Clinical effect of Fuhe Beihua prescription combined with transcatheter arterial chemoembolization in treatment of primary liver cancer patients with liver depression and spleen deficiency: An analysis of 218 cases
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摘要: 目的探究敷和备化方联合肝动脉化疗栓塞术(TACE)对肝郁脾虚型原发性肝癌患者的治疗效果和对T淋巴细胞亚群水平的影响作用。方法采用回顾性研究的方法收集2018年1月-2020年1月在广西中医药大学第一附属医院肿瘤科、肝病科和介入科接受治疗的肝郁脾虚型Ⅲ期原发性肝癌患者资料。按患者是否服用中药敷和备化方分为治疗组与对照组,两组均行常规TACE治疗,治疗组加用敷和备化方内服。两组疗程均为16周。比较两组患者的近期有效率、生存质量评分、血清AFP水平、肝纤维化四项水平、凝血功能指标、外周血T淋巴细胞亚群水平,肝功能指标情况。计量资料两组间比较采用独立样本t检验;计数资料两组间比较采用χ2检验。计量资料不同时间不同组间比较采用重复测量资料的方差分析。结果最终整理出患者218例,其中对照组患者118例,治疗组患者100例。治疗组治疗8周的客观缓解率和疾病控制率分别为33%、66%,16周的客观缓解率和疾病控制率分别为34%、69%;对照组疗8周的客观缓解率和疾病控制率分别为26.27%、68.64%,16周的客观缓解率和疾病控制率分别为30.51%、68.64%,两组患者8周...Abstract: Objective To investigate the clinical effect of Fuhe Beihua prescription combined with transcatheter arterial chemoembolization( TACE) in the treatment of primary liver cancer patients with liver depression and spleen deficiency and its effect on T lymphocyte subsets.Methods A retrospective analysis was performed for the clinical data of stage Ⅲ primary liver cancer patients with liver depression and spleen deficiency who were treated in Department of Hepatology and Department of Oncology in The First Affiliated Hospital of Guangxi University of Chinese Medicine from January 2018 to January 2020. According to whether the traditional Chinese medicine Fuhe Beihua prescription was used,the patients were divided into treatment group( treated with routine TACE and oral administration of Fuhe Beihua prescription) and control group( treated with routine TACE alone),and the course of treatment was 16 weeks for both groups. The two groups were compared in terms of short-term response rate,quality-of-life score,serum alpha-fetoprotein( AFP) level,four indicators of liver fibrosis,coagulation function parameters,peripheral blood T lymphocyte subsets,and liver function parameters. The independent samples t-test was used for comparison of continuous data between two groups,and the chi-square test was used for comparison of categorical data between two groups. A repeated-measures analysis of variance was used for comparison of continuous data between different groups at different time points. Results A total of 218 patients were selected,with 118 in the control group and 100 in the treatment group. The treatment group had an objective response rate of 33% and a disease control rate of 66% at week 8 of treatment and an objective response rate of 34%and a disease control rate of 69% at week 16 of treatment,and the control group had an objective response rate of 26. 27% and a disease control rate of 68. 64% at week 8 of treatment and an objective response rate of 30. 51% and a disease control rate of 68. 64% at week 16 of treatment; there was a significant difference in objective response rate between the two groups at weeks 8 and 16 of treatment( P < 0. 05).Both groups had significant increases in Karnofsky Performance Scale( KPS) score,fibrinogen,and albumin( Alb) from before treatment to weeks 8 and 16 of treatment( all P < 0. 05),and there were significant differences in KPS score,fibrinogen,and Alb between the two groups at weeks 8 and 16 of treatment( all P < 0. 05). Both groups had significant reductions in AFP,the four indicators of liver fibrosis,alanine aminotransferase( ALT),aspartate aminotransferase( AST),prothrombin time( PT),and traditional Chinese medicine( TCM) syndrome score after treatment( all P < 0. 05),and at weeks 8 and 16 of treatment,there were significant differences between the two groups in AFP,the four indicators of liver fibrosis,ALT,AST,PT,and TCM syndrome score( all P < 0. 05). At weeks 8 and 16 of treatment,the treatment group had significant increases in the levels of CD3+,CD4+,and CD4+/CD8+( all P < 0. 05) and a significant reduction in the level of CD8+( P < 0. 05),and there were significant differences in the levels of T lymphocyte subsets between the two groups at weeks 8 and16 of treatment( all P < 0. 05). Conclusion Fuhe Beihua prescription combined with routine TACE has a better clinical effect than TACE alone in the treatment of primary liver cancer patients with liver depression and spleen deficiency,possibly by regulating the levels of T lymphocyte subsets.
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