中医辨证结合化疗治疗晚期结直肠癌患者的临床分析

Clinical Analysis of Chemotherapy Patients with Advanced Colorectal Cancer Treated by TCM Syndrome Differentiation and Treatment

目的:评价中医辨证治疗对晚期结直肠癌患者的疗效及预后的影响。方法:分析2005年1月—2012年8月收治的363例晚期结直肠癌并接受化疗患者的临床资料。363例患者中,83例单纯化疗治疗的患者为对照组,73例服用扶正类中药为主进行治疗的患者为扶正组,67例服用祛邪类中药为主进行治疗的患者为祛邪组,140例服用扶正祛邪类中药并重进行治疗的患者为扶正祛邪组。用SPSS软件对11个临床因素进行多因素Cox比例风险模型分析和KaplanMeier生存分析。结果:对照组平均生存时间为(13.585±1.277)个月,中位生存期(10.800±0.852)个月;扶正组平均生存时间为(29.465±3.919)个月,中位生存期(17.500±3.177)个月;祛邪组平均生存时间为(21.406±2.406)个月,中位生存期(15.300±1.884)个月;扶正祛邪组平均生存时间为(42.656±7.488)个月,中位生存期(23.033±2.591)个月。各组间的差异有统计学意义(P<0.001)。Cox多因素分析显示年龄、肝转移、并发症、中医辨证治疗4个因素对晚期结直肠癌化疗患者生存期有显著影响,其中中医辨证治疗为保护因素。结论:中医辨证治疗可以延长晚期结直肠癌化疗患者的生存期,尤其以扶正祛邪并重的中药治疗效果相对明显,对患者预后具有一定的积极作用。

Objective： To analyze the survival condition and prognostic factors of chemotherapy patients with advanced colorectal cancer treated by TCM syndrome differentiation. Methods： The clinical pathological and follow- up data of 363 patients with advanced colorectal cancer from January 2005 to August 2012 in two hospitals was analyzed retrospectively. Patients were assigned to four groups： control group（ 83 cases）,Fuzheng group（ 73 cases）,Quxie group（ 67 cases）,and Fuzheng Quxie group（ 140 cases）. The survival was estimated by using Kaplan- Meier method and compared by using log- rank test. The effect of independent factors on prognosis was determined by Cox regression multivariate analysis. Results： Mean survival time of the four groups was（ 8. 176 ± 1. 734）,（ 11. 222 ± 1. 520）,（ 16. 469 ± 2. 342）,（ 27. 198 ± 2. 007） months,respectively. Median survival time of the four groups was（ 10. 800 ± 0. 852）,（ 17. 500 ± 3. 177）,（ 15. 300 ± 1. 884）,（ 23. 033 ± 2. 591） months,respectively. There was significant difference among the four groups（ P〈0. 001）. Cox regression analysis suggested that age,liver metastasis,complication and TCM therapy were independent prognostic factors for post- operation colorectum cancer patients. Among them,operation after metastasis or recurrence and TCM therapy were protective factors. Conclusion： The TCM treatment can prolong the survival time of patients treated with chemotherapy. Especially the medication principle of TCM of strengthening body resistance and eliminating evil have certain positive effect on the prognosis of the patients.