益气活血方联合华蟾素注射液对晚期肝癌患者生活质量的影响
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【摘要】目的：研究益气活血方联合华蟾素注射液对晚期肝癌患者生活质量的影响。方法68例晚期肝癌患者随机分为两组。两组均给予一般对症、护肝治疗；治疗组加口服益气活血方150ml，2次/d；华蟾素注射液20ml，静脉滴注，1次/d。2个月为1个疗程，记录治疗前后两组患者的肿瘤直径、远处转移、行为状态评分(采用Karnofsky评分标准)及生存时间。结果 治疗组2个月后肿瘤直径较治疗前无明显变化(P>0.05)。对照组2个月后肿瘤直径明显增大(P<0.05)；远处转移例数对照组明显多于治疗组(P<0.05)；治疗组行为状态评分较用药前明显增高(P<0.05 )，对照组明显下降(P<0.05)；患者生存时间治疗组较对照组明显延长(P<0.05 )。结论 益气活血方联合华蟾素注射液能提高晚期肝癌患者的生活质量。
【关键词】晚期肝癌；中医药治疗；生活质量
Effect of Yiqihuoxie Recipe Combined with Huachansu Injection on Quality of Life in Advancde Hepatic Patients
JIA Ying-li,WU Xin-li
(Oncology Department,Traditional Chinese medical hospital of Heilongjiang province, Haerbin 150036)
【Abstract】ObjectiveTo study the effect of Yiqihuoxie Recipe and Huachansu Injection on quafity oflife in advanced hepatic cancer patients. Methods68 patients with advanced hepatic cancer were divided into treatment group and control group. Two groups were treated with routine therapy. The treatment group had been treated with Yiqihuoxie Recipe and Huachansu Injection for two months. Tumor diameters, distant metastases, behavior scales(evaluated by Karnofsky scale) and survival time (before and after the treatment) were observed. ResultsThere was no significant difference in tumor diameters of treatment group after two months(P>0.05) , while the tumor diameter enlarged obviously in the control group (P<0.05). The cases complicated with distant metastases in the control group were more than thatin the treatment group (P<0.05 respectively ). The behavior scales of the treatment group ascended(P<0.05) and survival time was obviously prolonged (P<0.05)compared to that of the control group in which the behavior scales descended significantly (P<0.05).ConclusionYiqihuoxie Recipe combined with Huachansu Injection could improve the quality oflife in advanced hepatic cancer patients.
【Key words】Advanced hepatic cancer,Chinese medicine therapy , Quality of life
原发性肝癌是我国最常见的恶性肿瘤之一,其起病隐匿,进展迅速,治疗效果欠佳,预后不良；中医药治疗在控制肝癌病情发展、改善生存质量、延长生存期等方面取得一定的成效,已广泛应用于肝癌手术、放疗、介入、射频治疗等综合治疗中的各个环节,以及中晚期肝癌的单独治疗〔1-2〕。晚期肝癌患者随着病情的发展，常伴有免疫功能下降、肝功能差、合并全身转移、各种理化指标进一步恶化等现象，目前临床上缺乏有效的治疗手段和药物，预后较差。我们采用中药益气活血方联合华蟾素注射液治疗晚期肝癌，取得较好疗效，患者生活质量得到明显改善。报告如下。
1资料与方法
1.1研究对象
68例患者为我科2007—2010年门诊及住院患者，男46例，女22例；年龄35-75岁，平均52.1岁。全部经B超、CT、MR及甲胎蛋白(AFP)检查证实为原发性肝癌(AFP<400μg/L者，病理学证实)，合并肝硬化28例。本组均为Ⅲ期，全部患者均有客观的肿瘤观察指标和癌痛症状。伴有并发症者如消化道出血、肝性脑病、肝肾综合征等不列入观察差范围。所有患者随机分为两组，两组临床资料见表1。
1.2方法
1.2.1益气活血方益气活血方主要方药组成：黄芪30g，茯苓15g，白术15g，枸杞子15g，沙苑子15g，鸡内金15g，莪术10g，红花15g等。其中胁肋胀痛明显者加苏木10g；腹胀甚者加厚朴15g；舌苔腻者加薏苡仁30g。每日一剂，水煎300mL，分两次口服。
1.2.2治疗方法两组均采用一般护肝、对症治疗，治疗组加用益气活血方150mL口服，2次/d；华蟾素注射液20ml静脉滴注，1次/d。2个月为1个疗程。
1.2.3结果判定采用门诊及电话随访相结合，每月随访1次，共随访1年，治疗前及前2次随访记录患者的行为状态评分，采用Karnofsky评分标准 ......
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