组均治疗4个月,观察近期临床疗效及治疗后患者临床症状体征、生活质量的变化情况;疗程结束后随访3年,观察0.5、1、2、3年的生存率。结果治疗组、对照组肿瘤稳定率分别为为87.5%、63.3%,组间近期临床疗效差异有统计学意义（P〈0.01）;治疗组治疗后肝区疼痛、腹胀、食欲不振、全身乏力明显改善,与对照组比较,差异有统计学意义（P〈0.05,P〈0.01）;治疗组治疗后生活质量、血清白蛋白及丙氨酸氨基转移酶改善情况均明显优于对照组（P〈0.05）;治疗组0.5、1年、2年、3年生存率分别为81.25%、68.75%、43.75%、31.25%,对照组分别为73.33%、43.33%、20.0%、10.0%;组间比较,1、2、3年生存率差异有统计学意义（P〈0.05）。结论护肝消癥汤、散结消痛膏配合肝动脉化疗栓塞治疗中晚期原发性肝癌具有较好的临床疗效。

Clinical observation of Chinese medicine combined with transcatheter arterial chemoembolization in treating 32 cases of advanced primary hepatic carcinoma

Objective To observe the clinical efficacy of ＂Hugan Xiaozheng Decoction＂, ＂Sanjie Xiaotong Ointment＂ combined with transcatheter arterial chemoembolization（TACE） in the treatment of advanced primary hepatic carcinoma（PHC）. Methods Sixty-two cases of PHC were randomized into treatment group（32 cases） and control group（30 cases）, both of which were treated with TACE, once every 4 to 6 weeks for total 3 times; meanwhile the treatment group additionally orally took ＂Hugan Xiaozheng Decoction＂ and externally applied ＂Sanjie Xiaotong Ointment＂. After 4-month treatment, the short-term efficacy, changes in clinical symptoms, signs and quality of life were observed. The follow-up was conducted for 3 years to observe the half-year, one-year, two-year and three-year survival rates. Results The tumor stabilization rate was 87.5% in the treatment group and 63.3% in the control group, with a difference between them（P0.05）. Compared with the control group, hepatic pain, abdominal distention, anorexia and general weakness in the treatment group were greatly ameliorated（P0.05, P0.01）. The improvements in quality of life, serum albumin and ALT were more significant in the treatment group than in the control group（P0.05）. Half-year, one-year, two-year and three-year survival rates were respectively 81.25%, 68.75%, 43.75% and 31.25% in the treatment group, and respectively 73.33%, 43.33%, 20.0% and 10.0% in the control group, with striking differences in the one-year, two-year and three-year survival rates between the two groups（P0.05）. Conclusion ＂Hugan Xiaozheng Decoction＂, ＂Sanjie Xiaotong Ointment＂ combined with TACE is quite effective for advanced PHC.