【作者】 罗溢昌；

【导师】 张华；

【作者基本信息】 广州中医药大学 ， 中西医结合， 2008， 硕士

【摘要】 本文主要从文献、临床研究方面对青蒿琥酯联合介入治疗对原发性肝癌患者免疫功能的影响进行初步的观察、归纳和总结。背景:中医认为本病乃由七情、劳倦内伤、外感六淫、饮食不洁,脏腑虚损、气血不和,导致气滞血瘀、痰气凝聚日久而成。与体内“正气不足”和外来的“邪气滞留”有关。现代医学对原发性肝癌的定义、流行病学、病因、临床分型分期、治疗等方面进行了大量的讨论。原发性肝癌可发生于任何年龄,多见于以40～49岁的中壮年,男女之比约为2-5:1。以其发病隐匿、发展迅速、预后极差而严重危害着人类健康,对该病的防治是重要的医学及社会课题。中医药应用于原发性肝癌的治疗己有较多的尝试,经肝动脉灌注中药制剂就是其中一种方法,常可起到与TACE常规方案相同或更高的治疗效果,且毒副作用较小。因此,为提高肝癌的介入治疗效果,研制高效低毒的抗癌中药,尤其是将中药有效成分或复方应用于肝癌介入治疗的研究越来越引起重视。目的:观察青蒿琥酯介入治疗原发性肝癌的疗效和对患者免疫功能的影响。探索临床新的抗肿瘤中药,以提高中药介入治疗原发性肝癌的疗效,减低介入治疗的副作用和提高机体免疫力。方法:本研究根据1991年中华人民共和国卫生部医政司编著的《中国常见恶性肿瘤诊治规范》关于原发性肝癌的诊断标准及UICC肝癌1997年TNM分期标准,选取在2007年3月—2008年4月在广州市中医医院肿瘤科诊断为原发性肝癌的患者,在临床观察中,选取60例符合纳入标准者,随机分治疗组30例和对照组30例。两组均给予必要的一般输液和对症治疗,治疗组在运用TACE常规治疗方案的同时,加用青蒿琥酯灌注。对照组采用TACE常规方案治疗。一个疗程后根据瘤体变化、AFP的变化、免疫功能指标及肝、肾功能、白细胞的变化,采用SPSS12.0统计软件包进行分析处理。结果:治疗组在提高机体免疫力方面明显优于对照组(P＜0.05)。在缩小瘤体、降低AFP近期疗效方面两组大致相似(P＞0.05)。在介入副作用方面,两组未见明显差异(P＞0.05)。结论:青蒿琥酯联合介入治疗能提高原发性肝癌患者的机体免疫力,但存在增加对肝功能损害的风险,对于开展青蒿琥酯临床抗肿瘤的研究有一定的意义。更多还原

【Abstract】 This article from the literature and clinical research on Artesunate combined with interventional therapy treatment of patients with primary liver cancer,To observe the fluence of immune function and then summed up and concluded.Background:The Chinese medicine thought that this sickness is by the seven emotions,the weary internal injury,the external disease factors excesses of the six factors,eating unclean,the internal organs empty damage,the vitality disagreement,will cause the stagnation of flow of vital energy blood stasis,the mental disorder to condense will become in the course of time."The healthy tendency is insufficient" and external "the perverse trend detention" with in vivo concerns。The modern medicine to the primary liver cancer’s from the definition、the epidemiology、etiology、clinical-stage、treatment and other aspects has carried ona great deal of discussion。Primary liver cancer can occur at any age。Misprision of its incidence、rapid development、poor prognosis and seriously endanger human health,to prevent and treat the disease is one of the most important medical and social issues。Chinese medicine used in the treatment of primary liver cancer have been more attempts,by the hepatic artery infusion Traditional Chinese Medicine is one of the methods,it often can play a conventional TACE with the same or a higher treatment result and make side effects smaller。Therefore, in order to increase the involvement of liver cancer treatment result, the development of high efficiency and low toxicity of anti-cancer traditional Chinese medicine,particularly applies the traditional Chinese medicine effective component or the compound prescription in liver cancer involves the treatment the research to cause more and more attention。Objective:To investigate the effect of Artesunate combined with interventional treatment of primary liver cancer and the influences of the immune function in patients。Try to Explores the clinical new anti-tumor traditional Chinese medicine,enhances the traditional Chinese medicine involvement treatment primary liver cancer’s curative effect,decreases the involvement treatment the side effects and enhances organism immunity。Method:The study under the People’s Republic of China Ministry of Health for medical Secretary of the "Chinese cancer diagnosis and treatment of common standards" on the diagnostic criteria for primary liver cancer in 1991 and liver cancer in 1997 UICC TNM classification standards,selected 60 patients who has been diagnosised for primary liver cancer that treatment in Tumor inpatient department Of Chinese Medicine hospitals in Guangzhou from March 2007 to April 2008,were randomly divided into 30 cases of the treatment group and control group of 30 cases。Two groups give the essential general infusion and the just right for the illness treatment,The treatment group uses the TACE convention plan treatment,combined Artesunate perfusion。The control group uses the TACE convention plan treatment。After a treatment course, acts according to the tumor size change、the AFP change、the immune function target and the liver、the kidney function、white blood cell’s change,uses the SPSS12.0 statistics software package to carry on the analysis processing。Results:The treatment group increase in immunity obviously better than the control group(P＜0.05);In narrowing the tumor and reducing effect of AFP broadly similar in both groups(P＞0.05);Intervention in the side-effects,There are not seen the obvious difference between Two groups(P＞0.05)。Conclusion:Artesunate combined intervention therapy can improve patients with primary liver cancer in the body immunity,increase the involvement of liver damage.To Artesunate anti-tumor clinical research have a certain significance。更多还原