摘要
目的:探讨柴胡疏肝散加减对射频消融(RFA)治疗后不可切除肝癌患者预后的影响。方法:选择RFA治疗的85例不可切除的肝癌患者为研究对象,采用随机数字表法分为对照组(n=42)、观察组(n=43)。对照组采用RFA治疗,观察组采用RFA联合柴胡疏肝散加减治疗,两组均治疗2个月。出院后随访,比较两组患者并发症、总生存率、肝内无复发生存率等指标。结果:观察组中40例患者治疗成功,其中16例完成1个RFA疗程,20例完成2个疗程,4例完成3个疗程。对照组22例完成1个疗程的RFA,8例完成2个疗程,4例完成3个疗程。64例患者在RFA治疗后的3年内死亡,其中对照组40例、观察组24例,观察组3年总生存率高于对照组(P<0.05)。在RFA开始后3年内对照组肝内复发19例、观察组8例,观察组肝内无复发生存率高于对照组(P<0.05)。肿瘤直径>5 cm、肿瘤低分化是影响总生存率、复发的独立危险因素,柴胡疏肝散加减是独立保护因素;肝硬化是肝癌复发的独立危险因素,但对总生存率无明显影响。结论:柴胡疏肝散加减可增加RFA治疗成功率,提高不可切除肝癌患者总存活率。
Objective:To explore effect of Chaihu Shugan powder on prognosis of patients with unresectable hepatocellular carcinoma after radiofrequency ablation(RFA).Methods:85 patients with unresectable hepatocellular carcinoma were selected as study subjects,using random number table method divided into control group(n=42)and observation group(n=43).The control group were treated with RFA,and the observation group treated with RFA combined with Chaihu Shugan powder.Both groups were treated for 2 months.After discharge,patients were closely followed up.Compare complications,overall survival rate,and intrahepatic recurrence free survival rate between the two groups.Results:In the observation group,40 patients were successfully treated,which 16 completed 1 RFA course,20 completed 2 courses,and 4 completed 3 courses.In the control group,22 patients completed 1 RFA,8 patients completed 2 RFA,and 4 patients completed 3 RFA.64 patients died within 3 years after RFA treatment,including 40 in the control group and 24 in the observation group.3-year overall survival rate in the observation group were significantly higher than that in the control group(P<0.05).Within 3 years after the start of RFA,19 patients in the control group and 8 patients in the observation group had intrahepatic recurrence,and the survival rate of intrahepatic recurrence in the observation group was higher than that in the control group(P<0.05).Tumor diameter greter 5 cm and low tumor differentiation were independent risk factors affecting overall survival and recurrence.Chaihu Shugan powder was an independent protective factor.Cirrhosis was an independent risk factor for hepatocellular carcinoma recurrence,but has no significant effect on overall survival.Conclusion:Chaihu Shugan powder can increase the success rate of RFA treatment and improve overall survival rate of patients with unresectable liver cancer.
作者
刘鹏
陈青山
杨建波
LIU Peng;CHEN Qingshan;YANG Jianbo(Department of Hepatobiliary,the First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410021,China)
出处
《陕西中医》
CAS
2023年第7期892-896,共5页
Shaanxi Journal of Traditional Chinese Medicine
基金
湖南省自然科学基金资助项目(2022JJ40330)
湖南省卫生健康委员会科研计划项目(202304019027)。
关键词
肝癌
柴胡疏肝散
射频消融
存活率
复发
Liver cancer
Chaihu Shugan powder
Radiofrequency ablation
Survival rate
Recrudescence
