中医辨证治疗胃癌患者的近期和远期临床疗效分析

Analysis of Short-term and Long-term Clinical Efficacy of TCM Treatment of Gastric Cancer

目的探讨中医辨证治疗胃癌患者的近期和远期临床疗效分析。方法选取深圳市宝安第二人民医院(集团)第二总医院2011年12月—2013年1月期间收治的88例胃癌患者作为研究对象,按照随机数字表的方法分为观察组和对照组,每组44例,其中对照组患者采用常规的西医治疗,观察组患者则在术后早期根据胃癌的不同类型再予以中医辨证论治,采用生存质量(功能状态评分KPS量表和症状积分)评估两组患者近期临床疗效,并就两组的远期生存率以及免疫功能进行客观的比较与随访。结果两组治疗前后的功能状态(KPS)评分及症状积分比较存在差异(P<0.05),且两组间治疗后的KPS评分及症状积分亦存在差异;治疗前,两组的CD_4^+、CD_8^+、CD_4^+/CD_8^+水平比较差异无统计学意义(P>0.05),治疗后,观察组的CD_8^+水平显著低于对照组,而CD_8^+、CD_4^+/CD_8^+水平则高于对照组,差异有统计学意义(P<0.05);随访发现,两组间1年和3年的生存率比较差异有统计学意义(P<0.05),但5年生存率比较差异无统计学意义(P>0.05)。结论中医辨证治疗胃癌患者的近期临床疗效确切,并在一定程度上提高了患者的免疫功能以及远期疗效,故具推广优势。

Objective To investigate the short-term and long-term clinical efficacy of TCM in the treatment of gastric cancer. Methods 88 patients with gastric cancer admitted to The Second General Hospital of Bao’an Second People’s Hospital(Group)in Shenzhen from December, 2011 to January, 2013 were selected as the subjects of study. According to the random number table method,they were divided into observation group and control group,with 44 cases in each group. The patients in the control group were treated with conventional western medicine,and the patients in the observation group were treated with syndrome differentiation traditional Chinese Medicine treatment according to the different types of gastric cancer in the early postoperative period. The shortterm clinical efficacy of two groups of patients was evaluated by the quality of life(functional state score KPS scale and symptom score),and the long-term survival rate and immune function of the two groups were compared and followed up. Results There were differences in KPS scores and symptom scores between the two groups before and after treatment(P < 0.05), and there were differences in KPS scores and symptom scores between the two groups after treatment. Before treatment,the levels of CD4^+,CD8^+ and CD4^+/CD8^+ in the two groups were not significantly different(P>0.05). After treatment,the level of CD8^+ in the observation group was significantly lower than that of the control group,while the level of CD8^+ and CD4^+/CD8^+ was higher than that of the control group(P< 0.05),and the survival rate of the two groups was significantly different in 1 and 3 years(P<0.05). However,there was no significant difference in the 5 year survival rate(P>0.05). Conclusion The clinical effect of TCM syndrome differentiation in the treatment of gastric cancer is accurate,and to a certain extent,it improves the immune function and long-term effect of the patients. So it has the advantage of popularization.