中药复方胃肠安对胃癌肝转移患者总生存期的影响

Effects of Chinese herbal compound Weichang’an on overall survival of patients of gastric cancer with liver metastases

目的:评价健脾法为主的中药复方胃肠安对胃癌肝转移(GCLM)患者总生存期(OS)的影响。方法:采用多中心、回顾性队列研究,将胃癌肝转移患者分为以胃肠安治疗的中药组及非中药姑息治疗的对照组,记录最终结局。应用KaPlan-Meier法估算中位生存期,Log Rank检验对预后因素组间生存分布差异进行显著性检验,并将影响预后的病例变量应用Cox回归模型进行多因素分析。结果:共有202例GCLM病例纳入本研究,中药组88例,对照组114例。Cox多因素研究结果显示,中药、转移情况是影响GCLM患者OS的独立预后因素,其中中药的回归系数β=-0.601,相对危险度为0.548,95%CI[0.411,0.732],P=0.000。中药组的中位OS为14.01个月,较对照组的8.81个月显著延长(P=0.000)。结论:胃肠安是影响GCLM患者预后的独立保护性因素,可延长患者OS。

Objective: To evaluate the effect of Chinese herbal compound Weichang’an which based on invigorating spleen therapy for gastric cancer with liver metastases. Methods: Patients with liver metastases from gastric cancer were enrolled and divided into Weichang’an treatment group and palliative treatment control group, with the multi-center and retrospective cohort study. Followed up and recorded the final outcome. KaPlan-Meier curves were used to assess the median OS. Log Rank tests were used to do the significance test to the distribution differences between prognosis factors. Multivariate Cox regression analysis was performed to determine survival trends adjusted for clinical and demographic factors. Results: A total of 202 GCLM patients were assigned to the study(88 cases in TCM group and 114 cases in control group). Cox-regression analysis suggested that TCM treatment, metastasis of tumor were the independent prognostic factors for OS. In TCM group, β=-0.601, HR=0.548(95%CI[0.411, 0.732]), P=0.000. Overall survival time was 14.01 months in the TCM group compared with 8.81 months in control group(P=0.000). Conclusion: Weichang’an is an independent protective factor for GCLM patients, which could prolong the overall survival time.