下瘀血汤加减辅助TACE 治疗原发性肝癌肝热血瘀证临床研究
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R735.7

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Clinical Study on Modified Xiayuxue Tang Assisting TACE for Primary Liver Cancer with Liver Heat and Blood Stasis Syndrome
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    摘要:

    目的:观察下瘀血汤加减治疗对行经皮肝动脉化疗栓塞术(TACE) 的原发性肝癌(PLC) 肝热血瘀证患者中医证候、血清基质金属蛋白酶(MMP)、肝功能、生活质量及化疗毒副反应的影响。方法:选取78例行TACE治疗的PLC肝热血瘀证患者,按住院先后顺序随机分为观察组和对照组各39例。对照组术后给予复方甘草酸苷胶囊治疗,观察组在对照组基础上给予下瘀血汤加减治疗,均治疗12周。比较2组中医证候积分、临床疗效、血清MMP-1及MMP-9水平、Child-Pugh分级、卡氏评分(KPS评分)、化疗毒副反应发生情况。结果:治疗后,2组中医证候积分均较治疗前降低,观察组中医证候积分低于对照组,差异均有统计学意义(P<0.05)。观察组总有效率为89.74%,高于对照组的71.79%(P<0.05)。治疗后,2组血清MMP-1、MMP-9水平均较治疗前降低(P<0.05),观察组血清MMP-1、MMP-9水平均比对照组降低更明显(P<0.05)。治疗后,2组Child-Pugh分级A级比率均较治疗前升高(P<0.05),观察组Child-Pugh分级A级比率高于对照组(P<0.05)。治疗后,2组KPS评分均较治疗前升高(P<0.05),观察组KPS评分比对照组升高更明显(P<0.05)。治疗6周、12周,观察组血小板下降、谷丙转氨酶升高情况均优于对照组,差异均有统计学意义(P<0.05)。结论:下瘀血汤加减用于治疗PLC肝热血瘀证行TACE术后患者,可改善其中医证候,降低血清MMP-1、MMP-9水平,改善患者的肝功能和生活质量,减少化疗毒副反应。

    Abstract:

    Abstract: Objective: To observe the effect of modified Xiayuxue tang on Chinese medicine syndrome, matrix metalloproteinase(MMP) in serum,the liver function,quality of life and side effects of chemotherapy due to chemotherapy in patients with primary liver cancer(PLC) with liver heat and blood stasis syndrome after transarterial chemoembolization(TACE). Methods:A total of 78 cases of PLC patients with liver heat and blood stasis syndrome treated by TACE were selected and randomly divided into the observation group and the control group according to the order of hospitalization,39 cases in each group. After operation,the control group was treated with compound glycyrrhizin capsules,and the observation group was additionally treated with modified Xiayuxue tang based on the treatment of the control group. Both groups were treated for 12 weeks. The Chinese medicine syndrome scores,clinical effect,the levels of MMP-1 and MMP-9 in serum,Child-Pugh classification,Karnofsky Performance Status(KPS) scores and the side effects of chemotherapy were compared between the two groups. Results: After treatment, the Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment,and the scores in the observation group were lower than those in the control group, differences being significant(P<0.05). The total effective rate was 89.74% in the observation group, higher than that of 71.79% in the control group(P<0.05). After treatment,the levels of MMP-1 and MMP-9 in serum in the two groups were decreased when compared with those before treatment(P<0.05), and the decrease in the observation group was more significant than that in the control group(P<0.05). After treatment,the percentage of grade A of Child-Pugh classification in the two groups were increased when compared with that before treatment(P<0.05),and the percentage in the observation group was higher than that in the control group(P<0.05). After treatment,the KPS scores in the two groups were increased when compared with those before treatment(P<0.05),and the increase in the observation group was more significant than that in the control group(P<0.05). After treatment for six weeks and twelve weeks, the thrombocytopenia and elevated alanine aminotransferase in the observation group was better than that in the control group,differences being significant(P< 0.05). Conclusion:The modified Xiayuxue tang in treating PLC patients with liver heat and blood stasis syndrome after TACE can improve their Chinese medicine syndromes,the liver function and quality of life,reduce the levels of MMP-1 and MMP- 9 in serum and the adverse side effects of chemotherapy.

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王曜,程铜斐,胡天穹.下瘀血汤加减辅助TACE 治疗原发性肝癌肝热血瘀证临床研究[J].新中医,2020,52(9):19-23

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  • 在线发布日期: 2020-05-09
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