中医药对老年晚期非小细胞肺癌患者氩氦刀冷冻术后生存期影响的回顾性研究
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摘要
目的研究中医药对老年晚期非小细胞肺癌(NSCLC)患者氩氦刀冷冻术后生存期和生存率的影响。方法回顾性收集自2012年1月1日至2017年6月30日期间老年晚期NSCLC并接受氩氦刀冷冻治疗患者共106例,根据术后治疗模式分为中医治疗组、中西医结合组和西医治疗组,主要观察指标为术后生存期、6个月和一年生存率。结果中医治疗组患者术后6个月生存率为68%,一年生存率为42%,比西医治疗组6个月生存率(44%)和一年生存率(25%)高;中医治疗组术后生存期为15个月(95%CI:7. 58～22. 42),比西医治疗组9个月(95%CI:4. 60～13. 40)长,差异具有统计学意义(P <0. 05)。中西医结合组与其他两组比较,差异无统计学意义(P> 0. 05)。采用中医药治疗的患者术后6个月生存率为66%,一年生存率为41%,比未采用中医药治疗的患者6个月生存率(44%)和一年生存率(25%)高;采用中医药治疗的患者术后生存期为15个月(95%CI:11. 35～18. 65),比未采用中医药治疗的患者9个月(95%CI:4. 60～13. 40)长,差异具有统计学意义(P <0. 05)。采用西医抗肿瘤治疗的患者显示较低的术后生存率和较短的术后生存期,但差异无统计学意义(P>0. 05)。结论老年晚期NSCLC患者氩氦刀术后给予中医药治疗能给患者带来生存获益。
Objective To study the effects of traditional Chinese medicine(TCM) treatment on the lifetime and survival rate of elderly patients with advanced non-small cell lung cancer(NSCLC) after treated with cryoablation.Methods A total of 106 cases of elderly patients with advanced NSCLC who treated with cryoablation from January1,2012 to June 30,2017 were retrospectively collected. According to the post-operative treatment methods,they were divided into TCM treatment group,integrated TCM and western medicine group,and the western medicine treatment group. The primary observation indexes were survival times after operation,half-year survival rate and 1-year survival rate. Results Half-year and 1-year survival rate of the TCM treatment group was 68% and 42% respectively,which was higher than 44% and 25% in the western medicine treatment group. The survival time of the TCM treatment group was 15 months(95% CI: 7. 58-22. 42),which was longer than 9 months(95% CI: 4. 60-13. 40) in the western medicine treatment group. The difference was statistically significant(P < 0. 05). Comparison between the integrated TCM and western medicine group with the other 2 groups showed no statistically significant difference(P > 0. 05). The half-year survival rate was 66% in patients who were treated with TCM,and the 1-year survival rate was 41%,which were higher than 44% and 25% in the patients without TCM treatment. The post-operative survival time was 15 months for patients treated with TCM(95% CI: 11. 35-18. 65),which was longer than 9 months for patients without TCM treatment(95% CI: 4. 60-13. 40). The difference was statistically significant(P < 0. 05). Patients who received anti-tumor therapy with western medicine showed lower post-operative survival rate and shorter post-operative survival,but the difference was not statistically significant(P > 0. 05). Conclusion TCM treatment is helpful for the prolongation of the survival time of advanced NSCLC patients after cryoablation.
Objective To study the effects of traditional Chinese medicine(TCM) treatment on the lifetime and survival rate of elderly patients with advanced non-small cell lung cancer(NSCLC) after treated with cryoablation.Methods A total of 106 cases of elderly patients with advanced NSCLC who treated with cryoablation from January1,2012 to June 30,2017 were retrospectively collected. According to the post-operative treatment methods,they were divided into TCM treatment group,integrated TCM and western medicine group,and the western medicine treatment group. The primary observation indexes were survival times after operation,half-year survival rate and 1-year survival rate. Results Half-year and 1-year survival rate of the TCM treatment group was 68% and 42% respectively,which was higher than 44% and 25% in the western medicine treatment group. The survival time of the TCM treatment group was 15 months(95% CI: 7. 58-22. 42),which was longer than 9 months(95% CI: 4. 60-13. 40) in the western medicine treatment group. The difference was statistically significant(P < 0. 05). Comparison between the integrated TCM and western medicine group with the other 2 groups showed no statistically significant difference(P > 0. 05). The half-year survival rate was 66% in patients who were treated with TCM,and the 1-year survival rate was 41%,which were higher than 44% and 25% in the patients without TCM treatment. The post-operative survival time was 15 months for patients treated with TCM(95% CI: 11. 35-18. 65),which was longer than 9 months for patients without TCM treatment(95% CI: 4. 60-13. 40). The difference was statistically significant(P < 0. 05). Patients who received anti-tumor therapy with western medicine showed lower post-operative survival rate and shorter post-operative survival,but the difference was not statistically significant(P > 0. 05). Conclusion TCM treatment is helpful for the prolongation of the survival time of advanced NSCLC patients after cryoablation.
引文
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[9]何佩珊,冯兴中,杨公博,等.老年晚期非小细胞肺癌氩氦刀冷冻治疗前后证型变化规律探讨[J].中华中医药杂志,2017,32(4):1795-1798.
[10]何佩珊,胡凯文,李泉旺,等.中药干预对老年晚期非小细胞肺癌氩氦刀冷冻术前后证型影响的临床研究[J].环球中医药,2015,8(11):1354-1358.
[11]周天,胡凯文.论肿瘤绿色治疗体系[J].中医学报,2017,32(11):2049-2052.
[2]CHRISCHILLES EA,PENDERGAST JF,KAHN KL,et al. Adverse events among the elderly receiving chemotherapy for advanced non-small-cell lung cancer[J]. J Clin Oncol,2010,28(4):620-627.
[3]王洪武,宋志华.肿瘤超低温冷冻治疗[M].北京:人民卫生出版社,2010:6-10.
[4]何佩珊,胡凯文,杨公博,等.中药“养肺方”联合氩氦刀冷冻治疗老年晚期非小细胞肺癌的临床研究[J].中华中医药杂志,2016,31(9):3808-3811.
[5]中国抗癌协会肺癌专业委员会. 2010年中国肺癌临床指南[M].北京:人民卫生出版社,2010:31-38.
[6]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:216.
[7]何佩珊,冯兴中,杨公博,等.养肺方治疗老年晚期非小细胞肺癌氩氦刀冷冻术后并发症的临床研究[J].世界中医药,2016,11(2):228-231,235.
[8]何佩珊,刘传波,张可睿,等.应用“护场”理论治疗乳腺癌溃疡1例[J].中国中西医结合外科杂志,2013,19(6):712-713.
[9]何佩珊,冯兴中,杨公博,等.老年晚期非小细胞肺癌氩氦刀冷冻治疗前后证型变化规律探讨[J].中华中医药杂志,2017,32(4):1795-1798.
[10]何佩珊,胡凯文,李泉旺,等.中药干预对老年晚期非小细胞肺癌氩氦刀冷冻术前后证型影响的临床研究[J].环球中医药,2015,8(11):1354-1358.
[11]周天,胡凯文.论肿瘤绿色治疗体系[J].中医学报,2017,32(11):2049-2052.