健脾理氣方配合肝動(dòng)脈化療灌注栓塞治療原發(fā)性肝癌的臨床療效及安全性分析

陳艷　潘云苓　陳堅(jiān)

[摘要] 目的 分析健脾理氣方配合肝動(dòng)脈化療灌注栓塞治療原發(fā)性肝癌的臨床療效及安全性。 方法 選取2015年2月～2019年2月在我院接受治療的原發(fā)性肝癌患者86例，采用隨機(jī)數(shù)字表法分為兩組，各43例。兩組均行肝動(dòng)脈化療栓塞治療，對(duì)照組在肝動(dòng)脈化療栓塞治療后給予常規(guī)西醫(yī)治療，觀察組則加用健脾理氣方治療。對(duì)比兩組臨床療效、治療前后肝功能水平變化及不良反應(yīng)。 結(jié)果 觀察組治療有效率為60.47%，高于對(duì)照組37.21%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;觀察組治療后ALT水平為（66.42±18.25）U/L、AST水平為（73.66±10.28）U/L、TBIL水平為（30.63±11.29）mmol/L，均低于對(duì)照組的（90.17±16.34）U/L、（120.41±20.69）U/L、（36.28±13.71）mmol/L，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;觀察組骨髓抑制、感染、惡心嘔吐、肝功能損傷發(fā)生率分別為25.58%、6.98%、16.28%、27.91%，均低于對(duì)照組的46.51%、23.26%、34.88%及48.84%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。 結(jié)論 健脾理氣方配合肝動(dòng)脈灌注化療栓塞介入治療原發(fā)性肝癌可獲得較好的臨床療效，有利于改善肝功能指標(biāo)，緩解化療產(chǎn)生的不良反應(yīng)，值得推廣應(yīng)用。

[關(guān)鍵詞] 原發(fā)性肝癌;健脾理氣方;肝動(dòng)脈栓塞介入治療;鹽酸表柔比星;肝功能;不良反應(yīng)

[中圖分類號(hào)] R735.7? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] B? ? ? ? ? [文章編號(hào)] 1673-9701（2020）01-0076-03

Clinical efficacy and safety analysis of Jianpi Liqi decoction combined with hepatic arterial chemoembolization in the treatment of primary liver cancer

CHEN Yan? ?PAN Yunling? CHEN Jian

Department of Integrated Traditional Chinese and Western Medicine Oncology， Fuzhou First Hospital， Fuzhou 350004， China

[Abstract] Objective To analyze the clinical efficacy and safety of Jianpi Liqi decoction combined with hepatic arterial chemoembolization in the treatment of primary liver cancer. Methods 86 patients with primary liver cancer who underwent treatment from February 2015 to February 2019 in our hospital were enrolled. The patients were randomly divided into two groups， with 43 cases in each group. Hepatic arterial chemoembolization was performed in both groups. The control group was treated with conventional Western medicine after hepatic arterial chemoembolization， and the observation group was treated with Jianpi Liqi decoction. The clinical efficacy， changes in liver function levels before and after treatment and adverse reactions between the two groups were compared. Results The effective rate was 60.47% in the observation group， which was higher than that in the control group （37.21%）， and the difference was statistically significant（P<0.05）. The ALT （66.42±18.25） U/L， AST （73.66±10.28） U/L and TBIL （30.63±11.29） mmol/L in the observation group were lower than those of the control group （90.17±16.34） U/L， （120.41±20.69） U/L， （36.28±13.71） mmol/L，and the difference was statistically significant（P<0.05）. The incidence of myelosuppression， infection， nausea and vomiting and liver function injury in the observation group were 25.58%， 6.98%， 16.28%， and 27.91%， respectively， which were lower than those of the control group （46.51%， 23.26%， 34.88% and 48.84%）， and the difference was statistically significant（P<0.05）. Conclusion Jianpi Liqi decoction combined with hepatic arterial chemoembolization for the treatment of primary liver cancer can obtain better clinical efficacy， improve liver function indicators， and alleviate the adverse reactions caused by chemotherapy. It is worthy of popularization and application.

[Key words] Primary liver cancer; Jianpi Liqi decoction; Interventional treatment of hepatic arterial chemoembolization; Epirubicin hydrochloride; Liver function; Adverse reactions

原發(fā)性肝癌是臨床常見(jiàn)的惡性腫瘤，該病癥與肝硬化、病毒性肝炎、黃曲霉素等化學(xué)致癌物質(zhì)及環(huán)境因素存在密切聯(lián)系[1]。現(xiàn)階段，原發(fā)性肝癌治療主張行手術(shù)切除，但大部分患者發(fā)病時(shí)已處于晚期，且合并肝硬化及慢性肝病等，貽誤最佳手術(shù)時(shí)機(jī)[2]。因此，綜合治療現(xiàn)已成為非手術(shù)治療原發(fā)性肝癌的主要方法。肝動(dòng)脈栓塞介入術(shù)是目前較成熟的治療方法，但治療過(guò)程中栓塞劑及化療藥物易對(duì)肝臟造成損害，極易加重不良反應(yīng)。近年來(lái)，中醫(yī)在原發(fā)性肝癌治療中具有較好的優(yōu)勢(shì)，中醫(yī)配合肝動(dòng)脈栓塞介入治療有助于減輕肝臟損傷、緩解不良反應(yīng)[3]。基于此，本研究旨在探討原發(fā)性肝癌患者給予健脾理氣方配合肝動(dòng)脈栓塞介入治療的臨床療效及安全性，現(xiàn)報(bào)道如下。……