中医药减少Ⅱ、Ⅲ期结直肠癌根治术后复发转移的用药规律分析

Analysis on Medication Rules of Using Chinese Medicine in Reducing Recurrence and Metastasis of Stage II and III Colorectal Cancer among Postoperative Patients

目的：分析杨宇飞教授中医治疗术后II、III期结直肠癌的患者生存状态和用药规律。方法：以西苑医院队列从2007年9月-2009年8月入组的II、III期结直肠癌根治术后的70例患者为研究对象，查阅门诊病历并进行随访，分析随访结果。结果：截止2013年7月，失访率为8.6%，小于15%。高暴露组和低暴露组术后4年复发转移率分别为7.1%和25.0%，经Fisher精确概率检验，高暴露长疗程的中医治疗能够降低患者的复发转移率（〈0.05）。挖掘杨宇飞教授的中医治疗结直肠癌术后的用药规律，辨证频次最高的是脾胃亏虚，其次是肝肾阴虚。方剂使用频次最高的是四君子汤和六味地黄丸。结论：中医综合治疗方案具有改善II、III期结直肠癌预后的作用，对降低患者的复发转移率，延长出现复发转移的时间有一定意义。

This study was aimed to analyze the living status and medication rules of traditional Chinese medicine （TCM） treatment of postoperative patients with stage II and III colorectal cancer by Prof. Y ang Y ufei. A total of 70 postoperative patients with stage II and III colorectal cancer were enrolled in the cohort study at the Xiyuan Hospital from September 2007 to August 2009. The out-patient records were reviewed and follow-ups were given for the analysis. The results showed that until July 2013, the loss to follow-up rate was 8.6%, which was less than 15%. The four-year postoperative recurrence and metastasis rates of the high and low exposure group were 7.1% and 25.0%, respectively. The Fisher exact probability test showed that the high exposure and long period therapy of TCM treatment can significantly reduce the recurrence and metastasis rate of patients （P 〉.05）. The analysis of Prof. Y ang Y ufei＆#39;s medication rules in TCM treatment of postoperative colorectal cancer showed that the syndrome differ-entiation pattern with the highest frequency was spleen-stomach deficiency pattern; and the liver-kidney yin defi-ciency pattern was in the second place. The prescriptions used with the highest frequency were Si-Jun-Zi Decoction and Liu-Wei-Di-Huang Decoction. It was concluded that the comprehensive TCM treatment can improve the prog-nosis of stage II and III colorectal cancer. The treatment also has certain meaning in the reducing of the recurrence and metastasis rate of patients, and prolonging the time of the recurrence and metastasis.