發(fā)布時間：2018-05-21 09:41

  本文選題：微調(diào)二號方 + 中醫(yī)藥治療��； 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:應(yīng)用微調(diào)二號方聯(lián)合肝動脈灌注化療栓塞術(shù)治療原發(fā)性肝癌,并與單純肝動脈灌注化療栓塞術(shù)治療原發(fā)性肝癌隨機對照,觀察前法在實體瘤大小縮小、臨床癥狀緩解、生活質(zhì)量改善以及毒副反應(yīng)減輕等方面是否具有優(yōu)勢。評價微調(diào)二號方治療原發(fā)性肝癌的療效及安全性,進一步推廣其在原發(fā)性肝癌的應(yīng)用。方法:選用隨機對照的臨床試驗研究設(shè)計方法,將經(jīng)納排標(biāo)準(zhǔn)篩選的60例原發(fā)性肝癌患者隨機分成對照組和治療組,兩組各30例,其中對照組在治療上行單純TACE,4周為1周期,2周期為1個療程,治療組則在TACE后連續(xù)口服微調(diào)二號方直至療程結(jié)束,兩組行TACE后均予常規(guī)補液及對癥治療。療程結(jié)束后觀察兩組原發(fā)性肝癌患者瘤體大小、臨床常見癥狀、KPS評分、生存質(zhì)量評分、毒副反應(yīng)、腫瘤指標(biāo)、淋巴細胞亞群等變化情況。結(jié)果:在實體瘤大小縮小方面,疾病控制率上,治療組和對照組分別為83.3%和73.3%,無統(tǒng)計學(xué)差異(P0.05);在臨床常見癥狀改善方面,治療組治療后癥狀總積分明顯比對照組更低,具有顯著統(tǒng)計學(xué)差異(P0.01),較之于對照組,有效率亦更高,兩組之間有統(tǒng)計學(xué)差異(P0.05);在腫瘤指標(biāo)改善方面,治療后兩組均能明顯降低AFP、和CEA,具有顯著統(tǒng)計學(xué)差異(P0.01),但兩組之間的差異無優(yōu)劣性(P0.05);在免疫功能提高方面,較之對照組,治療組治后CD3+、CD4+均更高,且兩組之間有統(tǒng)計學(xué)差異(P0.05);在KPS評分改善方面,較之于對照組,治療組治療后明顯更高,具有顯著統(tǒng)計學(xué)差異(P0.01),同時治療組在有效率方面亦更高,兩組之間有統(tǒng)計學(xué)差異(P0.05);在生存質(zhì)量改善方面,治療組治療后在情緒功能、總體健康等領(lǐng)域積分均高于對照組,兩組之間有統(tǒng)計學(xué)差異(P0.05),而在疲倦、惡心嘔吐、疼痛、失眠、腹瀉、食欲等領(lǐng)域積分均低于對照組,其中食欲領(lǐng)域兩組之間比較具有顯著統(tǒng)計學(xué)差異(P0.01),其余領(lǐng)域均具有統(tǒng)計學(xué)差異(P0.05);在毒副反應(yīng)減輕方面,治療組治療后在惡心嘔吐、腹瀉、發(fā)熱等方面發(fā)生程度均輕于對照組,其中發(fā)熱方面兩者之間具有顯著統(tǒng)計學(xué)差異(P0.01),惡心嘔吐、腹瀉方面亦有統(tǒng)計學(xué)差異(P0.05),同時治療組發(fā)熱發(fā)生率更低,兩組之間有統(tǒng)計學(xué)差異(P0.05)。結(jié)論:WD-2聯(lián)合TACE方案治療原發(fā)性肝癌,雖然在實體瘤大小縮小方面較單純TACE方案未能體現(xiàn)出優(yōu)勢,但其在臨床癥狀改善、生活質(zhì)量提高及TACE毒副反應(yīng)減輕等方面擁有優(yōu)勢。
[Abstract]:Objective: to treat primary liver cancer with Wei Tiao No. 2 prescription combined with hepatic artery infusion chemoembolization, and compared with simple hepatic artery infusion chemoembolization to treat primary liver cancer at random, and to observe the reduction of solid tumor size and the relief of clinical symptoms. The improvement of quality of life and the reduction of side effects have the advantage or not. To evaluate the efficacy and safety of Weitiao No. 2 prescription in the treatment of primary liver cancer and to promote its application in primary liver cancer. Methods: 60 patients with primary liver cancer were randomly divided into control group (n = 30) and treatment group (n = 30). The patients in the control group were treated with TACEE for 4 weeks and 1 cycle and 2 cycles as a course of treatment, while the treatment group received routine rehydration and symptomatic treatment after the treatment of TACE. The treatment group took the second prescription of fine tuning until the end of the course of treatment. Both groups were given routine rehydration and symptomatic therapy after TACE. The changes of tumor size, KPS score, quality of life score, toxic side effect, tumor index and lymphocyte subgroup of patients with primary liver cancer were observed at the end of the course of treatment. Results: the disease control rate was 83.3% in the treatment group and 73.3% in the control group, with no statistical difference (P 0.05), and the total symptom score in the treatment group was significantly lower than that in the control group in the improvement of common clinical symptoms. There was significant statistical difference between the two groups (P 0.01), the effective rate was higher than that in the control group, and there was a statistical difference between the two groups (P 0.05). After treatment, AFP and CEA were significantly decreased in both groups (P 0.01), but there was no significant difference between the two groups (P 0.05), and the improvement of immune function in the treatment group was higher than that in the control group. The improvement of KPS score in the treatment group was significantly higher than that in the control group (P 0.01), and the effective rate in the treatment group was higher than that in the control group. In terms of quality of life improvement, the scores of emotional function and general health in the treatment group were higher than those in the control group, and there was a significant difference between the two groups (P 0.05), while the scores of fatigue, nausea, vomiting, pain, insomnia, and so on were significantly higher in the treatment group than in the control group. The scores of diarrhea, appetite and other fields were lower than those of the control group, among which there was significant difference between the two groups in the area of appetite (P 0.01), and in the other fields there was a statistical difference (P 0.05), and in the side effect relief, the treatment group had nausea, vomiting and diarrhea after treatment. The incidence of fever was lower in the treatment group than in the control group. There was a significant difference in fever between the two groups (P 0.01), nausea and vomiting, diarrhea, and the incidence of fever in the treatment group was lower than that in the control group, and there was a significant difference between the two groups (P 0.05). Conclusion although the treatment of primary liver cancer with TACE combined with WD-2 has no advantage over that of TACE alone, it has advantages in improving clinical symptoms, improving quality of life and alleviating side effects of TACE.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.7

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