CAJ | 학술논문

目的：评价复元活血汤联合肝动脉栓塞化疗术治疗原发性肝癌的临床疗效。方法收集2012年8月至2013年12月湖南省长沙市岳麓区人民医院肿瘤科患者80例，按随机数字表法，将患者随机分为2组各40例，观察组采用复元活血汤联合介入治疗，对照组采用介入治疗。观察治疗前后实体瘤体积变化、肿瘤标志物、临床症状、KPS评分、生活质量等。对比观察两组治疗前后临床疗效、生活质量。结果两组实体瘤客观疗效比较，观察组有效率47.5%（19/40），对照组为35%（14/40），两组比较差异无统计学意义（χ2＝-1.229，P＞0.05）。中医临床总有效率，观察组为87.5%（35/40）、对照组为32.5%（13/40），两组比较差异有统计学意义（χ2＝-5.633，P＜0.05）；合并门静脉癌栓经治疗后癌栓缩小＞1/2者，观察组为78.95%（15/19），对照组为33.33%（6/18），两组比较差异有统计学意义（χ2＝7.836，P＜0.05）；甲胎蛋白转阴或滴度下降者，观察组为78.95%（30/38），对照组为37.83%（14/37），两组比较差异有统计学意义（χ2＝-3.857，P＞0.05）；治疗后两组体力状况（KPS）评分疗效均改善，观察组有效率为80%（32/40）；对照组有效率为72.5%（29/40），两组比较差异无统计学意义（χ2＝-1.203，P＞0.05）。生活质量QOL评分疗效比较，观察组有效率为80%（32/40），对照组有效率为42.5%（17/40），两组比较差异有统计学意义（χ2＝-3.025，P＜0.05）。结论复元活血汤加减联合介入治疗原发性肝癌可更有效提高临床治疗效果，改善患者临床症状，提高生活质量。
목적：평개복원활혈탕연합간동맥전새화료술치료원발성간암적림상료효。방법수집2012년8월지2013년12월호남성장사시악록구인민의원종류과환자80례，안수궤수자표법，장환자수궤분위2조각40례，관찰조채용복원활혈탕연합개입치료，대조조채용개입치료。관찰치료전후실체류체적변화、종류표지물、림상증상、KPS평분、생활질량등。대비관찰량조치료전후림상료효、생활질량。결과량조실체류객관료효비교，관찰조유효솔47.5%（19/40），대조조위35%（14/40），량조비교차이무통계학의의（χ2＝-1.229，P＞0.05）。중의림상총유효솔，관찰조위87.5%（35/40）、대조조위32.5%（13/40），량조비교차이유통계학의의（χ2＝-5.633，P＜0.05）；합병문정맥암전경치료후암전축소＞1/2자，관찰조위78.95%（15/19），대조조위33.33%（6/18），량조비교차이유통계학의의（χ2＝7.836，P＜0.05）；갑태단백전음혹적도하강자，관찰조위78.95%（30/38），대조조위37.83%（14/37），량조비교차이유통계학의의（χ2＝-3.857，P＞0.05）；치료후량조체력상황（KPS）평분료효균개선，관찰조유효솔위80%（32/40）；대조조유효솔위72.5%（29/40），량조비교차이무통계학의의（χ2＝-1.203，P＞0.05）。생활질량QOL평분료효비교，관찰조유효솔위80%（32/40），대조조유효솔위42.5%（17/40），량조비교차이유통계학의의（χ2＝-3.025，P＜0.05）。결론복원활혈탕가감연합개입치료원발성간암가경유효제고림상치료효과，개선환자림상증상，제고생활질량。
Objective To evaluate the clinical effects of combined therapy of Fuyuan Huoxue decoction and transcatheter hepatic arterial chemoembolization in the treatment of primary hepatic carcinoma. Methods 80 patients with primary hepatic carcinoma were randomly divided into a control group, treated by transcatheter hepatic arterial chemoembolization, and a treatment group, additionally treated by Fuyuan Huoxue decoction on the basis of the control group. By observing the change of gross tumor volume、tumor markers、clinical symptoms、Karnofsky Performance Status(KPS) score、quality of life and so on,compare the clinical effects and quality of life between the two groups. Results The effective rate of solid tumor was 47.50%and 35%in the treatment and the control group respectively, with no significant difference(χ2=-1.229, P>0.05);The total effect rate was 87.50%and 32.50%in the treatment and the control group respectively, with significant difference(χ2=-5.633, P<0.05);The rate of patients merged with portal vein tumor thrombus whose cancer embolus narrowed more than 1/2 after the treatment was 78.95%and 33.33%in the treatment and the control group respectively, with significant difference(χ2=7.836, P<0.05);The rate of alpha fetoprotein(AFP) decreasing or turning negative was 78.95%and 37.83%after the treatment in the treatment and the control group respectively, with significant difference(χ2=-3.857, P<0.05);Both groups have improvement in Karnofsky Performance Status(KPS) score after the treatment, the ratios was 80% and 72.50% in the treatment and the control group respectively, with no significant difference(χ2=-1.203, P>0.05);The accumulated scores change of quality of life(QOL) has asignificant difference(χ2=-3.025, P<0.05) between the two groups after the treatment. Conclusion The combined therapy of Fuyuan Huoxue decoction and transcatheter hepatic arterial chemoembolization can alleviate the clinical symptoms, improve treatment effects and quality of life of patients with primary hepatic carcinoma.