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医药导报  2019, Vol. 38 Issue (6): 758-762    DOI: 10.3870/j.issn.1004-0781.2019.06.016
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自拟化癥消癌方联合微波消融术治疗老年肝癌患者30例
项琼1,2(),宋恩峰2,莫郑波2,胡伟3,林丽珠1()
1.广州中医药大学第一临床学院,广州 510504
2.武汉大学人民医院中医科,武汉 430060
3.武汉大学人民医院超声科,武汉 430060
Effect of Huawei Xiaoai Fang Combined with Microwave Ablation in the Treatment of 30 Case of Aged Patients with Liver Cancer
Qiong XIANG1,2(),Enfeng SONG2,Zhengbo MO2,Wei HU3,Lizhu LIN1()
1.First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510504,China
2.Department of Chinese Traditional Medicine, Renmin Hospital of Wuhan University,Wuhan 430060,China
3.Department of Ultrasonography,Renmin Hospital of Wuhan University,Wuhan 430060,China
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摘要 

目的 探讨自拟化癥消癌方联合经皮微波消融治疗老年肝癌的近期疗效。方法 收集2017年1月—2018 年9月60例全麻下肝癌微波消融术老年肝癌患者,分为联合治疗组与微波消融组,每组30例。联合治疗组为口服化癥消癌方联合经皮微波消融术,微波消融组仅采用经皮微波消融术。比较两组治疗前后血常规、肝功能、凝血功能、甲胎蛋白、T淋巴细胞亚群参数、卡氏评分等,并观察不良反应发生情况。结果 治疗后,联合治疗组总有效率86.7%,优于微波消融组73.3%(P<0.05);治疗后,联合治疗组血常规、肝功能、凝血功能、甲胎蛋白、T淋巴细胞亚群参数、卡氏评分等均高于微波消融组(P<0.05)。两组不良反应均较轻微,经对症处理后症状好转。结论 化癥消癌方联合经皮微波消融术治疗老年肝癌具有创伤微小,疗效确切,安全性高的特点,能提高患者机体免疫力,促进骨髓造血功能激活及升高白细胞,保护肝功能,对提高患者的生活质量有积极意义。

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项琼
宋恩峰
莫郑波
胡伟
林丽珠
关键词 化癥消癌方中药煎剂微波消融术肝癌    
Abstract

Objective To analyze the effect of Huawei xiaoai fang combined with microwave ablation for treating liver cancer on aged patients. Methods A total of 60 aged patients with liver cancer were selected and divided into combine treatment group and microwave ablation group.The patients in the microwave ablation group were treated with ultrasound-guided percutaneous microwave ablation.The combine treatment group was treated with Huawei xiaoai fang on the basis of the microwave ablation group.The two groups were both to test the blood counts, liver function, PT, AFP,T cell immunity and Karnofsky performance status. Results The total effective rate of combine treatment group was 86.7%,much better than the microwave ablation group(73.3%)(P<0.05).After treatment, the levels of blood counts, liver function, PT,AFP and T cell immunity were significantly better than those of the microwave ablation group(P<0.05).The scores of Karnofsky performance status for the patients in the combine treatment group was significantly better than the microwave ablation group(P<0.05). Conclusion The efficacy of Huawei xiaoai fang combined with percutaneous microwave ablation for the treatment of elderly patients with liver cancer has the characteristics of small trauma, definite curative effect and high safety.It can improve the body immunity of patients, promote the activation of hematopoietic function of bone marrow, increase white blood cells and protect liver function.It has positive significance for improving the quality of life of patients.

Key wordsHuawei xiaoai fang    Decoction of traditional Chinese medicine    Microwave ablation    Liver cancer
收稿日期: 2018-08-18      出版日期: 2019-06-11
引用本文:   
项琼,宋恩峰,莫郑波,胡伟,林丽珠. 自拟化癥消癌方联合微波消融术治疗老年肝癌患者30例[J]. 医药导报, 2019, 38(6): 758-762.
Qiong XIANG,Enfeng SONG,Zhengbo MO,Wei HU,Lizhu LIN. Effect of Huawei Xiaoai Fang Combined with Microwave Ablation in the Treatment of 30 Case of Aged Patients with Liver Cancer. Herald of Medicine, 2019, 38(6): 758-762.
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http://www.yydbzz.com/CN/10.3870/j.issn.1004-0781.2019.06.016      或      http://www.yydbzz.com/CN/Y2019/V38/I6/758
组别与时间 ALT AST ALB/
(g·L-1)
T-BiL D-BiL
(U·L-1) (μmol·L-1)
微波消融组
治疗前 88.70±6.80 82.35±12.15 35.50±7.31 25.44±5.22 7.10±2.13
治疗后 60.20±6.80 69.89±8.26 37.13±6.92 18.22±6.34 6.70±3.08
联合治疗组
治疗前 89.83±7.05 84.73±13.28 35.88±6.95 26.79±5.63 7.40±2.27
治疗后 41.02±5.33*1*2 45.56±8.17*1*2 39.24±5.84*1 16.18±4.08*1 6.10±1.80*1
表1  两组患者肝功能相关指标比较
组别与时间 AFP/
(μg·L-1)
PT APTT TT FIB/
(g·L-1)
s
微波消融组
治疗前 2785.7±176.5 15.23±2.17 45.50±4.31 18.44±1.82 4.10±1.53
治疗后 1989.2±172.4*1 16.47±2.38 47.74±4.94 19.58±1.37 4.30±1.61
联合治疗组
治疗前 2796.8±181.8 15.71±2.35 45.92±4.54 18.79±1.62 4.20±1.92
治疗后 1274.9±166.8*1*2 16.28±2.06 48.21±4.76 19.87±1.71 4.40±1.78
表2  两组患者AFP及凝血功能比较
组别与时间 WBC/
(×109·L-1)
Hb/
(g·L-1)
PLT/
(×109·L)
微波消融组
治疗前 6.7±3.5 105.4±20.7 245.8±63.6
治疗后 5.2±1.9 92.4±16.8 177.6±56.9
联合治疗组
治疗前 6.8±3.6 105.8±20.3 255.9±70.4
治疗后 7.7±3.2*1 108.0±19.0*1 258.1±64.3*1
表3  两组患者治疗前后WBC、Hb和PLT比较
组别与时间 $CD^{+}_{3}$ $CD^{+}_{4}$ $CD^{+}_{8}$ $CD^{+}_{4}$/C$CD^{+}_{8}$
%
微波消融组
治疗前 56.72±6.15 35.24±4.37 26.18±3.611 1.33±0.61
治疗后 51.47±5.90 32.45±4.18 27.22±3.32 1.14±0.53
联合治疗组
治疗前 57.28±5.96 35.81±4.53 25.97±3.42 1.36±0.70
治疗后 64.96±4.28*1*2 40.37±4.29*1*2 29.95±3.17 1.45±0.68
表4  两组患者治疗前后T淋巴细胞亚群参数比较
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