益气化瘀解毒方加减联合鸦胆子油乳经血管介入治疗中晚期原发性肝癌的临床研究

目的:评价益气化瘀解毒方加减联合鸦胆子油乳经血管介入治疗中晚期原发性肝癌的临床疗效。方法:将65例中晚期原发性肝癌患者随机分为两组,试验组35例,益气化瘀解毒方加减联合鸦胆子油乳经血管介入治疗,对照组30例,单行化疗栓塞治疗。结果:(1)两组有效率(CR+PR+SD)分别为91.4%(32/35)和80%(24/30),经比较差异无统计学意义(P>0.05);(2)治疗后试验组患者肝区疼痛、乏力、食欲不振、腹胀等主要临床症状评分均低于对照组且差异有统计学意义(P<0.01);(3)试验组生活质量的改善优于对照组,差异有统计学意义(P<0.05);(4)试验组免疫功能改善优于对照组,差异有统计学意义(P<0.01);(5)试验组VEGF和bFGF水平在术后1周及术后1个月表达低于对照组,均为(P<0.05);(6)试验组白细胞下降、恶心呕吐等发生率为17.1%(6/35)、46.7%(14/30);对照组分别为31.4%(11/35)、80%(24/30),差异有统计学意义(P<0.05)。结论:益气化瘀解毒方加减联合鸦胆子油乳经血管介入治疗中晚期原发性肝癌,发挥了协同抗肿瘤效应,能稳定瘤体,改善患者主要临床症状和生活质量,提高机体免疫功能,减少白细胞下降、恶心呕吐等毒副反应的发生,下调血清中VEGF和bFGF的表达水平,可能在一定程度上抑制了肝肿瘤介入术后血管新生,有望发挥抗复发和转移作用,从而提高远期疗效。

Clinical Study of the Law of Strengthening Qi and Clearing Stasis and Poison Combined Javanica Oil Emulsion Through Blood Vessels Involved in Treatment of Advanced Primary Liver Cancer

Objective:To evaluate the clinical efficacy of Strengthening Qi and Clearing Stasis and Poison Decoction combined with javanica oil emulsion through the blood vessels involved in treatment of advanced primary liver cancer.Methods:65 cases of advanced primary liver cancer were randomly divided into two groups,treatment group(35 cases)was treated with Strengthening Qi and Clearing Stasis and Poison Decoction combined with javanica oil emulsion through the blood vessels and control group(30 cases)treated with chemotherapy embolization.Results:(1)The efficiency rates(CR+PR+SD)were 91.4%(32/35)and 80%(24/30)respectively,the comparative difference was not statistically significant(P>0.05).(2)After treatment,liver pain,fatigue,loss of appetite,abdominal distension and other major clinical symptom scores in treatment group were lower than those in the control group and the difference was statistically significant(P<0.01).(3)The quality of life of the treatment group was improved more than that of the control group,the difference was statistically significant(P<0.05).(4)The immune function in the treatment group had more improvement than that in the control group,the difference was statistically significant(P<0.01).(5)The levels of VEGF and bFGF 1 week after surgery and 1 month after operation were lower than those in the control group(P<0.05).(6)In the treatment group,the incidences of leukopenia,nausea and vomiting were 17.1%(6/35) and 46.7%(14/30),in the control group were 31.4%(11/35),80%(24/30),the difference was statistically significant(P<0.05).Conclusion:Strengthening Qi and Clearing Stasis and Poison Decoction combined javanica oil emulsion through the blood vessels involved in the treatment of advanced primary liver cancer plays a synergistic anti-tumor effect and can improve the main clinical symptoms and quality of life,improve immune function,reduce leukopenia,nausea and vomiting,reduce serum levels of VEGF and bFGF and it maybe inhibite angiogenesis to some extent after intervention of liver tumor,playing a role in anti-recurrence and metastasis,so as to enhance the long-term efficacy.