世界中医药2025，Vol.20Issue(13)：2326-2333,8.DOI:10.3969/j.issn.1673-7202.2025.13.015
中医联合西医标准治疗对转移性结直肠癌患者生存影响的队列研究
Effect of Traditional Chinese Medicine Combined with Western Medicine Standard Treatment on the Survival of Metastatic Colorectal Cancer Patients:A Cohort Study
摘要
Abstract
Objective:To investigate the impact of integrated traditional Chinese medicine(TCM)and Western medicine standard treatment on survival benefits and safety in patients with metastatic colorectal cancer(mCRC).Methods:A bidirectional cohort study design was employed,with"continuous TCM treatment for≥3 months"defined as the exposure factor.Patients were divided into an exposure group and a non-exposure group based on this criterion.The exposure group received integrated TCM and Western medicine standard treatment,while the non-exposure group received standard Western treatment alone.The overall survival(OS),progression-free survival(PFS),and 3-year and 5-year survival rates were compared between the two groups.A multivariate propor-tional hazards regression model was used to estimate the hazard ratios(HRs)and assess safety outcomes.Results:The median over-all survival(mOS)was 28.5 months in the exposure group and 21.3 months in the non-exposure group(HR=0.69,P=0.007).The 3-year and 5-year survival rates were 38.6％and 24.7％in the exposure group,and 21.6％and 12.4％in the non-exposure group,respectively.Subgroup analysis showed significantly longer mOS in the exposure group than in the non-exposure group among females,patients with right-sided colon cancer,RAS/BRAF wild-type,RAS mutations,and liver metastases(all P＜0.05).Multiva-riate analysis indicated that right-sided colon cancer,and RAS and BRAF mutations were independent poor prognostic factors,while inclusion in the exposure group was a protective factor,reducing the risk of death by 38％.Safety analysis showed that the incidence of grade ≥3 neutropenia,grade≥2 thrombocytopenia,and liver/kidney function impairment was significantly lower in the exposure group compared to the non-exposure group(P＜0.05).Conclusion:Integrated TCM and Western medicine standard treatment can prolong OS in patients with mCRC and offer superior safety compared to standard Western treatment alone.关键词
转移性结直肠癌/中西医结合/双向性队列研究/化疗/靶向治疗/多因素分析Key words
Metastatic colorectal cancer/Integrated traditional Chinese and western medicine/Bidirectional cohort study/Chemo-therapy/Targeted therapy/Multivariate analysis分类
医药卫生引用本文复制引用
张彤,陈悦,唐末,翟嘉威,杨宇飞..中医联合西医标准治疗对转移性结直肠癌患者生存影响的队列研究[J].世界中医药,2025,20(13):2326-2333,8.基金项目
国家自然科学基金面上项目(82174461) （82174461）
中国中医科学院科技创新工程面上项目(CI2021A01811) （CI2021A01811）
中国中医科学院西苑医院提升中医药临床循证证据级别研究专项(XYZX0201-22) （XYZX0201-22）
