白虎汤治疗原发性肝癌TACE术后患者的临床疗效及预后的影响研究

喻晖; 乔樵; 张财明; 郏伟军

doi:10.3969/j.issn.1671-038X.2017.11.12

白虎汤治疗原发性肝癌TACE术后患者的临床疗效及预后的影响研究

- 1. 浙江中医药大学, 浙江杭州 310053;
- 2. 台州黄岩中医院内科, 浙江台州 318020;
- 3. 浙江省中医院消化内科, 浙江杭州 310006;
- 4. 台州恩泽医疗中心(集团)浙江省台州医院肝胆外科, 浙江台州 318000

详细信息

作者简介:
喻晖,男,本科,主治中医师

通讯作者: 喻晖,E-mail:85346926@qq.com

中图分类号: R735.7

收稿日期: 2017-04-10

Clinical efficacy of baihu tang in patients with primary liver cancer after TACE

- 1. Zhejiang Chinese Medical University, Hangzhou 310053, China;
- 2. Department of Internal Medicine, Huangyan Hospital of Traditional Chinese Medicine, Taizhou 318020, Zhejiang, China;
- 3. Department of Gastroenterology, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou 310006, China;
- 4. Taizhou Enze Medical Center, Zhejiang, Taizhou 318000, China

More Information

Corresponding author: YU Hui, E-mail: 85346926@qq.com

Received Date: 10 April 2017

摘要

摘要: [目的]研究白虎汤治疗对原发性肝癌TACE术后患者的基质金属酶水平及T细胞亚群的影响。[方法]以2012年10月~2014年7月我院收治的120例原发性肝癌并行TACE术后有发热症状的患者作为研究对象,根据随机数字表法分成研究组和对照组,每组60例。对照组患者进行常规的西医治疗,口服头孢克无分散片,2次/d,100 mg/次,予消炎痛栓纳肛,2次/d,50 mg/次,疗程10 d。研究组在对照组基础上予以白虎汤加减治疗,早晚各一剂,疗程10 d。一个疗程结束后评价2组患者的疗效及不良反应情况,比较治疗前后基质金属蛋白酶以及T细胞亚群的改变情况,同时评估随访半年、1年和2年患者的生存率和复发率。[结果]1个疗程治疗后研究组患者的有效率(90.00%)明显高于对照组(71.67%),差异有统计学意义(P＜0.05)。治疗后研究组患者的MMP-1、MMP-3、MMP-9水平明显低于对照组,差异有统计学意义(P＜0.05)。治疗后研究组患者CD3⁺、CD4⁺细胞亚群以及CD4⁺ /CD8⁺比值显著升高,差异有统计学意义(P＜0.05),治疗后研究组患者CD3⁺、CD4⁺细胞亚群以及CD4⁺ /CD8⁺比值明显高于对照组,差异有统计学意义(P＜0.05)。治疗后对照组患者的ALT和AST水平明显高于研究组,差异有统计学意义(P＜0.05)。治疗后半年、1年、2年2组患者的生存率逐渐降低,且对照组患者的生存率低于研究组,仅随访第2年生存率之间的差异有统计学意义(P＜0.05)。治疗后研究组半年、1年和2年内肿块的复发率均明显低于对照组,差异有统计学意义(P＜0.05)。[结论]白虎汤治疗原发性肝癌TACE术后具有一定的疗效,且安全性高,能够增强患者的免疫保护和保肝降酶作用,对于术后复发具有一定的预防作用,有很好的临床应用前景。
- 白虎汤 /
- 原发性肝癌 /
- 基质金属酶 /
- TACE术后 /
- 免疫保护
Abstract: [Objective]To study the clinical efficacy of Baihu Decoction on patients with primary liver cancer after TACE,we analysed the level of MMPs and the proportion of T lymphocyte subpopulation in baihu tang treated and non-treated liver cancer patients after TACE.[Methods]From October 2012 to July 2014,120 patients with primary liver cancer who had fever after TACE were divided into study group(60 cases)and control group(60 cases)randomly.The patients in the control group were treated with conventional western medicine,and cefaclor was orally administered twice daily,100 mg/time,and indomethacin suppository was given twice a day for 10 days.Patients in the study group were treated with conventional western medicine combined Baihu Tang,10 days for a course.At the end of one course of treatment,the clinical efficacy and side effects were evaluated.The level of matrix metalloproteinases(MMPs)and the proportion of T lymphocyte subpopulation before and after treatment were compared.The 6 months,1 year and 2 years survival and recurrence rates were also assessed in patients.[Results]The effective rate(90.00%)in the study group was significantly higher than that in the control group(71.67%)(P<0.05).The levels of MMP-1,MMP-3 and MMP-9 in the study group were significantly lower than those in the control group(P<0.05).The ratio of CD3⁺,CD4⁺ and CD4⁺/CD8⁺ in the study group were significantly increased(P<0.05),and the ratios of CD3⁺,CD4⁺ and CD4⁺/CD8⁺ in the study group were significantly higher than those in the control group(P<0.05).The levels of ALT and AST in the control group were significantly higher than those in the study group(P<0.05).The 2 years survival rate of the study group was higher than control group(P<0.05).The 6 months,1 year and 2 years recurrence rate of the patients in the study group was significantly lower than the control group(P<0.05).[Conclusion]We found that liver cancer patients after TACE could be treated with Baihu Tang,which decreased the recurrence rate through enhancing the immune protection,protecting liver and reducing enzyme level.
- Baihu Tang /
- primary liver cancer /
- matrix metalloenzyme /
- TACE /
- immune protection

HTML全文

参考文献(15)

[1]	赵荣荣, 邓永东, 袁宏等.236例原发性肝癌患者流行病学及临床特点分析[J].临床肝胆病杂志, 2016, 32 (8):1538-1542.
[2]	李明岳, 刘嘉林, 郑锦锋, 等.原发性肝癌患者手术治疗后生存状况的影响因素分析[J].实用癌症杂志, 2014, 29 (7):802-804.
[3]	Yin X, Zhang L, Wang Y H, et al.Transcatheter arterial chemoembolization combined with radiofrequency ablation delays tumor progression and prolongs overall survival in patients with intermediate (BCLC B) hepatocellular carcinoma[J].BMC Cancer, 2014, 14 (1):849-849
[4]	Zheng J S, Long J, Sun B, et al.Transcatheter arterial chemoembolization combined with radiofrequency ablation can improve survival of patients with hepatocellular carcinoma with portal vein tumour thrombosis:extending the indication for ablation[J]?Clinical Radiology, 2014, 69 (6):253-263.
[5]	赵海霞, 徐向东.白虎汤的抗炎作用及其作用机理的研究[J].时珍国医国药, 2013, 24 (1):60-62.
[6]	于佳宏, 郭华.《名医类案》中白虎汤的应用研究[J].环球中医药, 2015, 8 (10):1240-1242.
[7]	中国抗癌协会肝癌专业委员会.原发性肝癌诊断标准[J].中华肝脏病杂志, 2000, 8 (3):135-135.
[8]	国家中医药管理局.中医病证诊断疗效标准[M].南京.南京大学出版社, 1994:210-217.
[9]	Mcglynn K A, Hagberg K, Chen J, et al.Statin Use and Risk for Primary Liver Cancer in the Clinical Practice Research Datalink[J].JNCI, 2015, 107 (4):993-996.
[10]	王伟, 葛瑞良, 胡雷, 等.原发性肝癌患者手术治疗远期疗效的影响因素[J].实用癌症杂志, 2014, 29 (6):678-680.
[11]	田慧, 夏景林.原发性肝癌介入治疗中化疗药物剂量的研究进展[J].实用肿瘤杂志, 2014, 29 (4):299-302.
[12]	冯超, 赵剑波, 陈勇, 等.原发性肝癌切除术后预防性经肝动脉介入治疗:肝动脉化疗栓塞术和化疗灌注术比较[J].介入放射学杂志, 2014, 23 (8):679-682.
[13]	Sarkate A P, Murumkar P R, Lokwani D K, et al.Design of selective TACE inhibitors using molecular docking studies:Synthesis and preliminary evaluation of anti-inflammatory and TACE inhibitory activity[J].SAR and QSAR in Environmental Research, 2015, 26 (11):905-923.
[14]	张巍巍, 解祥军, 耿长新, 等.胰腺肿瘤细胞外基质金属蛋白酶诱导因子的表达及意义[J].中华临床医师杂志 (电子版), 2015 (14):26-30.
[15]	朱江瑞.高转移性肿瘤细胞在细胞外基质界面的强侵袭性行为研究[D].中国科学院大学, 2015.