目的 探討復方苦參注射液聯(lián)合索拉非尼治療晚期原發(fā)性肝癌的臨床效果。方法 選取2013年10月-2015年10月惠州市中心人民醫(yī)院收治的原發(fā)性肝癌患者128例，按照治療方案的不同分為對照組和治療組，每組各64例。對照組患者于1~14 d口服甲苯磺酸索拉非尼片，0.4 g/次，2次/d。治療組患者在對照組的基礎上靜脈滴注復方苦參注射液，20 mL加入250 mL生理鹽水中，1次/d，14 d為1個療程，休息14 d進入下1個療程，連續(xù)治療3個療程。觀察兩組患者的臨床效果、疼痛緩解情況和生存質量改善情況，同時比較兩組患者治療前后血液中抗腫瘤因子變化情況。結果 治療后，對照組和治療組的有效率分別為20.31%、32.81%，臨床獲益率分別為59.38%、79.69%，兩組比較差異具有統(tǒng)計學意義（P<0.05、0.01）。治療后，對照組的疼痛緩解率為48.44%，顯著低于治療組的65.63%（P<0.01）。對照組和治療組患者生活質量改善率分別為56.25%和78.13%，兩組患者生存質量改善率比較差異具有顯著統(tǒng)計學意義（P<0.01）。治療后，對照組腫瘤壞死因子-α（TNF-α）水平顯著升高，治療組γ-干擾素（IFN-γ）和TNF-α水平均顯著升高，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；且治療組患者IFN-γ和TNF-α水平高于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療過程中，對照組的不良反應發(fā)生率為60.94%，顯著高于治療組的46.88%，兩組不良反應發(fā)生率比較差異具有顯著統(tǒng)計學意義（P<0.01）。結論 復方苦參注射液聯(lián)合索拉非尼片對晚期原發(fā)性肝癌患者具有較顯著的治療效果，可顯著緩解患者疼痛、提高生活質量、增強免疫功能，具有一定的臨床推廣應用價值。

Objective To explore the clinical efficacy of Compound Kushen Injection combined with sorafenib in treatment of advanced primary hepatocellular carcinoma. Methods Patients (128 cases) with advanced primary hepatocellular carcinoma in Huizhou Center People's Hospital from October 2013 to October 2015 were divided into control and treatment groups based on different treatments, and each group had 64 cases. Patients in the control group were po administered with Sorafenib Tosylate Tablets from the first day to the 14^th day, 0.4 g/time, twice daily. Patients in the treatment group were iv administered with Compound Kushen Injection on the basis of the control group, 20 mL added into 250 mL normal saline, once daily, and 14 d for a course of treatment. They were repeated the next course of treatment after rest for 14 d, and they were treated for three courses of treatment. After treatment, the clinical efficacy, pain relief rate, and the improvement of survival quality were evaluated, and the change of cytokines in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 20.31% and 32.81%, respectively, and there was difference between two groups (P<0.05). At the same time the clinical benefit rate in two groups were 59.38% and 79.69%, respectively, with significant difference between two groups (P<0.01). After treatment, the pain relief rate in the control was 48.44%, which was significantly lower than 65.63% in the treatment group (P<0.01). After treatment, TNF-α in the control group was significantly increased, IFN-γ and TNF-α in the treatment group was significantly increased, and the difference was statistically significant in the same group (P<0.05). And these indicators in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). In the process of treatment, incidence of adverse reactions in the control was 60.94%, which was significantly higher than 46.88% in the treatment group (P<0.01). Conclusion Compound Kushen Injection combined with sorafenib has a significant efficacy in treatment of advanced primary hepatocellular carcinoma, which can relief the pain, improve life quality, immune function, and has a certain clinical application value.