摘要
目的研究敷和备化方联合肝动脉栓塞(transcatheter haptic arterial embolization,TAE)术后持续动脉灌注(FOLFOX4方案)治疗的临床疗效。方法选取2017年6月—2019年10月广西中医药大学第一附属医院及贺州市中医医院收治的中晚期肝癌患者60例,随机分为观察组和对照组,每组30例。两组患者均行TACE术治疗,术中不进行化疗药物灌注,后续进行持续动脉灌注化疗,化疗方案为FOLFOX4方案,观察组患者在上述治疗基础上给予敷和备化方口服治疗。2个疗程后,依据mRECIST标准进行疗效评价。分别于治疗1周、2周、3周和4周后,依据世界卫生组织(WHO)抗癌药急性和非急性反应分级标准记录症状严重程度。分别于术前、治疗后2周和4周,检测血清肝功能指标[天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TbiL)]以及肿瘤标志物指标[甲胎蛋白(AFP)、癌胚抗原(CEA)、肿瘤特异性生长因子(TSGF)]。分别于术前和疗程结束后,采用QLQ-C30量表进行生活质量评分。结果观察组的总有效率显著高于对照组(66.67%vs 56.67%,χ^(2)=0.635,P=0.426);治疗第2周和第3周,观察组腹痛、恶心呕吐、发热症状较对照组显著改善;治疗2周和4周后,观察组AST、ALT和TBiL水平较对照组显著降低;观察组患者AFP、CEA和TSGF水平较对照组均显著降低;观察组生活质量各项评分均显著高于对照组。结论敷和备化方联合TAE术后持续动脉灌注(FOLFOX4方案)治疗可显著提高患者疗效,改善术后症状及肝功能,改善患者预后,提高生活质量。
Objective To study the clinical effect of Fuhe Beihua Recipe(敷和备化方)combined with FOLFOX4 hepatic arterial infusion chemotherapy on levels of AFP,CEA and TSGF after TAE.Methods Sixty patients with advanced liver cancer treated in the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine and Hezhou Hospital of Chinese Medicine from March 2018 to November 2019 were selected,with 30 cases in each group.Patients in both groups were treated with TAE.No chemoembolization was infusio during the operation.Continuous arterial infusion chemotherapy was subsequently performed.The chemotherapy regimen was FOLFOX4.Patients in the observation group were given oral preparations based on the above treatment.After 2 courses,the curative effect was evaluated according to mRECIST criteria.After 1,2,3 and 4 weeks of treatment,the severity of symptoms was recorded according to the World Health Organization(WHO)anticancer drug acute and non-acute response classification criteria[13].Serum liver function indicators[aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TbiL)],and tumors were measured before surgery,2 and 4 weeks after treatment,respectively and we tested marker indicators[Alpha-fetoprotein(AFP),Carcinoembryonic Antigen(CEA),Tumor Specific Growth Factor(TSGF)].The QLQ-C30 scale was used to evaluate the quality of life before and after the treatment.Results The total effective rate in the observation group was significantly higher than that in the control group(66.67%vs 56.67%,χ^(2)=0.635,P=0.426).At the second and third week of treatment,the observation group’s abdominal pain,nausea,vomiting and fever symptoms significantly improved compared with those of the control group.After 2 and 4 weeks of treatment,the levels of AST,ALT and TBiL in the observation group were significantly lower than those in the control group.The levels of AFP,CEA and TSGF were significantly higher in the observation group than those in the control group.Conclusion Fuhe Beihua Recipeg combined with continuous arterial infusion(FOLFOX4)after TAE can significantly improve the efficacy of patients,relieve postoperative symptoms and improve liver function,prognosis and quality of life.
作者
蒋著椿
王同彪
钟少琴
陈俊桦
JIANG Zhuchun;WANG Tongbiao;ZHONG Shaoqin;CHEN Junhua(Hezhou Hospital of Traditional Chinese Medicine,Hezhou 542899,Guangxi,China;The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530000,Guangxi,China)
出处
《中华中医药学刊》
CAS
北大核心
2021年第1期227-231,共5页
Chinese Archives of Traditional Chinese Medicine
基金
广西科技攻关项目(桂科攻1298003-2-12)。
作者简介
蒋著椿(1982-),男,广西桂林人,副主任医师,硕士,研究方向:恶性肿瘤中西医结合防治;通讯作者:王同彪(1987-),男,陕西安康人,主治医师,硕士,研究方向:中西医结合肿瘤防治。E-mail:wtb12@163.com。
