PTCD术联合茵陈蒿汤治疗肝胆湿热型恶性梗阻性黄疸的临床研究

目的探讨茵陈蒿汤联合PTCD(经皮肝穿刺胆道引流术治疗肝胆湿热型恶性梗阻性黄疸的近期疗效。方法 2009年1月—2010年12月间收治的恶性梗阻性黄疸(肝胆湿热型)患者80例,其中实验组40例PTCD术后口服茵陈蒿汤2周,单纯PTCD治疗40例为对照组。观察中医症候、肝功能、免疫指标改善情况,并随访观察12月,统计中位生存时间和1年生存率。结果实验组能明显改善中医症候、KPS评分、肝功能、免疫指标,与对照组比较差异有统计学意义;实验组1年生存率为28.2%,中位生存时间7.6月。结论茵陈蒿汤联合PTCD能有效改善肝胆湿热型恶性梗阻性黄疸病人的生活质量和生存期。

Clinical research of PTCD combined with Yinchenhao decoction (YCHD) in treatment of malignant obstructive jaundice plus hepatobiliary damp-heat type

Objective To observe short-term effect of PTCD combined with Yinchenhao decoction(YCHD) in the treatment of malignant obstructive jaundice plus hepatobiliary damp-heat type. Methods 80 patients,which were received by us during January 2009 to December 2010,40 patients in the experimental group accepted oral administration of YCHD for two weeks after PTCD treatment and another 40 cases as the control group were treated with PTCD alone.Traditional Chinese medicine symptoms,liver function and immune parameters were observed,and median survival time and time to progression(TTP) were recorded during the 12-months’follow-up postoperatively. Results Medicine symptoms,KPS score,liver function and immune parameters in the experimental group were significantly improved when compared with the control group.In the experimental group,one-year survival rate was 28.2% and median survival time was 7.6 months,respectively. Conclusion PTCD combined with YCHD can effectively improve life quality and prolong survival time of patients with malignant obstructive jaundice plus hepatobiliary damp-heat type.