“重建中气”中药复方对进展期胃癌患者生存预后影响的队列研究
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国家中医药管理局重大疑难疾病中西医临床协作试点项目


Effect of Compound Prescriptions for Reconstructing Middle Qi on the Survival and Prognosis of Patients with Advanced Gastric Cancer: A Clinical Cohort Study
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    目的 观察“重建中气”中药复方对进展期胃癌术后及辅助化学治疗后患者生存期的影响。方法 回顾分析62例进展期胃癌患者的临床资料,根据是否服用“重建中气”中药复方将其分为中药暴露、无中药暴露两个队列。中药暴露组以“香砂六君子汤”为主方辨证加减。观察性别、年龄、首次就诊体质量和体质量指数(body mass index,BMI)、卡氏功能状态(Karnorfsky performance status,KPS)评分、复发或转移、中药暴露等因素对进展期胃癌生存期的影响。结果 对62例患者随访2年,与无中药暴露组比较,中药暴露组患者体质量和BMI显著升高(P<0.05),复发或转移率显著降低(P<0.05);Kaplan-Meier单因素生存分析结果显示,中药暴露、基线KPS评分、复发或转移、基线BMI是生存期的影响因素(P<0.05);COX多因素回归分析显示,KPS评分是总生存期的独立影响因素。结论 进展期胃癌术后患者为口服中药的优势人群,“重建中气”中药复方可增加或稳定进展期胃癌患者的体质量,提高患者生存质量,改善预后生存。

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    Objective To investigate the effect of compound prescriptions for reconstructing middle Qi on the survival and prognosis of patients with advanced gastric cancer after surgery and adjuvant chemotherapy. Methods A retrospective analysis was performed for the clinical data of 62 patients with advanced gastric cancer, and according to whether compound prescriptions for reconstructing middle Qi were used, they were divided into traditional Chinese medicine (TCM) exposure group and non-TCM exposure group. The patients in the TCM exposure group were given modified Xiangsha Liujunzi Decoction based on syndrome differentiation. The effect of sex, age, body weight and body mass index (BMI) at initial visit, Karnofsky Performance Status (KPS), recurrence or metastasis, and TCM exposure on the survival time of advanced gastric cancer was analyzed. Results The 62 patients were followed up for 2 years. Compared with the non-TCM exposure group, the TCM exposure group had significant increases in body weight and BMI (P<0.05) and significant reductions in recurrence and metastasis rates (P<0.05). The Kaplan-Meier univariate analysis showed that TCM exposure, baseline KPS score, recurrence or metastasis, and baseline BMI were influencing factors for survival time (P<0.05), and the Cox multivariate regression analysis showed that KPS score was an independent influencing factor for survival. Conclusion Patients with advanced gastric cancer can benefit from oral TCM after surgery, and compound prescriptions for reconstructing middle Qi can increase or stabilize the body weight of patients with advanced gastric cancer and improve their quality of life, prognosis, and survival.

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董家欢,殷东风,高 宏,周跃华.“重建中气”中药复方对进展期胃癌患者生存预后影响的队列研究[J].安徽中医药大学学报,2020,39(1):12-15

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  • 在线发布日期: 2020-01-17