益气活血扶正解毒法治疗原发性肝癌晚期的临床疗效研究
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摘要
研究背景：原发性肝癌(Primaryhvercancer,PLC)在我国是发病率较高的肿瘤,随着现代医学的不断发展,诊疗技术不断进步,很大幅度的改善了肝癌的预后。但是如何延长患者的生存率仍然是学术界研究的焦点。
研究目的：采用扶正祛邪、标本同治的治疗原则对肝动脉化疗栓塞术后患者进行治疗,观察用益气活血扶正解毒联合TACE术治疗原发性肝癌的临床疗效,探索提高原发性肝癌患者的生活质量及延长生存期的有效方法,为我国原发性肝癌的治疗增添新的途径和思路。
研究方法：所有病例均为马来西亚吉隆坡中医医院住院患者,共观察病例60例,对照组术后采用予思美泰或苦黄注射液利胆退黄；若有腹水,予口服利尿剂呋塞米,螺内酯,；合并乙肝感染者,予口服恩替卡韦、拉米夫定或阿德福韦酯；补充白蛋白或血浆。治疗组在对照组治疗方案上,加用以益气活血清化利水为治疗大法组方的方剂,浓煎200m1,早晚分服；并应用具有抗肝肿瘤、提高免疫力作用的牛樟芝口服,疗程3个月。观察1-2个疗程。
研究结果：治疗后两组白蛋白水平无明显差异；治疗组与对照组两组血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBiL)治疗后均较前有显著差异(P<0.01),与对照组相比,治疗组第6个月可显著降低AST、TBil(P<0.01),明显降低ALT；治疗后两组AFP较前有明显下降(P<0.05),但是治疗后两组相比较无显著差异(P>0.05)；治疗前后B超下测定肿瘤最大直径,治疗组治疗6个月后对肿瘤生长有显著的抑制(P<0.01),对照组在治疗前后无明显差异(P>0.05)；治疗组在治疗后较治疗前可明显改善纳差、乏力症状(P<0.05),可显著改善胁痛、腹胀、腹水情况(P<0.01)；对照组对纳差、腹胀改善无显著统计学意义(P>0.05),但可明显改善乏力、胁痛、腹水情况(P<0.05)；两组治疗后相比较,治疗组在改善纳差症状方面有明显差异(P<0.05),在改善腹水方面有显著差异(P<0.01),其余症状方面无统计学意义(P>0.05)；两个疗程内治疗前后两组生存率无明显差异(P>0.05)。
结论：本研究方案可稳定和提高白蛋白水平,在改善肝脏合成功能、调节蛋白代谢的方面有一定的作用；具有保肝、降酶、退黄的作用；此外本治疗方法在改善消化道症状方面、消退腹水有比较好的疗效。
Background:The primary liver cancer (Primaryhvercancer, PLC) is a higher incidence of cancer, diagnosis and treatment technology continues to progress, with the continuous development of modern medicine, a very substantial improvement in the prognosis of liver cancer. How to prolong the survival rate is still the focus of academic research.
Objective:Rousing specimens wen principles of treatment of patients with hepatic artery chemoembolization treatment, clinical efficacy observed with the righting Yiqihuoxue detoxification combined with TACE treatment of primary liver cancer, to explore improve the quality of life of patients with primary liver cancer andan effective way to prolong survival for the treatment of primary liver cancer in China to add new ways and ideas.
Methods:All the cases were in Kuala Lumpur, Malaysia Chinese Medicine Hospital inpatients were observed in60cases and the control group after I think Mattel, or Kuhuang injection gallbladder jaundice; if ascites, to oral diuretic furosemide, spironolactone,; combined hepatitis B infection to oral entecavir, lamivudine or adefovir dipivoxil; adding albumin or plasma. Antrodia camphorata orally for the treatment group in the control group treatment program, plus used the Thanh Hoa diuresis, Yiqihuoxue for treatment of Dafa prescription prescription, thick fried200ml, morning and evening service; and application of the anti-hepatoma, improve immune function3months.1-2courses of treatment were observed.
Results:Albumin levels in the two groups after treatment after treatment no significant difference; treatment group and control group, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBiL) after treatment were significantly different compared with the previous(P<0.01), compared with the control group, the first6months of treatment group was significantly reduced AST TBil (P<0.01), significantly lower ALT; after treatment, AFP compared with the previous decreased significantly (P<0.05),but after treatment, the two groups relative to comparison no significant difference (P>0.05); before and after treatment B-Determination of the maximum diameter of the tumor, the treatment group after6months of tumor growth have significantly inhibited (P<0.01), the control group in the treatment ofshowed no significant difference (P>0.05); treatment group after treatment than before treatment can significantly improve anorexia, fatigue symptoms (P <0.05), can significantly improve the hypochondriac pain, abdominal distension, ascites conditions (P<0.01); control groupanorexia, abdominal distention improve statistically significant (P>0.05), but can be significantly improved fatigue, hypochondriac pain, ascites (P<0.05); compared two groups after treatment, the treatment group in improving the symptoms of anorexiasignificant difference (P<0.05), to improve the ascites were significantly different (P<0.01), the rest of the symptoms was not statistically significant (P>0.05); survival rate in the two courses before and after treatment was no significant difference (P>0.05).
Conclusion:The study protocol was stable and improving albumin levels have a certain role to improve liver synthetic function, and regulation of protein metabolism; liver, reducing enzyme, jaundice role;addition, the treatment in improving gastrointestinal symptoms,ascites subsided a better effect.
研究目的：采用扶正祛邪、标本同治的治疗原则对肝动脉化疗栓塞术后患者进行治疗,观察用益气活血扶正解毒联合TACE术治疗原发性肝癌的临床疗效,探索提高原发性肝癌患者的生活质量及延长生存期的有效方法,为我国原发性肝癌的治疗增添新的途径和思路。
研究方法：所有病例均为马来西亚吉隆坡中医医院住院患者,共观察病例60例,对照组术后采用予思美泰或苦黄注射液利胆退黄；若有腹水,予口服利尿剂呋塞米,螺内酯,；合并乙肝感染者,予口服恩替卡韦、拉米夫定或阿德福韦酯；补充白蛋白或血浆。治疗组在对照组治疗方案上,加用以益气活血清化利水为治疗大法组方的方剂,浓煎200m1,早晚分服；并应用具有抗肝肿瘤、提高免疫力作用的牛樟芝口服,疗程3个月。观察1-2个疗程。
研究结果：治疗后两组白蛋白水平无明显差异；治疗组与对照组两组血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBiL)治疗后均较前有显著差异(P<0.01),与对照组相比,治疗组第6个月可显著降低AST、TBil(P<0.01),明显降低ALT；治疗后两组AFP较前有明显下降(P<0.05),但是治疗后两组相比较无显著差异(P>0.05)；治疗前后B超下测定肿瘤最大直径,治疗组治疗6个月后对肿瘤生长有显著的抑制(P<0.01),对照组在治疗前后无明显差异(P>0.05)；治疗组在治疗后较治疗前可明显改善纳差、乏力症状(P<0.05),可显著改善胁痛、腹胀、腹水情况(P<0.01)；对照组对纳差、腹胀改善无显著统计学意义(P>0.05),但可明显改善乏力、胁痛、腹水情况(P<0.05)；两组治疗后相比较,治疗组在改善纳差症状方面有明显差异(P<0.05),在改善腹水方面有显著差异(P<0.01),其余症状方面无统计学意义(P>0.05)；两个疗程内治疗前后两组生存率无明显差异(P>0.05)。
结论：本研究方案可稳定和提高白蛋白水平,在改善肝脏合成功能、调节蛋白代谢的方面有一定的作用；具有保肝、降酶、退黄的作用；此外本治疗方法在改善消化道症状方面、消退腹水有比较好的疗效。
Background:The primary liver cancer (Primaryhvercancer, PLC) is a higher incidence of cancer, diagnosis and treatment technology continues to progress, with the continuous development of modern medicine, a very substantial improvement in the prognosis of liver cancer. How to prolong the survival rate is still the focus of academic research.
Objective:Rousing specimens wen principles of treatment of patients with hepatic artery chemoembolization treatment, clinical efficacy observed with the righting Yiqihuoxue detoxification combined with TACE treatment of primary liver cancer, to explore improve the quality of life of patients with primary liver cancer andan effective way to prolong survival for the treatment of primary liver cancer in China to add new ways and ideas.
Methods:All the cases were in Kuala Lumpur, Malaysia Chinese Medicine Hospital inpatients were observed in60cases and the control group after I think Mattel, or Kuhuang injection gallbladder jaundice; if ascites, to oral diuretic furosemide, spironolactone,; combined hepatitis B infection to oral entecavir, lamivudine or adefovir dipivoxil; adding albumin or plasma. Antrodia camphorata orally for the treatment group in the control group treatment program, plus used the Thanh Hoa diuresis, Yiqihuoxue for treatment of Dafa prescription prescription, thick fried200ml, morning and evening service; and application of the anti-hepatoma, improve immune function3months.1-2courses of treatment were observed.
Results:Albumin levels in the two groups after treatment after treatment no significant difference; treatment group and control group, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBiL) after treatment were significantly different compared with the previous(P<0.01), compared with the control group, the first6months of treatment group was significantly reduced AST TBil (P<0.01), significantly lower ALT; after treatment, AFP compared with the previous decreased significantly (P<0.05),but after treatment, the two groups relative to comparison no significant difference (P>0.05); before and after treatment B-Determination of the maximum diameter of the tumor, the treatment group after6months of tumor growth have significantly inhibited (P<0.01), the control group in the treatment ofshowed no significant difference (P>0.05); treatment group after treatment than before treatment can significantly improve anorexia, fatigue symptoms (P <0.05), can significantly improve the hypochondriac pain, abdominal distension, ascites conditions (P<0.01); control groupanorexia, abdominal distention improve statistically significant (P>0.05), but can be significantly improved fatigue, hypochondriac pain, ascites (P<0.05); compared two groups after treatment, the treatment group in improving the symptoms of anorexiasignificant difference (P<0.05), to improve the ascites were significantly different (P<0.01), the rest of the symptoms was not statistically significant (P>0.05); survival rate in the two courses before and after treatment was no significant difference (P>0.05).
Conclusion:The study protocol was stable and improving albumin levels have a certain role to improve liver synthetic function, and regulation of protein metabolism; liver, reducing enzyme, jaundice role;addition, the treatment in improving gastrointestinal symptoms,ascites subsided a better effect.
引文
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