本文選題：原發(fā)性肝癌 + 健脾補腎方　； 參考：《河南中醫(yī)學院》2015年碩士論文

【摘要】：目的:通過運用健脾補腎方聯(lián)合水冷微波消融術(shù)治療原發(fā)性肝癌(PLC)患者,觀察兩組受試者處理前后T淋巴細胞亞群的變化,探討健脾補腎方對PLC患者細胞免疫功能的影響,并比較治療前后患者AFP水平變化、癥狀及生存質(zhì)量改善情況,探討健脾補腎方結(jié)合水冷微波消融治療PLC的優(yōu)勢。方法:收取40例符合本次研究入選標準的PLC患者為觀察病例,并隨機歸入試驗組和對照組,各20例,兩組患者均給予水冷微波消融術(shù)及抗病毒、保肝降酶等對癥基礎治療,試驗組在此基礎上服用健脾補腎方并隨癥加減,療程為2個月。治療結(jié)束后,分別比較兩組治療前后CD3+、CD4+及CD8+T細胞絕對值、CD4+/CD8+比值、AFP水平、臨床癥狀及生存質(zhì)量改善情況,并進行統(tǒng)計學分析。結(jié)果:1、兩組患者治療后CD3+、CD4+T淋巴細胞水平及CD4+/CD8+比值較治療前均有所升高,試驗組差異明顯(P0.05),對照組無明顯差異(P0.05)。兩組患者治療后CD3+、CD4+T淋巴細胞水平及CD4+/CD8+比值比較有明顯差異(P0.05)。2、兩組患者治療后CD8+T淋巴細胞水平較治療前均有所下降,組內(nèi)治療前后比較無顯著差異(P0.05),兩組患者治療后CD8+T淋巴細胞水平相比無顯著差異(P0.05)。3、兩組患者治療后AFP水平較治療前均有不同程度的下降,差異明顯(P0.05),兩組患者治療后AFP水平相比無明顯差異(P0.05)。4、兩組患者治療后脅痛、納呆、腹脹、乏力癥狀較治療前均有所改善,但試驗組癥狀積分情況較治療前顯著改善,差異明顯(P0.05),對照組各癥狀積分情況較治療前改善不明顯,無顯著差異(P0.05)。兩組患者治療后各癥狀積分情況相比,存在明顯差異(P0.05)。兩組患者治療后總體癥狀改善情況相比,試驗組較治療組顯著改善,差異明顯(P0.05)。5、兩組患者治療后生存質(zhì)量提高方面相比,試驗組較對照組生存質(zhì)量提高顯著,差異明顯(P0.05)。結(jié)論:1、健脾補腎方聯(lián)合水冷微波消融術(shù)可提高PLC患者CD3+、CD4+T細胞水平及CD4+/CD8+比值,從扶正祛邪角度闡明了健脾補腎方在一定程度上可改善PLC水冷微波消融術(shù)后患者的細胞免疫功能。2、健脾補腎方可改善PLC微波消融術(shù)后患者的部分臨床癥狀,提高患者的生存質(zhì)量。3、微波消融治療對PLC患者細胞免疫情況及臨床癥狀有所改善,但改善不明顯。
[Abstract]:Objective: to observe the changes of T lymphocyte subsets in patients with primary liver cancer (PLC) treated with Jianpi Bushen recipe and water-cooled microwave ablation, and to explore the effect of Jianpi Bushen recipe on cellular immune function of PLC patients. The changes of AFP level, symptoms and quality of life were compared before and after treatment, and the advantages of Jianpi Bushen recipe combined with water-cooled microwave ablation in the treatment of PLC were discussed. Methods: 40 patients with PLC who met the criteria of this study were selected as observation cases and randomly divided into two groups: experimental group and control group, 20 cases each. The two groups were treated with water-cooled microwave ablation and basic therapy of anti-virus, anti-liver enzyme and so on, and the patients in the two groups were divided into two groups: control group (n = 20) and control group (n = 20). The experimental group was treated with Jianpi Bushen recipe for 2 months. After treatment, the CD3 levels, clinical symptoms and quality of life (QOL) were compared between the two groups before and after treatment. Results the levels of CD4 T lymphocytes and the ratio of CD4 / CD8 in CD3 were increased in both groups after treatment. The difference was significant in the trial group (P 0.05), but not in the control group (P 0.05). There were significant differences in the levels of CD3 T lymphocytes and CD4 / CD8 ratio between the two groups after treatment. The levels of CD8 T lymphocytes in the two groups were lower than those before treatment. There was no significant difference between the two groups before and after treatment, and there was no significant difference in the levels of CD8 T lymphocytes between the two groups after treatment. The levels of AFP in the two groups were lower than those before and after treatment. There was no significant difference in AFP level between the two groups after treatment. The symptoms of hypochondriac pain, anorexia, abdominal distension and fatigue were improved after treatment in the two groups, but the symptom scores in the test group were significantly improved compared with those before treatment. The difference was significant (P0.05). The scores of symptoms in the control group were not significantly improved compared with those before treatment, but there was no significant difference between the two groups. There was a significant difference between the two groups in the scores of symptoms after treatment (P 0.05). Compared with the treatment group, the overall symptoms of the two groups were improved significantly, the difference was significant (P0.05N. 5). Compared with the two groups, the quality of life in the experimental group was significantly higher than that in the control group, and the difference was significant (P 0.05). Conclusion: 1. The combination of Jianpi Bushen decoction and water-cooled microwave ablation can increase the level of CD3 CD4 T cells and the ratio of CD4 / CD8 in patients with PLC. From the point of view of nourishing qi and dispelling evil, it is expounded that Jianpi Bushen prescription can improve the cellular immune function of patients after PLC water cooling microwave ablation to a certain extent, and Jianpi Bushen decoction can improve some clinical symptoms of patients after PLC microwave ablation. The cell immunity and clinical symptoms of patients with PLC were improved by microwave ablation, but the improvement was not obvious.
【學位授予單位】：河南中醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R735.7

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