中西医结合综合治疗对胃癌患者远期生存预后的回顾性分析OA
Retrospective Analysis of the Long-Term Survival Prognosis of Gastric Cancer Patients Treated with Integrated Traditional Chinese and Western Medicine
目的 本研究回顾性分析中西医结合综合治疗对胃癌患者远期生存的影响.方法 采用回顾性研究方法,选取2018年1月-2022年6月期间就诊于上海中医药大学附属岳阳中西医结合医院且经病理明确诊断的胃恶性肿瘤患者342例.通过单因素分析法和多因素Cox回归分析,分析影响生存时间的预后因素.结果 ①342例中医药参与治疗的胃癌患者中位生存时间为32月,其中159例Ⅳ期胃癌患者中位生存时间为12月;②一至三年生存率分别为:Ⅰ期:98%、95%、84%;Ⅱ期:89%、87%、61%;Ⅲ期:81%、61%、36%;Ⅳ期:23%、9%、2%;③单因素分析法(Kaplan-Meier)显示:肿瘤TNM分期、肿瘤病理类型、肿瘤部位、化痰祛瘀中药、中药静脉制剂、化疗、手术、靶向、初次就诊血清癌胚抗原(carcinoembryonic antigen,CEA)水平是生存预后的影响因素(P＜0.05);④多因素分析显示:肿瘤TNM分期、肿瘤病理类型、化痰祛瘀中药、中药静脉注射液、化疗、手术、初次就诊血清CEA水平是胃癌患者预后的独立影响因素(P＜0.05).结论 中西医结合治疗胃癌患者的远期生存预后影响因素较多,其中临床分期、肿瘤病理类型、接受足量化痰祛瘀中药、接受中药静脉注射液、接受化疗、接受手术、初次就诊血清CEA水平是影响预后的主要因素.
Objective This study retrospectively analyzed the impact of integrated traditional Chinese and Western medicine treatment on the long-term survival of gastric cancer patients.Methods Using the retrospective clinical research method,342 patients with pathologically confirmed gastric cancer who were admitted to Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine from January 2018 to June 2022 were selected.The prognostic factors affecting survival time were analyzed by univariate analysis and multivariate Cox regression analysis.Results ①The median survival time was 32 months among 342 gastric cancer patients treated with traditional Chinese medicine(TCM),while it was 12 months for the 159 patients with stage Ⅳ.②The 1-year,2-year,and 3-year survival rates were as follows:98％,95％,and 84％for stage Ⅰ;89％,87％,and 61％for stage Ⅱ;81％,61％,and 36％for stage Ⅲ;23％,9％,and 2％for stage Ⅳ.③Univariate analysis(Kaplan-Meier)indicated that TNM stage,pathological type,tumor location,herbal medicine treatment of eliminating phlegm and resolving blood stasis,intravenous Chinese herbal injections,chemotherapy,surgery,targeted therapy,and initial serum carcinoembryonic antigen(CEA)level were significant prognostic factors for survival(P<0.05).④Multivariate analysis revealed that TNM stage,pathological type,use of phlegm-resolving and stasis-removing Chinese herbs,intravenous TCM injections,chemotherapy,surgery,and initial serum CEA level were independent prognostic factors for gastric cancer patients(P<0.05).Conclusion Multiple factors influence the long-term survival prognosis of gastric cancer patients treated with integrated traditional Chinese and Western medicine.The main prognostic factors include clinical stage,tumor pathological type,adequate administration of phlegm-resolving and stasis-eliminating Chinese herbal medicine,use of intravenous Chinese herbal injections,chemotherapy,surgery,and initial serum CEA level.
王立玉;陈舲;龚亚斌;陈洁;许玲
上海中医药大学附属岳阳中西医结合医院肿瘤一科,上海 200437上海中医药大学附属岳阳中西医结合医院肿瘤一科,上海 200437上海中医药大学附属岳阳中西医结合医院肿瘤一科,上海 200437上海中医药大学附属岳阳中西医结合医院肿瘤一科,上海 200437上海中医药大学附属岳阳中西医结合医院肿瘤一科,上海 200437
医药卫生
胃癌中西医结合生存预后化痰祛瘀
gastric cancerintegrated traditional Chinese and Western medicinesurvival prognosisresolving phlegm and removing blood stasis
《中医肿瘤学杂志》 2025 (5)
38-44,7
河北大学高层次创新人才科研启动项目(编号:521000981113)河北大学医学学科培育项目(编号:2022B14).
评论