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目的:观察中晚期原发性肝癌经皮穿刺肝动脉化疗栓塞术(TACE)后的中医药治疗疗效,为筛选有效的治疗肝癌的中药提供一定的理论依据。方法:运用前瞻性队列研究观察健脾消痰散结方治疗中晚期原发性肝癌行TACE术后的患者32例,对照组30例,治疗疗程12周,观察并比较患者治疗前后的临床症状、中医证候、生活质量情况及治疗组1年、2年、3年的生存率。结果:①在证候疗效方面,治疗组和对照组治疗后分别为78.13%、63.33%;在证候积分方面,治疗组和对照组治疗后的积分分别为20.31±9.19、24.63±5.66,均有统计学差异(P<0.05);②生活质量改善比较,治疗组和对照组治疗后的生活质量积分分别为74.06±7.96、66.97±8.02,有统计学差异(P<0.05);③甲胎蛋白(AFP)比较,治疗组和对照组治疗后分别为(818.63±327.13)ng/mL、(744.88±235.46)ng/mL,无统计学差异(P>0.05)。结论:中晚期原发性肝癌患者行介入术后多表现为虚实夹杂证候,应用健脾消痰散结方治疗可以有效改善患者的症状,提高其生活质量及生存率。
Objective: To observe the effect of traditional Chinese medicine (TCM) after percutaneous transhepatic arterial chemoembolization (TACE) in the treatment of advanced primary liver cancer, and to provide a theoretical basis for the screening of traditional Chinese medicine for the treatment of hepatocellular carcinoma. Methods: A prospective cohort study was conducted to observe the effects of Jianpi Xiaotan Sanjie Decoction on advanced hepatocellular carcinoma (HCC) after TACE in 32 patients and in control group (30 patients) for 12 weeks. The clinical symptoms and signs before and after treatment were observed and compared , TCM syndrome, quality of life and treatment group 1 year, 2 years, 3 years survival rate. Results: ①In the treatment of syndromes, the treatment group and the control group were 78.13% and 63.33% respectively after treatment; in terms of syndrome score, the scores of the treatment group and the control group were 20.31 ± 9.19,24.63 ± 5.66 (P <0.05). (2) Compared with the quality of life improvement, the quality of life scores of the treatment group and the control group after treatment were respectively 74.06 ± 7.96 and 66.97 ± 8.02 (P <0.05) (818.63 ± 327.13) ng / mL and (744.88 ± 235.46) ng / mL respectively in the treatment group and the control group (P> 0.05). Conclusion: The patients with primary hepatocellular carcinoma in the middle and late stages showed more complicated syndromes after interventional therapy. The treatment with Jianpi Xiaotan Sanjie Decoction could effectively improve the symptoms and improve the quality of life and survival rate of patients with primary liver cancer.