中医方案治疗晚期胰腺癌的临床分析

Clinical Analysis of Traditional Chinese Medicine in Treatment of Advanced Pancreatic Cancer

目的:评估中医治疗晚期胰腺癌的临床优势。方法:收集住院的92例晚期胰腺癌患者临床资料,其中中医组30例、综合治疗组28例、化疗组16例、内科支持组18例。中医与综合治疗组均应用中医方案治疗,以益气扶正、散结解毒为治则,治疗方法包括口服汤药、辨证口服中成药、外敷中药药粉、静脉注射及经动脉介入灌注中药的注射制剂等。分析各组近期疗效及生存时间,患者的疼痛、体力评分、体质量改变、临床症状等计数资料间的比较采用卡方检验的Crosstabs过程进行统计;生存时间采用乘积极限法Kaplan-Miere法进行统计。结果:1晚期胰腺癌应用中医方案治疗后,常见临床症状的缓解率为70.7%,中医组和综合组之间的差异无统计学意义(P>0.05);应用中医方案治疗后,体力评分及体质量的改善与化疗之间的差异无统计学意义(P>0.05),但优于内科对症处理(P<0.05)。292例患者总的中位生存期为8.8个月,中医组、综合组、化疗组及内科对症组中位生存期分别为11.2、10.6、7.8、4.7月,综合治疗组与中医组之间的差异无统计学意义(P>0.05),且明显优于其他两组(P<0.05或P<0.01)。结论:因拒绝化疗或无条件行化疗的晚期胰腺癌患者入组中医方案治疗后,患者临床症状的改善优于内科支持治疗,并且可获得更长的生存期,因此晚期胰腺癌患者能从中医治疗方案中获益,体现了中医药治疗晚期胰腺癌的特色与优势。

Objective： To evaluate the clinical efficacy of traditional Chinese medicine in the treatment of advanced pancreatic cancer. Methods： 92 cases hospitalized patients with advanced pancreatic cancer were divided into 4 groups, 30 cases into the Chinese medicine group, 28 cases into combined treatment group, 16 cases into chemotherapy group, and 18 cases into internal medicine support group. Traditional Chinese Medicine therapy was applied to Chinese medicine group and combined treatment group. We applied the principle of tonifying Qi, dispersing clumping and detoxifying. The treatment methods included oral decoction of treatment based on syndrome differentiation, oral Chinese patent medicine, externally applied traditional Chinese medicine powder, intravenous injection of transcatheter arterial infusion and injection preparations of traditional Chinese Medicine. Finally we analyzed the efficacy and survival time. The comparison of such data as the patient＇s pain, physical score, weight change, clinical symptoms were conducted with the method of Crosstabs, and the survival time was analyzed with the method of Kaplan-Miere. Results：1The application of traditional Chinese medicine regimen in the treatment of advanced pancreatic cancer, the remission of clinical symptoms was 70. 7%, and there was no significant differences between the traditional Chinese medicine group and integrated group （ P 〉 0. 05 ）. After the application of traditional Chinese medicine, there was no significant differences between the improved physical score and weight with chemotherapy （P 〉0.05 ）, but both better than the internal medicine support group （P 〈 0.05 ）. 2The overall median survival of the 92 patients was 8.8 months, the Chinese medicine group 11.2 months, the combined treatment group 10.6 months, the chemotherapy group 7.8 months, and the internal medicine support group 4.7 months. There was no significant difference between combined treatment group and TCM group （ P 〉 0.05 ） ; but longer than the chemotherapy group and the internal medicine support groups （P 〈 0.05 or P 〈 0.01 ）. Conclusion： To those who refused to apply chemotherapy or had no conditions for chemotherapy of the advanced pancreatic cancer patients, after applying traditional Chinese medicine regimen, the symptoms relieved better than the internal medicine support group, and obtained a longer survival period than chemotherapy group. Therefore, patients with advanced pancreatic cancer can benefit from traditional Chinese medicine treatment, which reflects the characteristics and advantages of Chinese medicine.