临床肝胆病杂志
臨床肝膽病雜誌
림상간담병잡지
CHINESE JOURNAL OF CLINICAL HEPATOLOGY
2015年
4期
564-568
,共5页
肝肿瘤%胸腺素%亚砷酸盐类%治疗结果
肝腫瘤%胸腺素%亞砷痠鹽類%治療結果
간종류%흉선소%아신산염류%치료결과
liver neoplasms%thymosin%arsenites%treatment outcome
目的：评价胸腺肽α1与三氧化二砷联合治疗中晚期原发性肝癌（PLC）的疗效。方法选取2011年7月－2014年7月泰州市姜堰中医院收治的中晚期PLC患者59例，分为两组，其中对照组在保肝对症支持治疗的基础上加用三氧化二砷治疗，联合组采用胸腺肽α1与三氧化二砷联合治疗。计量资料组间比较采用t检验，计数资料组间比较采用χ2检验。结果对照组临床获益率（CBR）为37．9％，联合组CBR为66．7％，差异具有统计学意义（χ2＝4．88，P＜0．05）；在生活质量方面，联合组生活质量改善率（63.3％）明显高于对照组（37．9％），差异具有统计学意义（χ2＝3．81，P＜0．05）；在疼痛方面，联合组疼痛缓解率（76.7％）明显高于对照组（44．8％），差异具有统计学意义（χ2＝6．28，P＜0．05）；甲胎蛋白（AFP）、癌胚抗原（CEA）、糖类抗原（CA）19－9、GGT均下降，联合组下降更明显（P值均＜0．05）；治疗后联合组中CD3＋T淋巴细胞，CD4＋T淋巴细胞，CD4＋与CD8＋T淋巴细胞比值均较治疗前有显著提高（P值均＜0．05），CD8＋T细胞显著降低（P＜0．01）；两组患者毒副反应差异无统计学意义。结论胸腺肽α1联合三氧化二砷治疗中晚期PLC能改善患者生活质量，提高患者免疫功能，且未发现明显毒副作用，值得临床推广应用。
目的：評價胸腺肽α1與三氧化二砷聯閤治療中晚期原髮性肝癌（PLC）的療效。方法選取2011年7月－2014年7月泰州市薑堰中醫院收治的中晚期PLC患者59例，分為兩組，其中對照組在保肝對癥支持治療的基礎上加用三氧化二砷治療，聯閤組採用胸腺肽α1與三氧化二砷聯閤治療。計量資料組間比較採用t檢驗，計數資料組間比較採用χ2檢驗。結果對照組臨床穫益率（CBR）為37．9％，聯閤組CBR為66．7％，差異具有統計學意義（χ2＝4．88，P＜0．05）；在生活質量方麵，聯閤組生活質量改善率（63.3％）明顯高于對照組（37．9％），差異具有統計學意義（χ2＝3．81，P＜0．05）；在疼痛方麵，聯閤組疼痛緩解率（76.7％）明顯高于對照組（44．8％），差異具有統計學意義（χ2＝6．28，P＜0．05）；甲胎蛋白（AFP）、癌胚抗原（CEA）、糖類抗原（CA）19－9、GGT均下降，聯閤組下降更明顯（P值均＜0．05）；治療後聯閤組中CD3＋T淋巴細胞，CD4＋T淋巴細胞，CD4＋與CD8＋T淋巴細胞比值均較治療前有顯著提高（P值均＜0．05），CD8＋T細胞顯著降低（P＜0．01）；兩組患者毒副反應差異無統計學意義。結論胸腺肽α1聯閤三氧化二砷治療中晚期PLC能改善患者生活質量，提高患者免疫功能，且未髮現明顯毒副作用，值得臨床推廣應用。
목적：평개흉선태α1여삼양화이신연합치료중만기원발성간암（PLC）적료효。방법선취2011년7월－2014년7월태주시강언중의원수치적중만기PLC환자59례，분위량조，기중대조조재보간대증지지치료적기출상가용삼양화이신치료，연합조채용흉선태α1여삼양화이신연합치료。계량자료조간비교채용t검험，계수자료조간비교채용χ2검험。결과대조조림상획익솔（CBR）위37．9％，연합조CBR위66．7％，차이구유통계학의의（χ2＝4．88，P＜0．05）；재생활질량방면，연합조생활질량개선솔（63.3％）명현고우대조조（37．9％），차이구유통계학의의（χ2＝3．81，P＜0．05）；재동통방면，연합조동통완해솔（76.7％）명현고우대조조（44．8％），차이구유통계학의의（χ2＝6．28，P＜0．05）；갑태단백（AFP）、암배항원（CEA）、당류항원（CA）19－9、GGT균하강，연합조하강경명현（P치균＜0．05）；치료후연합조중CD3＋T림파세포，CD4＋T림파세포，CD4＋여CD8＋T림파세포비치균교치료전유현저제고（P치균＜0．05），CD8＋T세포현저강저（P＜0．01）；량조환자독부반응차이무통계학의의。결론흉선태α1연합삼양화이신치료중만기PLC능개선환자생활질량，제고환자면역공능，차미발현명현독부작용，치득림상추엄응용。
Objective To evaluate the efficacy of thymosin ɑ1 combined with arsenic trioxide in the treatment of advanced primary liver cancer (PLC).Methods A total of 59 patients with advanced PLC who were admitted to Jiangyan Hospital of Traditional Chinese Medicine from July 201 1 to July 2014 were divided into two groups:control group and combination therapy group.The two groups were given symptom-atic and supportive treatment to protect the liver.In addition,29 cases in the control group were treated with arsenic trioxide,while 30 cases in the combination therapy group were administrated with thymosin ɑ1 combined with arsenic trioxide.Comparison of continuous data be-tween the two groups was made by independent-samples t test,and comparison of categorical data was made by chi-square test.Results There was a significant difference in clinical benefit rate between the control group and the combination therapy group (37.9% vs 66.7%,χ2 =4.88,P<0.05).The combination therapy group had significantly higher improvement rate of the quality of life (63.3%vs 37.9%,χ2 =3.81,P<0.05)and the pain remission rate (76.7%vs 44.8%,χ2 =6.28,P<0.05)than the control group.The levels of alpha fetal protein,carcinoembryonic antigen,carbohydrate antigen 199,and gamma glutamyl transpeptidase decreased in both groups,and the combination therapy group had significantly higher decreases in these indices than the control group (P<0.05).The combination thera-py group had significantly increased percentages of CD3 +and CD4 +T cells and CD4 +/CD8 +ratio (P<0.05)and a significantly reduced percentage of CD8 +T cells (P<0.01)after treatment.However,there was no significant difference in toxic or side effects between the two groups.Conclusion For patients with advanced PLC,the combination of thymosin ɑ1 and arsenic trioxide can improve the quality of life and the immune function of patients,and no obvious toxic or side effects are found.So it holds promise for clinical application.
