榄香烯注射液联合莲芪胶囊治疗中晚期原发性肝癌的临床疗效及对患者血清生长因子的影响被引量：11

Clinical study on Lianqi capsule combined with Elemene injection on patients with middle-late primary liver cancer and its effects on serum growth factor

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摘要目的观察榄香烯注射液联合莲芪胶囊治疗中晚期原发性肝癌(PLC)的临床疗效及对患者血清血管内皮生长因子(VEGF)、胰岛素样生长因子2(IGF-2)、胰岛素样生长因子结合蛋白2(IGFBP-2)的影响。方法将60例中晚期PLC患者随机分为2组。对照组30例予经导管肝动脉化疗栓塞术(TACE)治疗,每3周治疗1次为1个疗程,治疗2个疗程;治疗组30例在对照组治疗基础上加用榄香烯注射液联合莲芪胶囊治疗。榄香烯注射液2周为1个疗程,休息1周后进行下1个疗程,治疗2个疗程;莲芪胶囊介入前1周连续口服7 d。比较2组临床疗效;观察2组治疗前后肝功能指标[白蛋白(Alb)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)]变化;观察2组治疗前后中医证候积分变化;比较2组中医证候疗效;观察2组治疗前后卡氏评分(KPS)变化;比较2组功能状态疗效;观察2组治疗前后血常规白细胞计数(WBC)、血小板计数(PLT)、血红蛋白(Hgb)及肾功能指标血尿素氮(BUN)、血肌酐(Cr)变化;观察2组治疗前后VEGF、IGF-2、IGFBP-2水平变化。结果治疗组总有效率26.67%,控制率96.67%,对照组总有效率10.00%,控制率80.00%,2组总有效率、控制率比较差异均有统计学意义(P<0.05),治疗组临床疗效优于对照组。治疗组治疗后Alb较本组治疗前升高(P<0.05),ALT、AST均较本组治疗前降低(P<0.05);对照组治疗后ALT、AST均较本组治疗前降低(P<0.05)。治疗后治疗组Alb高于对照组(P<0.05),ALT、AST均低于对照组(P<0.05)。2组治疗后中医证候积分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。治疗组改善率73.33%,对照组改善率46.67%,2组改善率比较差异有统计学意义(P<0.05),治疗组中医证候疗效优于对照组。2组治疗后KPS评分均较本组治疗前升高(P<0.05),治疗后治疗组高于对照组(P<0.05)。治疗组功能状态改善率46.67%,对照组功能状态改善率20.00%,2组改善率比较差异有统计学意义(P<0.05),治疗组功能状态疗效优于对照组。治疗组治疗前后WBC、Hgb、PLT比较差异均无统计学意义(P>0.05),对照组治疗后WBC、Hgb、PLT均较本组治疗前降低(P<0.05)。治疗组治疗后WBC、Hgb、PLT高于对照组治疗后(P<0.05)。2组治疗前后BUN、Cr比较差异均无统计学意义(P>0.05),2组治疗后BUN、Cr比较差异均无统计学意义(P>0.05)。2组治疗后VEGF、IGF-2、IGFBP-2均较本组治疗前降低(P<0.05);治疗后治疗组VEGF、IGF-2、IGFBP-2低于对照组(P<0.05)。结论榄香烯注射液联合莲芪胶囊治疗中晚期PLC疗效确切,并可有效缓解临床症状,降低不良反应,提高生活质量;患者血清VEGF、IGF-2、IGFBP-2水平可能与肝癌进展及预后相关。 Objective To observe the clinical study on Lianqi capsule combined with Elemene injection on patients with middle-late primary liver cancer(PLC) and its effects on serum vascular endothelial growth factor(VEGF),insulin-like growth factor-2(IGF-II) and insulin-like growth factor binding protein-2(IGFBP-2).Methods 60 patients with middle-late PLC were randomly divided into two groups.30 cases in control group were treated by transcatheter arterial chemoembolization(TACE),One course of treatment was treated once even three weeks continuously treated for two conrses.30 cases in treatment group were treated by Lianqi capsule combined with Elemene injection on the basis of the control group.The Elemene injectal was on course for two weeks.After on week of rest.The next course of treatmenf was carried out continuously treated for two conrses.The liver indexes including albumin(Alb),alanine aminotransferase(ALT) and aspartate aminotransferase(AST) before and after treatment were observed in two groups.The score changes of TCM syndrome were observed and the curative effects of TCM syndrome were compared in two groups.The changes of KPS score before and after treatment were observed in two groups.The effects of functional status were compared between two groups.The changes of blood routine including white blood cell(WBC),platelets(PLT) and hemoglobin(Hgb),and the renal function indexes including blood urea nitrogen(BUN) and serum creatinine(Cr),and level changes of VEGF,IGF-Ⅱ,IGFBP-2 before and after treatment were observed in two groups.Results There were statistical differences on the total effective rate and the control rate of between the treatment group(26.67%,96.67%) and the control group(10.00%,80.00%,P < 0.05),and the clinical effects in treatment group was superior to that in control group.The Alb after treatment was increased in treatment group(P < 0.05),ALT and AST were decreased(P < 0.05),and ALT and AST reduced(P <0.05).The ALT and AST after treatment were reduced in control group(P < 0.05).After treatment,Alb in treatment group was higher than that in control group(P < 0.05),and ALT and AST were lower than those in control group(P < 0.05).The TCM syndrome after treatment were lower tha that before treament(P < 0.05).There were statistical differences on the improvement rate between treatment group(73.33%) and control group(46.67%,P <0.05).The curative effects of TCM syndrome in treatment group were superior to that in control group.The KPS scores after treatment were increased in two groups(P < 0.05),and which in treatment group was superior to that in control group(P < 0.05).There were statistical differences on the improvement rate between the treatment(46.67%) group and the control group(20.00%,P < 0.05).The effects of functional status in treatment group were superior to that in control group.There was no statistical difference on WBC,Hgb and PLT between before and after treatment in treatment group(P > 0.05).The WBC,Hgb and PLT after treatment were reduced in control group(P< 0.05).The WBC,Hgb and PLT after treatment in treatment group were higher than that in control group(P <0.05).There was no statistical difference on BUN and Cr between before and after treatment in two groups(P >0.05).There was no statistical difference on BUN and Cr after treatment between two groups(P > 0.05).The VEGF,IGF-II and IGFBP-2 after treatment were reduced in two groups(P < 0.05),and which in treatment group were lower than that in control group(P < 0.05).Conclusion Lianqi capsule combined with Elemene injection on middle-late PLC patients can effectively relieve the clinical symptoms,reduce the adverse reactions and improve the quality of life.The levels of serum VEGF,IGF-II and IGFBP-2 of PLC patients may be associated with the progress and prognosis of liver cancer.