活血化瘀健脾法对肝癌患者介入治疗后免疫功能及生活质量影响的研究

目的探讨活血化瘀健脾中药对肝动脉化疗栓塞术（TACE）术后患者血液中CD3＋、CD4＋、CD8＋、自然杀伤细胞（NK）及患者生活质量的影响。方法 92例患者随机分为中药组46例,对照组46例。两组患者在介入治疗后使用还原型谷胱甘肽、肌苷片、肝泰乐作为常规保肝用药,中药组加服具有活血化瘀健脾作用中药4周,两组分别于介入术前1 d及术后4周,监测患者血液中CD3＋、CD4＋、CD8＋、NK细胞,并观察患者生活质量评分等。结果经活血化瘀健脾中药治疗后外周血中CD3＋、CD4＋、CD4＋/CD8＋、NK细胞较单纯介入中药组明显增高（P〈0.05或P〈0.01）;中药组的整体生活质量量表（GOL）和5个功能量表的得分高于对照组,差异有统计学意义（P〈0.05）,而3个症状量表的得分低于对照组,差异有统计学意义（P〈0.05）。6个单项测量项目的得分中药组要低于对照组,但差异无统计学意义（P〉0.05）。结论活血化瘀健脾中药可作为肝癌介入治疗的常规辅助用药,以利于提高患者免疫力及改善患者生活质量,值得临床推广。

Impacts on the Immune Function and Quality of Life for the Patients with Liver Cancer Intervened with the Treating Program of Activating Blood Circulation,Resolving Stasis and Strengthening the Spleen

Objective To discuss the impacts on blood CD3+,CD4+,CD8+,natural killer cells(NK)and the quality of life(QOL)for the patients after the transcatheter arterial chemoembolization(TACE)treated with the herbal medication for activating blood circulation,resolving stasis and strengthening the spleen.Methods 92 cases were randomized into an herbal medication group(46 cases)and a control group(46 cases).After the intervention,reduced glutathinone tablets,inosine tablets and glucurolactone were administered for the liver protection in two groups.In the herbal medication group,the herbal medication for activating blood circulation,resolving stasis and strengthening the spleen was supplemented for 4 weeks.In two groups,1 day before and 4 weeks after the interventional treatment,the blood CD3+,CD4+,CD8+ and NK cells were monitored separately.QOL was observed.Results After the herbal medication for activating blood circulation,resolving stasis and strengthening the spleen,the levels of the peripheral CD3+,CD4+,CD4+/CD8+,CD8+ and NK cells in the herbal medication group were increased obviously as compared with those the simple intervention group(P<0.05 or P<0.01).In the herbal medication group,the scores of the global quality of life scale(GOL)and 5 function scales were all higher than those in the control group,indicating the statistical significant difference(P<0.05);and the scores of 3 symptoms scales were lower than those in the control group,indicating the statistical significant difference(P<0.05).The scores in the assessment of 6 single items in the herbal medication group were lower than those in the control group,but without presenting the statistical significance(P>0.05).Conclusion The herbal medication for activating blood circulation,resolving stasis and strengthening the spleen can be the conventional adjuvant approach to the interventional treatment of liver cancer.It benefits the improvements of the immunity and QOL for the patients.Hence,it deserves to be promoted clinically.