中医药综合方案提高根治术后小肝癌患者生存率回顾性队列研究  

Traditional Chinese Medicine in Improving Overall Survival Rates for Small Hepatocellular Carcinoma After Resection:A Retrospective Cohort Study

作　　者：孙振[1] 崔珺[2] 朱役[1] 梁水庭[3] 王忠[1] 陈兴东[1] 穆小苏[1] 向维[1] 覃晓[3] 徐静[3] 翟笑枫[4] 张院辉[4] 郎庆波[4] 吴美京[5] 

机构地区：[1]南京军区南京总医院疗养区,江苏南京211131 [2]中国石化管道储运分公司南京输油处,江苏南京210046 [3]广西医科大学第一附属医院,广西南宁530021 [4]第二军医大学附属长海医院中医系,上海200433 [5]第二军医大学卫勤系卫生统计学教研室,上海200433

出　　处：《辽宁中医药大学学报》2014年第12期63-66,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：中国博士后科学基金面上项目(2012M521937);江苏省博士后科研资助计划项目(1201024C);江苏省"333"工程课题(BRA2012232);南京军区南京总医院疗养区科研课题(2013075)

摘　　要：目的:本研究评价中医药综合方案治疗根治术后小肝癌的疗效。方法:对2005年1月—2008年12月在广西医科大学第一附属医院行根治术的小肝癌患者161例纳入回顾性队列分析,其中53例接受中医药综合方案治疗(TCM组),80例接受介入疗法(TACE组),20例接受中医药和介入疗法(TCM-IT组),8例单纯手术治疗(SO),以无病生存期(DFS)和总生存期(OS)为观察指标,Kaplan-Meier方法统计分析各组总生存率和无病生存率。结果:共纳入161例小肝癌患者,12例失访,失访率7.45%,其中TCM组第1年、2年、3年总生存率分别为91.5%、84.8%、84.8%;介入组1年、2年,3年总生存率分别为91%、85.5%、60.5%,有明显统计学差异(P=0.008);TCM与介入联合组和单纯手术组中位生存期分别是30.667个月和29.267个月。TCM组1年、2年的无病生存率分别为84.5%、81.7%,介入组1年、2年的无病生存率为83.9%、76.5%,无统计学差异(P=0.461)。结论:中医药综合治疗方案与TACE介入治疗术相比,在提高根治术后小肝癌患者的生存率方面具有优势,其结果有待于进一步前瞻性随机对照研究验证。Objective ： To investigate the therapeutic effects of a comprehensive individualized treatment program using TCM for small hepatocellular carcinoma after resection. Methods： In this trial, a total of 161 patients who stayed in First Affiliated Hospital of Guangxi Medical University were enrolled from January 2005 to December 2008. 53 patients were treated with a TCM-only （ TCM ） group. 80 patients were treated with an transarterial ehemoembolization-only （ TACE ） group. 20 patients were treated with a TCM combined with interventional therapy （ TCM-IT ） group. 8 patients were treated with patients were treated with a simple operation （ SO ） group. Disease free survival （ DFS ） and overall survival （ OS ） were the observation indexes. Prognostic factors were correlated with OS rates and （ DFS ） rates, which calculated with the Kaplan-Meier method. Results ： The overall loss to follow-up rate was 14.0% （ 12/161 ）. The Overall survival （OS）rates at 1,2, and 3 years of TCM patients were 91.5%,84.8% and 84.8%. The Overall survival （ OS ）rates at 1,2 and 3 years of TACE group patients were 91%, 85.5%, 60.5%. There was significant difference in survival time between the two groups （ P=0.008 ）. The overall median survival time in TCM combined with interventional therapy （ TCM-IT ）was 30.667 months and simple operation （ SO ） group was 29.267 months. The Disease free survival （ DFS ）rates at 1,2 years of TCMO patients were 84.5% and 81.7%. The DFS rates at 1,2 years of ITO patients were 83.9% and 76.5%. There was no significantdifference in survival time between the two groups （ P=0.461 ）. Conclusions ： In comparison with TACE therapy, the comprehensive individualized treatment program using TCM for small hepatocellular carcinoma after resection may improve overall survival for small- HCC after resection. However, these findings need to be confirmed in a prospective, randomized controlled trial.

关 键 词：原发性肝癌 介入治疗 中医药 回顾性队列研究 

分 类 号：R735.7[医药卫生—肿瘤]