肝动脉化疗栓塞术联合中药治疗原发性肝癌的临床疗效观察

摘要

目的观察肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)联合中药治疗原发性肝癌的临床疗效.方法连续130例肝功能 Child-pugh A/B 级的原发性肝癌患者根据患者意愿,分为 TACE 联合中药组和 TACE 组.TACE 联合中药组(66例)采用 TACE 同时配合中药治疗.TACE 组(64例)仅单行 TACE 治疗.观察终点指标为总生存期、疾病进展时间、生活质量、中医临床症候改善和介入术后并发症及不良反应变化.结果 TACE 联合中药组和单纯 TACE 组的中位疾病进展时间分别为7.3个月和4.0个月,有显著统计学差异(P <0.05).两组中位生存期分别为19个月和9个月.两组组半年、1年、2年总生存率分别为87.7%,59.1%,40.5%和63.8%,34.1%,20.2%(图2).两组比较有显著统计学差异(P <0.05).两组生活质量治疗后均有改善,组间差异有统计学意义(P <0.05).治疗组临床中医征候改善有效率为89.4%,对照组59.4%,两组间差异有统计学意义(P <0.05).TACE 联合中药组恶心呕吐的消化道反应明显低于对照组,存在统计学显著性差异(P <0.05),其余并发症和不良反应发生率在两组间虽无统计学显著性差异(P >0.05).结论原发性肝癌进行 TACE 术时联合中药同步治疗不仅能显著改善患者症状,提高生活质量,而且能够减轻毒副反应,进一步延长患者生存期.%　　Objective This study was to evaluate the efficacy of transcatheter arterial chemoembolization (TACE) combined with Chinese herbs on HCC. Methods The study population consisted of 130 HCC patients with Child-pugh A/B. According to the wishes of patients, 66 patients were treated with TACE combined with Chinese herbs, 64 patients were treated with TACE alone. The end points were overall survival (OS), time to progression(TTP), and the quality of life(QOF), clinical symptoms of TCM, complications and adverse reaction. Results The median TTP was 7.3 months in TACE combined with Chinese herbs group and 4.0 months in TACE group (P<0.05). The median OS was 19 months in TACE combined with Chinese herbs group and 9.0 months in TACE group.The 6-month, 1-year, and 2-year OS rates were 87.7%, 59.1%, 40.5% in TACE combined with Chinese herbs group, and 63.8%, 34.1%, 20.2% (Figure 2). The two groups, there is a statistically significant difference (P <0.05). The two sets of quality of life were improved after treatment, the difference between the groups was statistically significant (P <0.05).. After treatment, the total effective rate of clinical symptoms of TCM was 89.4% in TACE combined with Chinese herbs group, and 59.4% in TACE group , the difference of total effective rate of clinical symptoms of TCM between two group was statistically significant (P<0.05). Nausea and vomiting in TACE combined with Chinese herbs group was significantly lower than that in TACE group(P<0.05). There had no statistically significant difference of the rate of other complications and adverse reaction between the two groups(P>0.05). Conc lusion Ttranscatheter arterial chemoembolization combined with Chinese hers could not only improve the patients symptoms and the quality of life, but also could reduce the adverse reaction, further prolong patient surial.