实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (4): 585-588.doi: 10.3969/j.issn.1672-5069.2026.04.027

• 肝癌 • 上一篇    下一篇

TACE联合靶向免疫和槐耳颗粒治疗不可切除的原发性肝癌患者疗效及生存获益分析*

陈唯唯, 陈可, 刘平, 胡燕, 游忠岚   

  1. 400038 重庆市 陆军军医大学(第三军医大学)西南医院感染病科(陈唯唯,胡燕,游忠岚);军事预防医学系军队卫生统计学教研室(陈可);第一附属医院江北分院感染病科(刘平)
  • 收稿日期:2025-12-10 出版日期:2026-07-10 发布日期:2026-07-20
  • 通讯作者: 游忠岚,E-mail:yzl@tmmu.edu.cn
  • 作者简介:陈唯唯,女,29岁,医学硕士,主治医师。E-mail:vvkeyan@163.com
  • 基金资助:
    *重庆市自然科学基金面上项目(编号:CSTB2022NSCQ-MSX0221)

Clinical effectiveness of TACE in combination with targeted and immunotherapy plus Huai’er granule in treatment of patients with unresectable primary liver cancer

Chen Weiwei, Chen Ke, Liu Ping, et al   

  1. Department of Infectious Diseases, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
  • Received:2025-12-10 Online:2026-07-10 Published:2026-07-20

摘要: 目的 探讨经导管动脉化疗栓塞术(TACE)联合靶向免疫和槐耳颗粒治疗不可切除的原发性肝癌(PLC)患者的疗效及生存获益情况。方法 2022年6月~2024年6月我院收治的78例不可切除的PLC患者被分成两组,给予对照组(n=38)TACE联合靶向免疫治疗,观察组(n=40)则在TACE联合靶向免疫治疗的基础上加用槐耳颗粒治疗。随访至2025年9月,记录客观缓解率(ORR)、疾病控制率(DCR)、总生存时间(OS)和无进展生存期(PFS)。采用ELISA法检测血清α-L-岩藻糖苷酶(AFU)和甲胎蛋白(AFP)水平,采用化学发光免疫分析法检测血清异常凝血酶原(DCP)水平。结果 观察组ORR为45.0%,显著高于对照组的21.1%(P<0.05),而两组DCR(80.0%对60.5%)无显著性差异(P>0.05);在治疗后,观察组DCP、AFU和AFP水平分别为(95.3±23.4)mAU/mL、(67.9±20.9)U/L和(231.8±78.9)ng/mL,均显著低于对照组【分别为(121.5±25.7)mAU/mL、(111.5±18.2)U/L和(368.5±85.7)ng/mL,P<0.05】;观察组β2-MG为(0.6±0.1)mg/L,显著低于对照组【(0.9±0.1)mg/L,P<0.05】,而eGFR为(108.8±11.9)mL/min /1.73m2,显著高于对照组【(90.9±11.3)mL/min /1.73m2,P<0.05】; 在随访结束时,观察组生存率为62.5%,显著高于对照组的39.5%(x2=4.136,P=0.042);观察组OS为(10.4±0.3)个月,PFS为(9.5±0.5)个月,均显著长于对照组【分别为(8.3±0.5)个月和(7.6±0.6)个月,Log-Rank x2=6.970,P=0.008;x2=5.651,P=0.017】。结论 采用TACE联合靶向和免疫治疗不可切除的PLC患者,加用槐耳颗粒治疗可能保护肝肾功能,是否能使患者生存获益还需要观察。

关键词: 原发性肝癌, 不可切除, 经导管动脉化疗栓塞术, 靶向治疗, 免疫治疗, 槐耳颗粒, 治疗

Abstract: Objective This aimed to investigate clinical effectiveness of transhepatic arterial chemoembolization (TACE) in combination with targeted and immunotherapy plus Huai’er granule, an herbal compound, in the treatment of patients with unresectable primary liver cancer (PLC ). Methods 78 patients with unresectable PLC were admitted to our hospital between June 2022 and June 2024, and were divided into control (n=38) and observation (n=40) groups. All patients in the two groups received TACE in combination with targeted and immunotherapy, and those in the observation group received additionally Huai’er granules for six circles. All patients were followed-up until September 2025, and objective response rate (ORR) and disease control rate (DCR) were recorded. Serum des-γ-carboxy prothrombin (DCP), α-L-fucosidase (AFU) and alpha-fetoprotein (AFP) levels were routinely detected. Results ORR in the observation group was 45.0%, much higher than 21.1%(P<0.05)in the control, while there was no significant difference as respect to DCR(80.0% vs. 60.5%) between the two groups (P>0.05); after treatment, serum DCP, AFU and AFP levels in the observation group were (95.3±23.4)mAU/mL, (67.9±20.9)U/L and (231.8±78.9)ng/mL, all much lower than [(121.5±25.7)mAU/mL, (111.5±18.2)U/L and (368.5±85.7)ng/mL, respectively, P<0.05] in the control; β2-MG level was (0.6±0.1)mg/L, much lower than [(0.9±0.1)mg/L,P<0.05], while eGFR was (108.8±11.9)mL/min /1.73m2,much higher than [(90.9±11.3)mL/min /1.73m2,P<0.05] in the control; by end of follow-up, survival rate was 62.5%,much higher than 39.5%(x2=4.136,P=0.042)in the control; OS was (10.4±0.3)mon, and PFS was (9.5±0.5)mon, both much longer than [(8.3±0.5)mon and (7.6±0.6)mon, respectively, Log-Rank x2=6.970,P=0.008; x2=5.651,P=0.017] in the control. Conclusion Oral Huai’er granule at base of TACE and targeted and immunotherapy in dealing with unresectable PLC might protect hepatic and renal functions, and the clinical survival benefits needs further observation.

Key words: Hepatoma, Unresectable, Transhepatic arterial chemoembolization, Targeted, Immunotherapy, Huai’er granule, herbal medicine, Therapy