【摘要】 [目的]评价以羟基喜树碱行肝动脉灌注栓塞术结合参桃软肝丸加减方(主要由人参、桃仁、茵陈、白花蛇舌草、半 枝莲、丹参、茯苓、冬虫夏草等中药组成)治疗大肝癌的近期及远期疗效。[方法]将符合入选标准的85例患者按简单随 机法分为治疗组和对照组。治疗组52例,予羟基喜树碱(HCPT)局部介入,配合参桃软肝丸随症加减。对照组33例,予 常用的化学药物丝裂霉素(MMC)、卡铂(CBP)、吡柔比星(THP)肝动脉插管灌注。两组按需均可用栓塞剂LP／GS(碘化 油／明胶海绵)。每4周介入1次,共介入2次。[结果]治疗组和对照组的近期疗效(瘤体变化、症状计分、卡氏评分、甲 胎蛋白下降水平等)差异均无显著性(P>0.05),说明两组的疗效相当;而治疗组介入治疗后的肝功能损害较轻(与对照 组比较,P<0.05)。治疗组中位生存期为326 d,平均存活407 d;对照组中位生存期262 d,平均存活291 d。半年、一年及 两年生存率,治疗组分别为80.95％、38.80％、15.46％,对照组分别为64.29％、25.00％、8.33％,治疗组的生存率较对照 组同一时点的生存率高(P<0.05),提示治疗组的远期疗效较对照组好,可延长患者的生存期。[结论]该方法可提高大 肝癌治疗效果,延长患者的存活时间。更多还原

【Abstract】 [Objective] To evaluate the short-term and long-term therapeutic effect of perfusion-embolism with hydrocamptothecin (HCPT) into hepatic artery and oral use of modified Shentao Ruangan Pill (SRP), a prescription mainly composed of Radix Ginseng, Semen Persicae, Herba Artemisiae Scopariae, Herba Hedyotis Diffusae, Herba Scutellariae Barbatae, Radix Salviae Miltiorrhizae, etc., in treating primary liver cancer. [Methods] Eighty-five cases confirmed as primary liver cancer were randomized into groups A and B. Group A ( n=52) was given local transcatheter hepatic arterial chemoembolization with HCPT and oral use of SRP; group B (n = 33) was given transcatheter hepatic arterial chemoembolization with mitomycin C (MMC), carboplatin (CBP), theprubicin (THP); lipiodol or gelatin sponge could be used in the two groups when necessary. The treatment was carried out once every 4 weeks and 2 times in all. [Results] The difference of the short-term effect, evaluated by the changes of tumor mass, symptoms scoring, Karnofsy scoring, serum alpha-fetoprotein (AFP) level, etc. was no statistical significance between the two groups (P > 0.05) , indicating the short-term effect being similar in the two groups. After treatment, the injury of hepatic function in group A was mild as compared with that in group B ( P < 0.05); the median survival period was 326 days in group A and 262 days in group B, and the mean survival period was 407 days in group A and 291 days in group B. Survival rates during half a year, one year and two years were 80.95% , 38.80% and 15.46% respectively in group A and 64.29% , 25.00% and 8.33% respectively in group B; the survival rate in group A was higher than that in group B at the same time point ( P < 0.05) , indicating the long-term effect in group A being better than that in group B. [Conclusion] Local transcatheter hepatic arterial chemoembolization with HCPT and oral use of SRP exert better effect in treating primary liver cancer, the survival time being prolonged.更多还原