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目的:观察参苓白术散加减辅助西医治疗脾虚证原发性肝癌的临床效果。方法:选取我院收治的74例脾虚证原发性肝癌患者作为研究对象,随机分为对照组与观察组2组,各37例,2组均给予对症处理,对照组采用经皮射频消融术干预,观察组加用参苓白术散加减方案,比较2组近远期疗效,观察实体瘤体积、肝功能指标及患者生活自理能力、日常活动能力的改善情况。结果:1观察组治疗总稳定率为91.89%,高于对照组的79.38%,但对比差异无统计学意义(P>0.05);2治疗后,观察组TBIL、ALT、ALP、AFP下降[(11.19±3.18)μmol/L、(48.56±19.54)U/L、(79.64±28.12)U/L、(424.51±357.64)μg/L],幅度高于对照组[(17.26±4.15)μmol/L、(75.21±27.41)U/L、(98.36±25.26)U/L、(689.91±334.25)μg/L],ALB上升[(36.71±2.58)g/L],幅度同样高于对照组[(32.16±3.12)g/L](P<0.05);3治疗8周,末次随访,观察组KPS、ADL评分均明显上升[(78.36±5.32)分、(84.36±3.21)分;(75.97±3.67)分、(89.98±2.97)分],幅度高于对照组[(67.11±4.26)分、(72.36±1.26)分;(65.33±2.84)分、(75.16±1.58)分](P<0.05)。结论:采用参苓白术散加减方联合射频消融术治疗脾虚证原发性肝癌患者,近远期疗效好,患者肝功能指标改善明显,日常生活能力提高。
Objective: To observe the clinical effect of Shenling Baizhu San on reducing and assisting western medicine in treating primary liver cancer of spleen deficiency syndrome. Methods: Totally 74 patients with primary liver cancer treated with spleen deficiency syndrome admitted to our hospital were randomly divided into 2 groups: control group and observation group, 37 cases in each group, 2 groups were given symptomatic treatment, and the control group were treated by percutaneous radiofrequency ablation Intervention, observation group plus Shenling Baizhu addition and subtraction programs, compared two groups of short-term efficacy, observe the volume of solid tumors, liver function indicators and patients with self-care ability, ability to improve daily activities. Results: 1 The total stability rate of observation group was 91.89%, which was higher than 79.38% of control group, but there was no significant difference between the two groups (P> 0.05); After treatment, the levels of TBIL, ALT, ALP and AFP decreased (19.26 ± 4.15) μmol / L, (48.96 ± 19.54) U / L, (79.64 ± 28.12) U / L, (424.51 ± 357.64) μg / L] , (75.21 ± 27.41) U / L, (98.36 ± 25.26) U / L, (689.91 ± 334.25) μg / L] and ALB increased [(36.71 ± 2.58) g / L] 32.16 ± 3.12) g / L] (P <0.05) .3 After 8 weeks of treatment, the KPS and ADL scores in the observation group were significantly increased at the last follow-up (78.36 ± 5.32 and 84.36 ± 3.21 and 75.97 ± 3.67 ), (89.98 ± 2.97) points higher than those in the control group (67.11 ± 4.26 points, 72.36 ± 1.26 points, 65.33 ± 2.84 points, 75.16 ± 1.58 points, P <0.05) . Conclusion: Shenling Baizhu San plus radiofrequency ablation combined with radiofrequency catheter ablation in the treatment of patients with primary liver cancer of spleen deficiency syndrome has good short-term and long-term effects, with significant improvement of liver function and improvement of daily living ability.