中医药治疗晚期肺腺癌的生存分析

Survival Analysis of Traditional Chinese Medicine for Advanced Lung Adenocarcinoma

目的观察中医药干预治疗晚期肺腺癌的效果及对患者生存期的影响。方法回顾性分析2013年1月~2017年12月广西玉林市红十字会医院收治的80例晚期肺腺癌患者的临床资料,根据中医药参与治疗程度分为中医组(化疗、放疗、靶向治疗中任意一项+中成药或者中药汤剂治疗)和西医组(化疗、放疗及靶向药物),比较两组晚期肺腺癌患者的生存情况,采用Kaplan-Meirer法进行生存分析和Cox模型进行预后影响因素分析。结果80例患者6个月、1、2、3、5年生存率分别为79.30%、52.51%、18.33%、2.73%、0,中位生存时间为370 d;中医组、西医组中位生存期分别为512 d、270 d,6个月、1、2、3、5年生存率分别为87.51%、65.23%、27.14%、15.22%、3.47%,65.12%、37.53%、16.25%、0、0。单因素分析显示,两组生存期比较,差异有统计学意义(P<0.05)。Cox多因素分析显示,血行转移、放射治疗、中医证型是影响晚期肺腺癌患者死亡的独立预后因素,根据相对风险系数及回归系数可知,血行转移是独立危险因素(B=1.625,RR=5.216),放射治疗(B=-0.915,RR=0.400)及中医证型(B=-0.287,RR=0.751)为独立保护因素。结论中医药干预治疗能有效延长晚期肺腺癌患者的中位生存期,其中放疗及中医证型既是晚期肺腺癌预后的独立影响因素,又是独立保护因素,而血行转移则为独立危险因素。

Objective To observe the effect of traditional Chinese medicine intervention in the treatment of advanced lung adenocarcinoma and its impact on the survival time of patients.Methods Retrospectively analyzed the clinical data of 80 patients with advanced lung adenocarcinoma admitted to the Red Cross Hospital of Yulin City,Guangxi from January 2013 to December 2017,and divided them into traditional Chinese medicine groups(chemotherapy,radiotherapy,targeted therapy)according to the degree of participation of traditional Chinese medicine Any one of the above+Chinese patent medicine or Chinese medicine decoction and the Western medicine group(chemotherapy,radiotherapy and targeted drugs),compare the survival of the two groups of patients with advanced lung adenocarcinoma,use Kaplan-Meirer method for survival analysis and Cox model Analysis of prognostic factors.Results The 6-month,1,2,3,and 5-year survival rates of 80 patients were 79.30%,52.51%,18.33%,2.73%,and 0,respectively.The median survival time was 370 d;the median survival time of the Chinese medicine group and the Western medicine group 512 d,270 d,6-month,1,2,3,5-year survival rates were 87.51%,65.23%,27.14%,15.22%,3.47%,65.12%,37.53%,16.25%,0,0.Univariate analysis showed that the difference in survival between the two groups was statistically significant(P<0.05).Cox multivariate analysis showed that blood metastasis,radiotherapy,and TCM syndromes are independent prognostic factors that affect the death of patients with advanced lung adenocarcinoma.According to the relative risk coefficient and regression coefficient,blood metastasis is an independent risk factor(B=1.625,RR=5.216),radiotherapy(B=-0.915,RR=0.400)and TCM syndrome type(B=-0.287,RR=0.751)are independent protective factors.Conclusion Interventional treatment with traditional Chinese medicine can effectively prolong the median survival time of patients with advanced lung adenocarcinoma.Among them,radiotherapy and TCM syndromes are both independent influencing factors and prognostic factors for advanced lung adenocarcinoma,and blood metastasis is an independent risk factor.