目的 探討槐耳顆粒與索拉非尼聯(lián)合治療晚期肝癌患者的臨床效果。方法 選擇上海中醫(yī)藥大學附屬曙光醫(yī)院2016年1月-2017年1月收治的晚期肝癌患者113例，隨機分成對照組（56例）和治療組（57例）。對照組患者口服甲苯磺酸索拉非尼片，2片/次，2次/d。治療組患者在對照組基礎(chǔ)上口服槐耳顆粒，1袋/次，3次/d。兩組患者均連續(xù)治療2個月。觀察兩組患者臨床療效，同時比較治療前后兩組患者血管內(nèi)皮生長因子（VEGF）、甲胎蛋白（AFP）和白蛋白（ALB）水平，KPS和IBI評分及不良反應情況。結(jié)果 治療后，對照組臨床有效率為46.43%，臨床控制率為64.28%，1年生存率為57.14%，治療組臨床有效率為68.42%，臨床控制率為87.72%，1年生存率為77.19%，兩組分別比較差異均具有統(tǒng)計學意義（P<0.05）。治療后，兩組患者VEGF、AFP和ALB水平均顯著降低（P<0.05），且治療組患者VEGF、AFP和ALB水平明顯低于對照組患者（P<0.05）。治療后，兩組患者KPS評分顯著升高（P<0.05），IBI評分顯著降低（P<0.05），同時治療后治療組患者的KPS評分和IBI評分均顯著優(yōu)于對照組患者（P<0.05）。治療期間，對照組患者不良反應發(fā)生率為19.64%，顯著高于治療組患者的5.26%，兩組比較差異具有統(tǒng)計學意義（P<0.05）。結(jié)論 槐耳顆粒聯(lián)合索拉非尼治療晚期肝癌臨床療效顯著，不良反應發(fā)生率低，具有一定的臨床推廣應用價值。

Objective To explore the clinical effect of Huaier Granules combined with sorafenib in treatment of advanced liver cancer. Methods Patients (113 cases) with advanced liver cancer in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2016 to January 2017 were randomly divided into control (56 cases) and treatment (57 cases) groups. Patients in the control group were po administered with Sorafenib Tosylate Tablets, 2 tablets/time, twice daily. Patients in the treatment group were po administered with Huaier Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacy was evaluated, and the VEGF, AFP and ALB levels, KPS and IBI scores, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical curative effect in the control group was 46.43%, and the clinical control rate was 87.72%, 1 year survival rate was 77.19%, and the clinical curative effect, the clinical control rate, 1 year survival rate in the treatment group respectively were 68.42%, 64.28%, and 57.14%, and there were differences between two groups (P<0.05). After treatment, the VEGF, AFP, and ALB levels in two groups were significantly decreased (P<0.05), and these indexes in the treatment group after treatment were significantly lower than those in the control group (P<0.05). After treatment, the KPS scores in two groups were significantly increased (P < 0.05), the IBI scores in two groups were significantly decreased (P<0.05). After treatment, the KPS and IBI scores in the treatment group after treatment were significantly better than those in the control group (P<0.05). During the treatment, the adverse reactions rate in the control group was 19.64%, which was significantly higher than 5.26% in the treatment group, with significant difference between two groups (P<0.05). Conclusion Huaier Granules combined with sorafenib in treatment of advanced liver cancer has good clinical efficacy with lower adverse reactions incidence, which has a certain clinical application value.

國家自然科學基金資助項目（81603589、81403351、81774256）；上海市青年科技啟明星計劃項目（13QA1403500）