复方苦参注射液联合体外高频热疗治疗晚期肝癌腹腔积液的疗效分析
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摘要
目的:探讨复方苦参注射液腹腔内注射联合体外高频热疗治疗晚期肝癌腹腔积液的疗效以及对患者免疫功能、生命质量及不良反应的影响。方法:将2012年3月—2017年2月唐山市人民医院肿瘤内科收治的102例晚期肝癌腹腔积液患者采用随机数字表法分为研究组(51例)和对照组(51例),对照组患者采用复方苦参注射液治疗,研究组在对照组基础上加用体外高频热疗。比较两组疗效,分析治疗前后免疫功能指标自然杀伤(NK)细胞、CD_3~+、CD_4~+、CD_8~+、CD_4~+/CD_8~+的变化、观察患者生命质量改善及不良反应发生情况。结果:研究组CR 13例,PR 29例,有效率82. 35%,对照组CR 6例,PR 18例,有效率47. 06%,研究组有效率高于对照组(χ~2=13. 909,P=0. 000)。治疗后研究组NK细胞[(19. 72±1. 16:17. 21±1. 05),t=11. 456,P <0. 001]、CD_3~+[(64. 94±5. 27:62. 27±6. 93),t=2. 190,P <0. 05]、CD_4~+[(41. 93±4. 34:39. 72±3. 28),t=2. 901,P <0. 05]、CD_4~+/CD_8~+[(1. 49±0. 17:1. 33±0. 15),t=5. 040,P <0. 001]均高于对照组,而CD_8~+低于对照组[(29. 15±2. 85:33. 38±3. 01),t=7. 288,P <0. 001]。研究组患者生命质量改善率高于对照组(82. 35%:52. 94%,χ~2=10. 079,P=0. 001),研究组不良反应发生率为5. 88%,对照组不良反应发生率为3. 92%,两组比较差异无统计学意义(χ~2=0. 210,P=0. 647)。结论:复方苦参注射液腹腔内注射联合体外高频热疗可提高晚期肝癌的治疗效果,提高患者免疫功能和生命质量,且不增加不良反应。
Objective: To investigate the effect of intraperitoneal injection of Compound Sophora Flavescens Injection combined with extracorporeal high-frequency hyperthermia on the immune function,quality of life and adverse reactions of patients with advanced hepatocellular carcinoma. Methods: One hundred and two cases of advanced hepatocellular carcinoma with peritoneal effusion from March 2012 to February 2017 were selected from Tangshan People' s Hospital. They were randomly divided into study group( n = 51) and control group( n = 51). The control group was treated with Compound Sophora Flavescens Injection. The study group was treated with external high frequency hyperthermia on the basis of the control group. The curative effects of the two groups were compared. The changes of NK cells,CD_3~+,CD_4~+,CD_8~+,CD_4~+/CD_8~+were analyzed before and after treatment. The improvement of quality of life and the occurrence of adverse reactions were observed. Results: The study group had 13 cases of CR and 29 cases of PR and the effective rate was 82. 35%. The control group had 6 cases of CR and 18 cases of PR and the effective rate was 47. 06%. The effective rate of the study group was higher than that of the control group( χ~2= 13. 909,P = 0. 000). After treatment,the NK cells in the study group [( 19. 72 ± 1. 16) :( 17. 21 ± 1. 05),t = 11. 456,P < 0. 001 ],CD_3~+[( 64. 94 ± 5.27) :( 62. 27 ± 6. 93),t = 2. 190,P < 0. 05 ],CD_4~+[( 41. 93 ± 4. 34) :( 39. 72 ± 3. 28),t = 2. 901,P < 0. 05],CD_4~+/CD_8~+[( 1. 49 ± 0. 17) :( 1. 33 ± 0. 15),t = 5. 040,P < 0. 001] were higher than those of the control group,while CD_8~+in the study group was lower than that of the control group[( 29. 15 ± 2. 85: 33. 38 ± 3. 01),t = 7. 288,P < 0. 001]. The quality of life improvement rate of the study group was higher than that of the control group( 82. 35% : 52. 94%,χ~2= 10. 079,P = 0. 001). The incidence of adverse reactions in the study group was 5. 88%,and that in the control group was 3. 92%. The difference was not statistically significant( χ~2= 0. 210,P = 0. 647). Conclusion: Intraperitoneal injection of Compound Matrine Injection combined with extracorporeal high frequency hyperthermia can improve the therapeutic effect of advanced hepatocellular carcinoma,immune function and quality of life without increasing adverse reactions.
Objective: To investigate the effect of intraperitoneal injection of Compound Sophora Flavescens Injection combined with extracorporeal high-frequency hyperthermia on the immune function,quality of life and adverse reactions of patients with advanced hepatocellular carcinoma. Methods: One hundred and two cases of advanced hepatocellular carcinoma with peritoneal effusion from March 2012 to February 2017 were selected from Tangshan People' s Hospital. They were randomly divided into study group( n = 51) and control group( n = 51). The control group was treated with Compound Sophora Flavescens Injection. The study group was treated with external high frequency hyperthermia on the basis of the control group. The curative effects of the two groups were compared. The changes of NK cells,CD_3~+,CD_4~+,CD_8~+,CD_4~+/CD_8~+were analyzed before and after treatment. The improvement of quality of life and the occurrence of adverse reactions were observed. Results: The study group had 13 cases of CR and 29 cases of PR and the effective rate was 82. 35%. The control group had 6 cases of CR and 18 cases of PR and the effective rate was 47. 06%. The effective rate of the study group was higher than that of the control group( χ~2= 13. 909,P = 0. 000). After treatment,the NK cells in the study group [( 19. 72 ± 1. 16) :( 17. 21 ± 1. 05),t = 11. 456,P < 0. 001 ],CD_3~+[( 64. 94 ± 5.27) :( 62. 27 ± 6. 93),t = 2. 190,P < 0. 05 ],CD_4~+[( 41. 93 ± 4. 34) :( 39. 72 ± 3. 28),t = 2. 901,P < 0. 05],CD_4~+/CD_8~+[( 1. 49 ± 0. 17) :( 1. 33 ± 0. 15),t = 5. 040,P < 0. 001] were higher than those of the control group,while CD_8~+in the study group was lower than that of the control group[( 29. 15 ± 2. 85: 33. 38 ± 3. 01),t = 7. 288,P < 0. 001]. The quality of life improvement rate of the study group was higher than that of the control group( 82. 35% : 52. 94%,χ~2= 10. 079,P = 0. 001). The incidence of adverse reactions in the study group was 5. 88%,and that in the control group was 3. 92%. The difference was not statistically significant( χ~2= 0. 210,P = 0. 647). Conclusion: Intraperitoneal injection of Compound Matrine Injection combined with extracorporeal high frequency hyperthermia can improve the therapeutic effect of advanced hepatocellular carcinoma,immune function and quality of life without increasing adverse reactions.
引文
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[12]王薇,徐德立,于海生.肝动脉化疗栓塞术、射频消融、体外高频热疗法联合治疗肝癌的近期临床研究[J].中国医药指南,2013,11(35):532-533.
[13]杨柳,李小妹.复方苦参注射液腹腔内注射联合体外高频热疗对晚期肝癌腹水患者的疗效[J].中国医药导刊,2015(6):586-588.
[14]李夏东,马胜林,吴稚冰,等.肿瘤深部热疗智能温控系统临床效果研究[J].中华放射肿瘤学杂志,2016,25(11):1244-1247.
[15]Yang Jian,Guo Xinhong,Lu Wei,et al. Clinical evaluation of interventional chemoembolization combined with in vitro high frequency hyperthermia for advanced liver cancer[J]. China Journal of Modern Operative Surgery,2015(3):184-187.
[2]赵荣荣,邓永东,袁宏. 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.
[3]韩新臣,刘世育,陈光侠,等.复方苦参联合热疗对肝癌腹水患者的疗效分析[J].浙江临床医学,2013,15(7):967-969.
[4]马其辉,方黎明,陈日,等.复方苦参注射液在胃癌恶性腹腔积液患者顺铂腹腔灌注化疗中的应用及对免疫功能的影响[J].中国生化药物杂志,2017,37(2):109-112.
[5]杨晓环,黄十佳,于杰,等.超声引导经皮微波消融治疗邻近血管的原发性肝癌的长期疗效[J].肿瘤学杂志,2016,22(1):24-28.
[6]中华人民共和国卫生和计划生育委员会医政医管局.原发性肝癌诊疗规范(2017年版)[J].中华消化外科杂志,2017,16(7):635-647.
[7]孙燕,石远凯.临床肿瘤内科手[M].北京:人民卫生出版社,2007:147-148.
[8]于广计,李强,刘松,等.肝动脉化疗栓塞术及射频消融术联合调强放疗治疗原发性肝癌合并门静脉癌栓的疗效及预后因素分析[J].国际肿瘤学杂志,2016,43(2):99-102.
[9]Zhang Q,Tong J,Chen H,et al. A novel magnetic nanoparticle hyperthermia combined with ACMF-dependant drug release by DAMMs injection in VX-2 liver tumors[J]. J Nanosci Nanotechnol,2012,12(1):127-131.
[10]Kodama K,Doi O,Higashiyama M,et al. Long-term results of postoperative intrathoracic chemo-thermotherapy for lung cancer with pleural dissemination[J]. Cancer,2015,72(2):426-431.
[11]狄纪君,郭卫东,张惠洁,等. TACE联合热疗治疗原发性肝癌的临床观察[J].临床肿瘤学杂志,2012,17(1):42-46.
[12]王薇,徐德立,于海生.肝动脉化疗栓塞术、射频消融、体外高频热疗法联合治疗肝癌的近期临床研究[J].中国医药指南,2013,11(35):532-533.
[13]杨柳,李小妹.复方苦参注射液腹腔内注射联合体外高频热疗对晚期肝癌腹水患者的疗效[J].中国医药导刊,2015(6):586-588.
[14]李夏东,马胜林,吴稚冰,等.肿瘤深部热疗智能温控系统临床效果研究[J].中华放射肿瘤学杂志,2016,25(11):1244-1247.
[15]Yang Jian,Guo Xinhong,Lu Wei,et al. Clinical evaluation of interventional chemoembolization combined with in vitro high frequency hyperthermia for advanced liver cancer[J]. China Journal of Modern Operative Surgery,2015(3):184-187.