中药治疗晚期左半结肠癌的生存分析及用药规律探析  

Survival Analysis and Medication Rule of Traditional Chinese Medicine in the Treatment of Advanced Left Colon Cancer

作　　者：阮啸锋 姚丽婷 张涛[2] 石齐 唐宇飞 王曦妤 吴行 石坤和[1] 李琦[1,4] 侯风刚[1] Ruan Xiaofeng;Yao Liting;Zhang Tao(Department of General Surgery,Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属市中医医院普外科,200071 [2]上海中医药大学附属第七人民医院重症医学科,200137 [3]上海市宝山区中西医结合医院肿瘤科,201999 [4]上海中医药大学附属曙光医院肿瘤科,201203

出　　处：《医学研究杂志》2020年第6期157-161,共5页Journal of Medical Research

基　　金：上海市科学技术委员会“科技创新行动计划”医学领域项目(16401970503);上海市卫生健康委员会中医药科研项目(2018LP0281)。

摘　　要：目的探讨中药对晚期左半结肠癌的生存影响及其用药规律。方法按有无系统服用中药,将入选的患者分为中药组和非中药组,并将患者的基本信息及随访资料录入数据库。单因素生存分析采用Kaplan-Meier法,Log-rank检验用于两组之间比较,多因素生存分析采用COX比例风险回归模型。根据中药组患者用药情况,使用K-means动态样本聚类法将患者分类,统计每类患者累积用药频率和高频中药功效频率,总结其用药规律。结果共纳入152例晚期左半结肠癌患者,其中,中药组83例,非中药组69例,中药组中位生存期为17.1个月,95%CI:12.845~21.355;非中药组中位生存期为11.1个月,95%CI:6.680~13.520,P=0.001;与不服用中药比较,服用中药:HR=0.612,95%CI:0.425~0.882,P=0.008。晚期左半结肠癌患者根据患者用药情况可分为3类,即健脾祛湿药配伍软坚散结药、健脾祛湿药配伍化痰药、健脾祛湿药配伍清热解毒药,对应的中医治法为以健脾祛湿为基础分别加以软坚散结、清热解毒或理气燥湿化痰。结论中药治疗能显著延长晚期左半结肠癌生存期,提高生存率。晚期左半结肠癌的治法以健脾祛湿为主,临证分别加以软坚散结、理气燥湿化痰或清热解毒。Objective To explore the effect of Chinese medicine on the survival of advanced left colon cancer and its medication.Methods Taking Chinese medicine according to the presence or absence of system,the selected patients were divided into Chinese medicine group and non-Chinese medicine group,and basic information and follow-up data of patients were entered into the database.The single-cause survival analysis was performed using the Kaplan-Meier method,the Log-rank test was used for comparison between the two groups,and the multivariate survival analysis was performed using the COX proportional hazard regression model.According to the medication situation of patients in the traditional Chinese medicine group,the K-means dynamic sample clustering method was used to classify patients,and the frequency of cumulative medications and the frequency of high-frequency Chinese medicines in each type of patients were counted,and the medication rules were summarized.Results A total of 152 patients with advanced left colon cancer were enrolled,including 83 patients in the Chinese medicine group and 69 patients in the non-Chinese medicine group.The median survival time was 17.1 months for the Chinese medicine group(95%CI:12.845-21.355)and 11.1 months for the non-Chinese medicine group(95%CI:6.68-13.52,P=0.001);Compared with not taking Chinese medicine,taking Chinese medicine:HR=0.612,95%CI:0.425-0.882,P=0.008.According to the patients′medication,patients with advanced left colon cancer can be divided into 3 categories.The medications are:spleen and dampness medicine compatible with Ruanjian Sanjie,spleen and dampness medicine combined with phlegm,and spleen and dampness medicine combined with heat Antidote,the corresponding Chinese medicine treatment method is based on strengthening the spleen and dampness,respectively,softening and solidifying,clearing away heat and detoxifying,or regulating qi,dampness and phlegm.Conclusion Chinese medicine treatment can significantly prolong the survival of advanced left colon cancer and imp

关 键 词：左半结肠癌 生存影响 用药规律 

分 类 号：R735.3[医药卫生—肿瘤]