加味柴苓汤联合顺铂、白介素-2腹腔内注射治疗肝癌腹水的临床研究
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摘要
目的:通过规范化随机对照临床研究,观察加味柴苓汤联合顺铂、白介素-2腹腔内注射治疗肝癌腹水的临床疗效,并与单纯腹腔内治疗对照组相比较,同时观察加味柴苓汤对患者生活质量、临床常见症状的改善情况、实体瘤近期客观疗效、肿瘤指标的影响和减轻化疗药物及生物反应调节剂毒副反应的作用,揭示中医药治疗肝癌腹水特色和优势弥补目前国内该项研究的缺憾。
     方法:采用随机分组,平行对照的方法,观察40例肝癌腹水患者,分为:治疗组(加味柴苓汤+腔内治疗)和对照组(腔内治疗),每组各20例。治疗组服用中药加味柴苓汤,并联合顺铂、白介素-2腔内治疗;对照组单纯予顺铂、白介素-2腔内治疗。观察两组患者治疗后腹水的消退情况以及对患者生活质量、临床常见症状的改善情况、实体瘤近期客观疗效、肿瘤指标的影响和减轻化疗药物及生物反应调节剂毒副反应的作用,并统计分析两组在上述指标方面的差异。
     结果:治疗组在增强腹水消退、提高生命质量、缓解临床症状、减轻化疗毒副反应方面,与对照组比较,差异有统计学意义。在近期疗效方面,有效率与对照组相当,疾病控制率高于对照组,两组有显著差异。两组对肿瘤指标的影响无显著差异。
     结论:加味柴苓汤治疗肝癌腹水患者能有效控制腹水,缓解胁痛、腹胀,改善体力状况;能提高患者生命质量,缓解常见临床症状;能控制肿瘤生长,稳定病灶,提高疾病控制率;能减轻化疗毒副反应,保证化疗顺利完成。
Objective:To observe the clinical effects of Jia Wei Chai Ling decoction (JWCLD) jointed cisplatin and interleukin-2 (IL-2) intraperitoneal injection in the treatment of hydroperitoneum in liver cancer, and elucidate JWCLD could ameliorate the short-term efficacy of solid tumor, quality of life, commom clinical symptom and tumor targets of patients and reduce the toxicity of chemotherapy and biological response modifier(BRM), which reveal the feature and dominance of traditional chinese medicine (TCM) on hydroperitoneum in liver cancer.
     Methods:Using randomized controlled methods of observation of 40 cases of hydroperitoneum in liver cancer patients, divided into JWCLD+intraperitoneal therapy group(treatment group) and the intraperitoneal therapy group(control group),20 cases in each group. The treatment group takes JWCLD and with cisplatin and IL-2 intraperitoneal injection, and control group are given cisplatin and IL-2 intraperitoneal injection alone. After treatment, the hydroperitoneum regression, quality of life, commom clinical symptoms, short-term efficacy of solid tumor and tumor targets changes of patients were obsereved. Besides, we also obsereved the effect of JWCLD on the toxicity of chemotherapy and BRM and analysised the differences between the two groups in the above-mentioned indicators.
     Results:Compared with control group, there have significant differences in treatment group in decreasing hydroperitoneum, improving quality of life, ameliorating symptoms and reducing the toxicity of chemotherapeutics. Effective rate and disease control rate in recent therapeutic effect of treatment group are higher than control group. The two groups on the impact of target tumor was no significant difference.
     Conclusion:JWCLD in the treatment of hydroperitoneum in liver cancer patients can reduce the hydroperitoneum, ease pain, improve physical condition; to improve patients quality of life and mitigate the common clinical symptoms; able to control tumor growth, stabilize lesions, improve disease control rate; can reduce the toxicity of chemotherapy to ensure the smooth completion of chemotherapy.
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