一例肝癌患者中药抗肿瘤治疗12年随访报告
Traditional Chinese Medicine Treatment for a Liver Cancer Patient: A 12-Year Follow-up Case Report
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1.首都医科大学附属北京佑安医院中西医结合中心
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刘洋, 杨华升. 一例肝癌患者中药抗肿瘤治疗12年随访报告[DB/OL].(2023-10-28)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43200152&Fpath=home&index=0
LIU Yang, YANG Huasheng. Traditional Chinese Medicine Treatment for a Liver Cancer Patient: A 12-Year Follow-up Case Report[DB/OL].(2023-10-28)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43200152&Fpath=home&index=0
刘洋, 杨华升. 一例肝癌患者中药抗肿瘤治疗12年随访报告[DB/OL].(2023-10-28)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43200152&Fpath=home&index=0 DOI:
LIU Yang, YANG Huasheng. Traditional Chinese Medicine Treatment for a Liver Cancer Patient: A 12-Year Follow-up Case Report[DB/OL].(2023-10-28)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43200152&Fpath=home&index=0 DOI:
病史摘要,2,患者,男性,41岁,主因“乙肝病史20年余,肝硬化5年余”于2011年3月,首次就诊北京佑安医院。面色晦暗,肝掌阳性。下肢轻度水肿,余无特殊。左脉弦滑有力,右脉弦细,舌质紫暗,舌苔花剥而干。2011年3月10日,我院检查结果: 乙肝五项HBsAg (+)、HBeAg (+)、HBcAb (+); 甲胎蛋白AFP 11.21 ng/ml; 肝功能ALT 54.5 U/L, AST 66.8 U/L, TBIL 52.6μmol /L, ALB 34.9 g/L, GGT 105.5 U/L, ALP 264.6 U/L, CHE 3152 U/L;乙肝病毒载量HBV-DNA 8.6×10^6 IU/ml;血常规PLT 59×10^9/L。上腹部MRI检查:肝左叶外侧上段包膜下、肝右叶后上段包膜下高级不典型增生结节(DN),建议AFP检查或(3-6月)复查。中医诊断 癥积,水瘀互结、兼有阴虚。西医诊断 肝炎肝硬化 代偿期 乙型,肝癌前病变,脾功能亢进。干预措施 西药予恩替卡韦抗病毒治疗。中医予活血化瘀、滋阴利水治疗,选用的药物以当归芍药散为主要方剂,同时加用楮实子30 g,水红花子10 g,庵闾子30 g等。后复诊20余次,均予中药联合抗病毒治疗。疗效转归 第一阶段为期14个月的治疗中,患者肝脏左侧的癌前病变消失,肝脏右侧癌前病变仍在进展。第二个阶段治疗时间为29个月,患者肝脏右侧癌前病变转变为肝癌。患者拒绝手术治疗,仅以中药抗肿瘤及恩替卡韦治疗。第三阶段,确诊肝癌后,患者继续仅口服恩替卡韦及中药,治疗13个月后,癌肿病灶体积减少。再次治疗16个月后,患者肝脏MRI提示癌肿成分减少。确诊肝癌后共计治疗33个月后,肿瘤成分消失。患者自2011年随访至2023年,目前肝脏无肿瘤表现,一般状况良好。
Summary of case history, The patient, male, 41 years old, was admitted to Beijing Youan Hospital for the first time in March 2011 with the chief complaint of "hepatitis B history for more than 20 years, liver cirrhosis for more than 5 years". He had a dark complexion, positive palmar erythema. Mild edema of the lower extremities, no other special symptoms. The left pulse was stringy and slippery, and the right pulse was stringy and thin. The tongue was dark purple, and the tongue coating was peeled and dry. March 10, 2011: The results of our hospital examination were: hepatitis B five items: HBsAg, HBeAg, HBcAb positive; alpha-fetoprotein: AFP 11.21ng/ml; liver function: ALT 54.5U/L, AST 66.8U/L, TBIL 52.6umol/L, ALB 34.9g/L, GGT 105.5U/L, ALP 264.6U/L, CHE 3152U/L; hepatitis B virus load: HBV-DNA 8.6×10^6IU/ml; blood routine: PLT 59×10^9/L. Upper abdominal MRI examination: high-grade atypical hyperplastic nodules (DN) under the capsule of the lateral upper segment of the left lobe of the liver and under the capsule of the posterior upper segment of the right lobe of the liver, suggesting AFP examination or (3-6 months) re-examination.,TCM diagnosis, Mass accumulation, water and blood stasis interlocking, with yin deficiency,Western medicine diagnosis, Hepatitis B cirrhosis in the compensatory stage, precancerous lesions of liver cancer, splenic hyperfunction,Therapeutic methods, In terms of western medicine treatment, we gave the patient entecavir antiviral treatment. In terms of traditional Chinese medicine treatment, we gave activating blood circulation and removing blood stasis, nourishing yin and promoting diuresis treatment, using Danggui Shaoyao Powder as the main prescription, and adding 30 grams of Chu Shi Zi, 10 grams of Safflower Seeds, 30 grams of An Lü Zi, etc. After more than 20 follow-up visits, all were given Chinese medicine combined with antiviral treatment.,Clinical outcomes, The first stage was a 14-month treatment during which the pre-cancerous lesion on the left side of the patient's liver disappeared and the pre-cancerous lesion on the right side of the liver continued to progress. In the second stage, after another 29 months, the pre-cancerous lesion on the right side of the patient's liver turned into liver cancer. The patient refused surgical treatment and only received traditional Chinese medicine anti-tumor and entecavir treatment. In the third stage, 13 months after being diagnosed with liver cancer, the tumor volume decreased. After another 16 months of treatment, an MRI of the liver suggested a decrease in tumor components. After a total of 33 months of treatment after being diagnosed with liver cancer, the tumor components disappeared.The patient has been followed up since 2011 until 2023, and currently has no tumor manifestation in the liver, and is in good general condition.
肝癌中医中药抗肿瘤乙肝
Liver cancerTraditional Chinese medicineChinese medicineAnti-tumorHepatitis B
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