经肝动脉化疗栓塞术后参芪肝康片联合抗病毒治疗HBV相关肝细胞癌的效果观察

杨道坤; 魏帅; 高海丽; 王新伟; 梁海军

doi:10.3969/j.issn.1001-5256.2018.11.015

经肝动脉化疗栓塞术后参芪肝康片联合抗病毒治疗HBV相关肝细胞癌的效果观察

DOI: 10.3969/j.issn.1001-5256.2018.11.015

新乡医学院第一附属医院感染三科

基金项目:

河南省卫生科技攻关工程资助项目(182102311234)；

详细信息

中图分类号: R735.7
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出版历程
- 出版日期: 2018-11-20

Clinical effect of Shenqi Gankang tablets combined with antiviral therapy after transcatheter arterial chemoembolization in treatment of hepatitis B virus-related hepatocellular carcinoma

Research funding:

摘要

摘要:
目的探讨经肝动脉化疗栓塞术（TACE）后参芪肝康片联合抗病毒治疗HBV相关肝细胞癌的临床效果。方法选取2015年10月-2017年2月新乡医学院第一附属医院收治的HBV相关肝细胞癌患者106例,随机分为对照组（TACE+恩替卡韦组） 57例、试验组（参芪肝康片+TACE+恩替卡韦组） 49例,最终完成随访89例（对照组44例、试验组45例）。观察治疗前和治疗1、3、6、12个月后患者TBil、ALT、AFP、Alb水平变化,记录治疗前及治疗12个月后患者CD3+、CD4+、CD8+T淋巴细胞水平、生存率、Child-Pugh分级和卡氏（KPS）评分变化。计数资料组间比较采用χ2检验或Wilcoxon秩和检验。符合正态分布的计量资料2组间比较采用t检验;非正态分布计量资料2组间比较采用Wilcoxon秩和检验。结果治疗3个月后,试验组ALT、TBil、Alb水平较对照组好转,差异均有统计学意义（P值均<0. 05）;治疗6、12个月后,试验组ATL、TBil、AFP、Alb水平较对照组进一步好转,差异均有统计学意义（P值均<0. 05）。试验组ALT、A...
- 癌,肝细胞 /
- 肝炎病毒,乙型 /
- 化学栓塞,治疗性 /
- 参芪肝康片
Abstract:
Objective To investigate the clinical effect of Shenqi Gankang tablets combined with antiviral therapy after transcatheter arterial chemoembolization ( TACE) in the treatment of hepatitis B virus ( HBV) -related hepatocellular carcinoma ( HCC) . Methods A total of106 patients with HBV-related HCC who were admitted to The First Affiliated Hospital of Xinxiang Medical University from October 2015 to February 2017 were enrolled and randomly divided into control group with 57 patients ( treated with TACE + entecavir) and experimental group with 49 patients ( treated with Shenqi Gankang tablets + TACE + entecavir) . Among these patients, 89 completed follow-up ( 44 in the control group and 45 in the experimental group) . The levels of total bilirubin ( TBil) , alanine aminotransferase ( ALT) , alpha-fetoprotein ( AFP) , and albumin ( Alb) were measured before treatment and after 1, 3, 6, and 12 months of treatment; the percentages of CD3+, CD4+, and CD8+T lymphocytes, Child-Pugh class, and Karnofsky Performance Scale ( KPS) score were recorded before treatment and after 12 months of treatment, and survival rate was calculated after 12 months of treatment. The chi-square test or Wilcoxon rank sum test was used for comparison of sex and genotype and allele frequencies between the two groups. The independent samples t-test and Wilcoxon rank sum test were used for comparison of continuous data between the two groups. Results After 3 months of treatment, the experimental group had significant improvements in the levels of ALT, TBil, and Alb than the control group ( all P < 0. 05) ; after 6 and 12 months of treatment, the experimental groups had further improvements in these indices than the control group ( all P < 0. 05) . Compared with the control group, the experimental group had a better change trend of ALT, AFP, TBil, and Alb and continuous improvements in ALT, TBil, and Alb. After 12 months of treatment, compared with the control group, the experimental group had a significantly higher percentage of CD4+T lymphocytes, a significantly higher CD4+/CD8+ratio, and a significantly lower percentage of CD8+T lymphocytes ( t =-2. 202, 3. 851, and-5. 324, P = 0. 030, < 0. 001, and < 0. 001) . At month 12 of follow-up, in the control group, 44 patients survived and 9 died, resulting in a survival rate of 83. 0%; in the experimental group, 45 survived and 2 died, resulting in a survival rate of 95. 7%; there was a significant difference in survival rate between the two groups ( χ2= 4. 121, P = 0. 042) . The experimental group had a significant improvement in Child-Pugh class than the control group, and there was a significant difference in Child-Pugh class between the two groups ( Z =-2. 260, P = 0. 024) . In the experimental group, 11 patients achieved a significant improvement in KPS score and 25 achieved a certain improvement, resulting in an improvement rate of 80. 00%; in the control group, 5 patients achieved a significant improvement in KPS score and 19 achieved a certain improvement, resulting in an improvement rate of 54. 55%; there was a significant difference in improvement rate between the two groups ( Z =-2. 688, P = 0. 007) . Conclusion Compared with antiviral therapy after TACE in the treatment of HBV-related HCC, Shenqi Gankang tablets combined with antiviral therapy after TACE has a better clinical effect in regulating the immune system, improving liver function, reducing bilirubin level, and improving survival rate.
- carcinoma, hepatocellular /
- hepatitis B virus /
- chemoembolization, therapeutic /
- Shenqi Gankang

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