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目的:探讨养正消积胶囊对原发性肝癌肝动脉化疗栓塞(TACE)术后患者无进展生存期(PFS)的影响及作用机制。方法:将97例患者随机按住院顺序分为对照组47例和观察组50例。对照组服用复方斑蝥胶囊,3粒/次,2次/d。观察组服用养正消积胶囊,4粒/次,2次/d。疗程:直到疾病出现进展。记录无进展生存期;治疗前及治疗后3个月进行KPS评分及外周血T淋巴细胞亚群和自然杀伤细胞(NK)水平检测;检测治疗前及治疗后3个月血管内皮生长因子(VEGF)、成纤维细胞生长因子(FGF)和血甲胎蛋白(AFP)水平。结果:对照组PFS时间为(17.5±6.2)周,观察组为(21.3±6.9)周,观察组PFS长于对照组(P<0.01);治疗后3个月对照组T淋巴细胞亚群(CD3+,CD4+,CD8+,CD4+/CD8+)和NK与治疗前比较变化不明显;观察组CD3+,CD4+,CD4+/CD8+,NK均比治疗前上升(P<0.01),治疗后3个月观察组CD3+,CD4+,CD4+/CD8+,NK高于对照组(P<0.01),CD8+低于对照组(P<0.01);治疗后3个月两组血清VEGF,bFGF和AFP水平较治疗前下降(P<0.01),观察组血清VEGF,bFGF和AFP水平低于对照组(P<0.01)。结论:养正消积胶囊能延长原发性肝癌TACE术后患者无进展生存期,稳定了患者的生活质量,其作用机制可能与提高患者细胞免疫功能,抑制血管形成有关。
Objective: To investigate the effect of Yangzheng Xiaoji Capsule on progression-free survival (PFS) in patients with primary hepatocellular carcinoma after transcatheter arterial chemoembolization (TACE) and its mechanism. Methods: Ninety-seven patients were randomly divided into control group (n = 47) and observation group (n = 50) according to the order of hospitalization. The control group took Compound Cantharidin capsules, 3 capsules / time, 2 times / d. Observation group taking Yangzheng Xiaoji capsule, 4 capsules / time, 2 times / d. Course of treatment: Until the disease progresses. The progression-free survival was recorded. KPS score, peripheral blood T-lymphocyte subsets and natural killer (NK) levels were measured before treatment and 3 months after treatment. Vascular endothelial growth factor (VEGF) ), Fibroblast growth factor (FGF) and blood alpha-fetoprotein (AFP) levels. Results: The PFS time in the control group was (17.5 ± 6.2) weeks and in the observation group was (21.3 ± 6.9) weeks, the PFS in the observation group was longer than that in the control group (P <0.01). At 3 months after treatment, the T lymphocyte subsets (CD3 + CD3 +, CD4 +, CD4 + / CD8 + and NK in the observation group were significantly higher than those before treatment (P <0.01). The levels of CD3 +, CD4 +, CD8 +, CD4 + / CD8 + (P <0.01), and the levels of CD8 + and CD4 (superscript +), CD4 + / CD8 + and NK were higher in the two groups than those in the control group ). The levels of serum VEGF, bFGF and AFP in the observation group were lower than those in the control group (P <0.01). Conclusion: Yangzhengxiaoji Capsule can prolong the progression-free survival of patients with primary hepatocellular carcinoma after TACE and stabilize the quality of life of patients. The mechanism may be related to improving cellular immune function and inhibiting blood vessel formation.