【摘要】 [目的]观察中药联合肝动脉栓塞化疗(transcatheter arterial chemoembolization,TACE)术治疗原发性肝癌的临床疗效,探索中晚期肝癌的中西医结合综合治疗模式。[方法]将93例原发性肝癌患者作为研究对象,经TACE后随机分为治疗组和对照组,对照组TACE后不服任何中药;治疗组TACE后3～7d开始服用中药扶正解毒方,每日1付,比较2组患者疗效、中位疾病进展时间和生存期。[结果]治疗组与对照组患者总有效率、肿瘤控制率比较均差异无统计学意义(P>0.05);治疗组与对照组的中位生存期分别为17个月(95%CI:11～24个月)、11个月(95%CI:9～14个月;治疗组半年、1年、2年、3年生存率分别为74.5%、57.4%、17.0%、6.4%,对照组半年、1年、2年、3年生存率分别为69.6%、28.3%、10.9%、4.4%,2组生存期有差别,除1年生存期有统计学意义外(P<0.05),其他均无统计学意义(P>0.05);治疗组和对照组的中位疾病进展时间分别为158d(95%CI:98～218d)、87d(95%CI:34～170d),2组差异有统计学意义(P<0.05)。[结论]中药联合TACE较单纯TACE能明显延长患者疾病进展时间与1年生存期。更多还原

【Abstract】 [Objective]Transcatheter arterial chemoembolization(TACE) is an important therapy for hepatocellular carcinoma(HCC),but how to improve the effect of TACE,quality of life and to extend the long term survival is to be considerated.This study was to evaluate the efficacy of TACE with Fuzhengjiedu prescription of traditional Chinese medicine(TCM) on hepatocellular carcinoma in advanced stage.[Methods]From August 2003 to August 2008,102 patients with unresectable primary HCC were randomized into treatment(TACE plus Fuzhengjiedu) group and TACE group.Treatment group received oral Fuzhengjiedu prescription of TCM(1/d) at least for 3 months.Both groups were treated with epirubicin 20-40 mg,gemcitabine 0.4-1.2 g,mitomycin 8-10 mg,and floxuridine 0.5-1.0 g as chemotherapeutic drugs(2-3drugs were selected),ethanol,glutin,and iodolipol as ambolic agent in TACE.The quality of life and survival of the patients were observed.[Results]The median survival period was 17months [ 95% confidence interval(CI),11-24 months ]in treatment group and 11 months(95% CI:9-14 months) in TACE group.The 6-month,1-year,2-year and 3-year survival rates were 74.5%,57.4%,17.0% and 6.4% respectively in treatment group,and 69.6%,28.3%,10.9% and 4.4% respectively in TACE group.The median time to progression and the accumulative time of KPS(>70) were significantly longer in treatment group than that in TACE group [158 days(95% CI:98-218 days) vs 87 days(95% CI:34-170 days),P<0.05]and 13 months(95% CI:8-18 months) vs 6 months(95% CI:5-7 months),P<0.05.[Conclusion]Compared with TACE alone,the treatment therapy of TCM with TACE can obviously postpone disease progression,prolong 1-year survival and keep good quality of life in HCC patients.更多还原