目的 观察乌梅丸联合奥曲肽治疗原发性肝癌靶向药物相关性腹泻的临床疗效。方法 研究对象选自唐山市人民医院2024年1月—2025年2月收治的100例原发性肝癌靶向药物相关性腹泻患者，经组间匹配原则分成对照组和治疗组，每组50例。对照组给予醋酸奥曲肽注射液皮下注射，0.1 mg/次，3次/d，若患者48 h内症状无显著改善剂量调整至0.5 mg/次。治疗组在对照组治疗基础上口服乌梅丸，3 g/次，3次/d。两组共治疗1周。观察两组临床疗效，比较治疗前后两组中医证候积分、血清炎症因子水平、卡氏功能状态（KPS）评分、腹泻相关指标的变化情况。结果 治疗后，治疗组总有效率是94.00%，显著高于对照组的78.00%（P＜0.05）。治疗后两组中医证候积分均较治疗前下降（P＜0.05）；治疗后治疗组中医证候积分低于对照组（P＜0.05）。治疗后，两组肿瘤坏死因子-α（TNF-α）、白细胞介素-33（IL-33）、白细胞介素-6（IL-6）均显著降低（P＜0.05）；治疗后治疗组TNF-α、IL-33、IL-6低于对照组（P＜0.05）。治疗后，两组KPS评分均显著提高（P＜0.05）；治疗后治疗组KPS评分高于对照组（P＜0.05）。治疗后，两组CTCAE分级和布里斯托粪便性状量表分级0～1级例数显著增加（P＜0.05）；治疗后治疗组CTCAE分级和布里斯托粪便性状量表分级0级例数多于对照组（P＜0.05）。结论 原发性肝癌患者靶向药物治疗期间伴相关性腹泻患者，给予乌梅丸联合奥曲肽治疗，可显著改善患者临床症状与炎症状态，促进患者腹泻相关不适症状恢复，且安全性尚可。

Objective To observe the effect of Wumei Pills combined with octreotide in treatment of diarrhea related to targeted drugs in primary liver cancer. Methods The research subjects were selected from 100 patients with targeted drug-related diarrhea in primary liver cancer admitted to Tangshan People’s Hospital from January 2024 to February 2025. They were divided into control group and treatment group according to the principle of inter-group matching, with 50 cases in each group. Patients in control group were administered with subcutaneous injection of Octreotide Acetate Injection, 0.1 mg/time, three times daily. If the patient’s symptoms did not improve significantly within 48 h, the dose was adjusted to 0.5 mg/time. Patients in treatment group were po administered with Wumei Pills on basis of treatment in control group, 3 g/time, 3 times daily. Both groups were treated for 1 week. The clinical efficacy of two groups was observed, and the changes in TCM syndrome scores, serum inflammatory factor levels, KPS scores, and diarrhea-related indicators of two groups were compare before and after treatment. Results After treatment, the total effective rate of treatment group was 94.00%, significantly higher than that of control group (78.00%, P < 0.05). After the treatment, the TCM syndrome scores of both groups decreased compared with those before the treatment (P < 0.05). After treatment, the TCM syndrome score of treatment group was lower than that of control group (P < 0.05). After treatment, TNF-α, IL-33, and IL-6 in both groups were significantly decreased (P < 0.05). After treatment, the levels of TNF-α, IL-33, and IL-6 in treatment group were lower than those in control group (P < 0.05). After treatment, the KPS scores of both groups were significantly increased (P < 0.05). After treatment, the KPS score of treatment group was higher than that of control group (P < 0.05). After treatment, the number of cases with CTCAE grades and Bristol Fecal Trait Scale grades of 0-1 in both groups increased significantly (P < 0.05). After treatment, the number of cases with CTCAE grade and Bristol Fecal Character Scale grade 0 in treatment group was higher than that in control group (P < 0.05). Conclusion For patients with primary liver cancer undergoing targeted drug treatment accompanied by related diarrhea, the administration of Wumei Pills combined with octreotide can significantly improve the clinical symptoms and inflammatory state of the patients, promote the recovery of diarrhea-related discomfort symptoms, and the safety is still acceptable.

R975

河北省中医药类科研计划项目（2024433）