中西医疗效评价方法在进展期胃癌中的比较研究

Comparative Study on the Methods of Chinese Medicine and Western Medicine Therapeutic Evaluation for Advanced Gastric Cancer

[目的]比较中医及西医两种疗效评价方法在进展期胃癌治疗应用中的差异。[方法]收集3个分中心进展期胃癌患者215例,分为2组:中药组115例采用中药注射剂联合辩证论治汤剂治疗,化疗组100例采用国际通用的胃癌OFL化疗方案治疗,疗程均为6周。以包含临床症状、瘤体、卡氏评分、体重、免疫功能评价的"中医治疗进展期胃癌患者临床受益(疗效)评定标准"和WHO实体瘤疗效评价标准同步进行疗效观察。[结果]按照"WHO实体瘤疗效评价标准"评价,化疗组疗效明显优于中药组(P<0.01);按照"中医治疗进展期胃癌患者临床受益(疗效)评定标准"评价,中药组疗效优于化疗组,两组比较差异有统计学意义(P<0.05)。[结论]"中医治疗进展期胃癌患者临床受益(疗效)评定标准"与"WHO实体瘤疗效评价标准"两种评价方法得出的结论存在差异,两者相比,前者更能反映中医药治疗肿瘤的特色与优势,具有进一步研究的价值。

[Objective]To compare the differences and characteristics in Chinese medicine and western medicine therapeutic evaluation methods in the application of advanced gastric cancer.[Methods]A total of 215 cases of advanced gastric cancer from 3 subcenters were enrolled in this study and assigned to two groups.115 in the TCM group treated with CM injection combined with treatment based on syndrome differentiation.100 in the chemotherapy group treated with the international chemothearapy scheme.Both the course of treatment lasted for 6 weeks.Their short-term therapeutic effects were observed by the 'clinic efficacy appraisal standard of therapy for advanced gastric cancer with TCM' simultaneously and by the follow-up western medical solid tumor' s effect evaluation criterion,including clinical symptoms,tumor body,Kamorfsky score,body weight and immune function evaluation.[Results]According to WHO solid tumor' s effect evaluation criterion,the efficacy of the chemotherapy group was much better than that of the TCM group.While,according to the 'clinic efficacy appraisal standard of therapy for advanced gastric cancer with CM',the efficacy of the TCM group was better than that of the chemodierapy group.There was difference in the results of the two evaluation methods.[Conclusion] Compared with WHO solid tumor' s effect evaluation criterion,'the clinic efficacy appraisal standard of therapy for advanced gastric cancer with CM' can reflect more features and advantages of TCM for advanced gastric cancer treatment,having value for further study.