徐大志 向彩琼 邹丹 张军 郑新平 杨春

摘要： 目的 探讨温阳通痞消积方联合热疗治疗中晚期肝癌的临床有效性和安全性。方法 将60例中晚期肝癌患者，随机分为对照组和观察组，对照组30例口服温阳通痞消积方治疗，观察组30例在对照组基础上联合热疗。观察2组患者治疗前后KPS评分、中医证候积分、免疫指标变化，并评价治疗结果及相关不良反应。结果 治疗后观察组患者KPS显著高于对照组（P<0.05）;中医证候积分显著低于对照组（P<0.05）;CD+4、CD+4/CD+8水平均高于對照组，而CD+8水平低于对照组（P<0.05）;治疗后观察组中医总有效率高于对照组（P<0.05）;2组不良反应比较，差异无统计学意义（P>0.05）。结论 温阳通痞消积方联合热疗治疗中晚期肝癌患者，能改善患者症状，提高免疫功能及生存质量，且无严重不良反应。

关键词： 热疗;中晚期肝癌;温阳通痞消积方

中图分类号：R735.7   文献标志码：B   文章编号：1007-2349（2021）08-0037-04

Effect of Wenyang Tongpi Xiaoji Prescription combined with Hyperthermiaon Symptoms and Immune Indexes of Patients with Advanced Liver Cancer

XU Da-zhi1， XIANG Cai-qiong1， ZOU Dan1， ZHANG Jun1， ZHENG Xin-ping1， YANG Chun2

（1. Traditional Chinese Medicine Hospital of Jingzhou City， Jingzhou 434000， China; 2. Key Laboratory of Quality and Efficacy Evaluation of Traditional Chinese Medicinal Granules， Jingzhou 434000， China）

【Abstract】Objective： To explore the clinical effect and safety of Wenyang Tongpi Xiaoji Prescription combined with hyperthermia in the treatment of advanced liver cancer patients. Methods： 60 patients were randomly divided into a control group and an observation group， 30 cases each group. The control group was treated with Wenyang Tongpi Xiaoji Decoction and the observation group was added hyperthermia on the basis of the control group. The changes of KPS score， TCM syndrome score， immunity index before and after treatment of the two groups were observed and the treatment results and related adverse reactions were evaluated. Results： After treatment， the KPS of the observation group was significantly higher than that of the control group （P<0.05）， the TCM syndrome score was significantly lower than that of the control group （P<0.05）， the CD+4， CD+4/CD+8 levels were higher than that of the control group and the CD+8 level was lower than that of the control group （P<0.05）. The TCM total effective rate of the observation group was higher than that of the control group after treatment （P<0.05） and there was no statistically significant difference in the adverse reactions between the two groups （P>0.05）. Conclusion： Wenyang Tongpi Xiaoji Prescription combined with hyperthermia in the treatment of patients with advanced liver cancer can improve symptoms， improve immune function and quality of life， without serious adverse reactions.

【Key words】Hyperthermia; Advanced Liver Cancer; Wenyang Tongpi Xiaoji Prescription

目前，肝癌已成为全球癌症相关死亡的第二大原因，每年新增肝癌患者30万～100万例[1]。中国属于肝癌高发区，占全世界发病人数的50%以上[2]。虽然肝癌的防治取得了一定的成效，但患者的中位生存期仍然较差，一般为确诊后6～20个月，西医有效治疗手段总体疗效有限。因此，尚需寻求新的治疗途径。研究表明，热疗能通过直接杀伤细胞、细胞凋亡效应、激发免疫反应等多方面的机制达到杀伤肿瘤细胞的作用，当前热疗已联合手术、放疗、化疗等手段运用于肝癌等多种实体肿瘤治疗过程中[3]。本课题将温阳通痞消积方联合热疗治疗中晚期肝癌，在临床中取得一定效果，现报道如下。

1 资料与方法

1.1 一般资料 选取2019年9月—2020年2月荆州市中医医院肿瘤科诊治的60例中晚期原发性肝癌患者作为研究对象。……