膈下逐瘀汤对瘀血内结型肝癌术后血凝状态与生存质量的影响

中国临床药理学与治疗学 ›› 2017, Vol. 22 ›› Issue (9): 1056-1061.

膈下逐瘀汤对瘀血内结型肝癌术后血凝状态与生存质量的影响

何扬彪¹，袁春樱²，史国军²

¹金华市中医医院血液净化中心，金华 321017，浙江；²宁波市中医院肿瘤科，宁波 315000，浙江

收稿日期:2016-11-30 修回日期:2017-01-21 出版日期:2017-09-26 发布日期:2017-09-30
作者简介:何扬彪，男，研究生，主治中医师，研究方向：中医内科，肾脏病，血液净化。 Tel:13867955280 E-mail：173942071@qq.com
基金资助:
宁波市自然科学基金（2016A610199）

Effect of gexiazhuyu decoction on blood coagulable status and life quality of patients with liver cancer

HE Yangbiao¹, YUAN Chunying², SHI Guojun²

¹ Hemopurification Center, Jinhua Hospital of Traditional Chinese Medicine, Jinhua 321017, Zhejiang, China; ² Oncology Department, Ningbo Hospital of Traditional Chinese Medicine, Ningbo 315000, Zhejiang, China

Received:2016-11-30 Revised:2017-01-21 Online:2017-09-26 Published:2017-09-30

摘要/Abstract

摘要：

目的: 分析膈下逐瘀汤对瘀血内结型肝癌术后血凝状态与生存质量的影响，为其临床应用提供数据支撑。方法: 将105例瘀血内结型原发性肝癌患者随机分为两组：对照组52例、观察组53例。所有患者均行手术治疗，观察组在手术治疗前后服用膈下逐瘀汤。术后完成3～5年随访，记录复发率、生存率与生存质量评分，并抽取外周血测定肝功能、血液流变性、血管内皮生长因子（VEGF）和细胞间黏附分子1（ICAM-1）水平。结果: 两组患者术后生存曲线和生存率差异无统计学意义（P>0.05）；观察组术后5年复发率低于对照组，生存质量QOL-LC总分和自我评价总分高于对照组，差异有统计学意义（P<0.05）。治疗前，两组患者的肝功能指标和血凝指标差异均无统计学意义（P>0.05）；治疗后，两组的谷草转氨酶（AST）、谷丙转氨酶（ALT）、全血高切粘度、全血低切粘度、红细胞聚集指数、纤维蛋白原、VEGF及ICAM-1有所降低，且观察组低于对照组，血浆凝血酶原时间有所升高，且观察组高于对照组，各项指标的组间差异均有统计学意义（P<0.05）。结论: 膈下逐瘀汤能够改善瘀血内结型肝癌患者血凝状态，利于预防病情复发，改善患者生存质量。

关键词: 膈下逐瘀汤, 中医证型, 原发性肝癌, 生存质量, 血凝状态

Abstract:

AIM: To analyze the effect of gexiazhuyu decoction on blood coagulable status and life quality of patients with liver cancer, so as to provide evidence for its clinical application. METHODS: 105 patients with liver cancer were divided into two groups: the control group (n=52) and the observation group (n=53). All the patients were given surgery,while the patients of the observation group were given gexiazhuyu decoction at the same time. A follow-up of three to five years was completed, and the recurrence rate, survival rate and life quality score of patients were record. Peripheral blood was extracted to detect liver function, hemorheology, vascular endothelial growth factor (VEGF) and intercellular adhesive molecular-1 (ICAM-1). RESULTS: There was no significant difference in postoperative survival curve and survival rate between groups (P>0.05), while the recurrence rate of the observation group in five years after treatment was lower than that of the control group, the QOL-LC score and self assessment score of the observation group were both higher than those of the control group, and the difference had statistical significance (P<0.05). There was no significant difference in liver function indexes and blood clotting indexes between groups before treatment (P>0.05). After treatment, the aspartate amino transferase (AST), alanine aminotransferase (ALT), whole blood high shear viscosity, low shear rates, red cell assembling index, plasma fibrinogen (Fb), VEGF and ICAM-1 of patients were decreased, and the levels of the observation group were lower; the plasma prothrombin time of patients was increased, and the levels of the observation group was higher; all the difference between groups had statistical significance (P<0.05). CONCLUSION: Gexiazhuyu decoction can remit the blood coagulable states, which is benefit to prevent relapse and improve life quality.

Key words: gexiazhuyu decoction, TCM syndrome types, primary hepatic carcinoma, life quality, , blood coagulable status

中图分类号:

R735.7

何扬彪，袁春樱，史国军. 膈下逐瘀汤对瘀血内结型肝癌术后血凝状态与生存质量的影响[J]. 中国临床药理学与治疗学, 2017, 22(9): 1056-1061.

HE Yangbiao, YUAN Chunying, SHI Guojun. Effect of gexiazhuyu decoction on blood coagulable status and life quality of patients with liver cancer[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2017, 22(9): 1056-1061.

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