八珍湯加減對原發性肝癌TACE術后不良反應的臨床觀察

王安镅 屠建國 王際云

[摘要] 目的 評價八珍湯加減對原發性肝癌TACE術后不良反應的影響。 方法 選取2018年1月～2019年1月我院住院治療的原發性肝癌TACE術后患者60例，按1：1隨機數字表法分為治療組和對照組。兩組均給予TACE治療，治療組在常規治療基礎上服用八珍湯加減治療，比較兩組術前3 d 和術后28 d臨床不良反應（疼痛、惡心嘔吐、肝功能毒性、發熱）的發生情況，比較兩組患者術前3 d和術后28 d WBC、RBC、ALT、AST變化情況及對患者生活質量的影響。 結果 治療后兩組疼痛、惡心嘔吐、谷丙轉氨酶上升、發熱比較，差異有統計學意義（P<0.05）;與治療前比較，治療后WBC、RBC、ALT、AST均見明顯好轉（P<0.05），但治療組好轉優于對照組（P<0.05）;治療組八珍湯加減應用后KPS評分明顯高于對照組（P<0.05）。 結論 八珍湯加減改善原發性肝癌TACE術后不良反應療效確切，提高了患者的生活質量，具有良好的臨床應用價值。

[關鍵詞] 八珍湯;原發性肝癌;TACE術后;不良反應

[中圖分類號] R735.7 ? ? ? ? ?[文獻標識碼] B ? ? ? ? ?[文章編號] 1673-9701（2020）12-0114-04

[Abstract] Objective To evaluate the effect of modified Bazhen decoction on adverse reactions after transcather arterial chemoembolization（TACE） in primary liver cancer（PLC）. Methods 60 patients with PLC after TACE hospitalized in our hospital from January 2018 to June 2019 were selected and divided into a treatment group and a control group using the random number table method， with 30 cases in each group. Both groups were treated with TACE， and the treatment group received modified Bazhen decoction on the basis of conventional treatment.The clinical adverse reactions（pain， nausea and vomiting， liver toxicity， and fever） were compared between the two groups 3 days before surgery and 28 days after surgery. The changes of white blood cell（WBC）， red blood cell（RBC）， alanine aminotransferase（ALT）， and aspartate aminotransferase（AST） and their effects on quality of life were compared between the two groups 3 days before and 28 days after surgery. Results After treatment， there were significant differences in pain， nausea and vomiting， increase of alanine amin otransferase， and fever between the two groups（P<0.05）; compared with before treatment， WBC， RBC， ALT， and AST showed significant improvement after treatment（P<0.05）， but the improvement in the treatment group was better than that in the control group（P<0.05）; the Karnofsky performance status（KPS） score of modified Bazhen decoction in the treatment group was significantly higher than that in the control group（P<0.05）. Conclusion Modified Bazhen decoction can improve the adverse effects of PLC after TACE， and promote the quality of life of patients. It has good clinical application value.

[Key words] Bazhen decoction; Primary liver cancer; Transcather arterial chemoembolization; Adverse reactions

根據最新腫瘤發病率統計，原發性肝癌已上升為全球惡性腫瘤的第二位，我國肝癌的發生率及死亡率均占全球的50%以上[1]。肝癌的早期癥狀一般不明顯，約有80%的患者在確診肝癌時已是中晚期，已無外科手術與根治性切除指征，中位生存期短，對患者的生存質量和生活質量產生了嚴重影響[2]。對于不適宜或拒絕手術的患者，目前常用的手段有肝動脈化療栓塞術（Transcatherter arterial chemoembolization，TACE）、射頻消融和微波消融等，其中，TACE因具有微創、療效確切、可重復等特點，在肝癌的治療上得到了廣泛應用和認可[3]。……