形神理论指导下晚期非小细胞肺癌中医综合疗效标准临床研究  

Clinical Research of TCM Comprehensive Therapeutic Criteria for Advanced Non-small Cell Lung Cancer Guided by Body and Spirit Theory

作　　者：钱立美 殷东风[2] 邢向荣[2] 高宏[2] 崔小天[2] QIAN Limei;YIN Dongfeng;XING Xiangrong;GAO Hong;CUI Xiaotian(Liaoning University of TCM,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of TCM,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《实用中医内科杂志》2020年第6期100-104,共5页Journal of Practical Traditional Chinese Internal Medicine

基　　金：辽宁省中医药临床学(专)科能力建设项目(2017A01)。

摘　　要：目的探究形神理论指导下建立的晚期非小细胞肺癌(NSCLC)中医综合疗效标准的可行性及有效性。方法采用回顾性分析病例研究方法,在形神理论的指导下,将影响晚期NSCLC疗效评价的4个因素,包括"形"(即瘤体大小)和"神"(即症状、KPS评分及神志),进行Cox回归分析,建立晚期NSCLC中医疗效标准模型,并用χ^2检验、Kaplan-Meier法与改良的Recist实体瘤疗效标准进行比较。结果85例晚期NSCLC患者纳入研究,根据Cox多因素回归分析,建立的中医综合疗效标准模型为h(t,x)=h0(t)exp(0.527瘤体大小变化+0.711症状变化+0.629 KPS变化+0.897神志改变)。按照中医综合疗效标准评价为有效、稳定、无效分别为20、33、32例,疾病控制率为62.4%,生存曲线明显分离;而以改良的Recist实体瘤疗效标准评价为有效、稳定、无效分别为13、23、49例,疾病控制率为42.4%,其生存曲线相互交叉,两种疗效标准评价差异有统计学意义(P<0.05)。结论在接近形神相对统一假说指导下建立的中医综合疗效标准可以引导晚期NSCLC合理治疗,提供宏观精准治疗,并更能反映晚期NSCLC患者的生存预后。Objective To explore the feasibility and validity of TCM comprehensive therapeutic criteria for advanced non-small cell lung cancer(NSCLC)guided by body and spirit theory.Methods Using a retrospective analysis of case study methods,guided by the body and spirit theory,four factors affecting the therapeutic evaluation of advanced NSCLC,including"body"(i.e.tumor size)and"spirit"(i.e.symptomatic,KPS scores and mental),were analyzed by Cox regression analysis to establish a standard model of TCM therapeutic criteria for advanced NSCLC.TCM comprehensive therapeutic criteria was compared with that of modified Recist solid tumors therapeutic criteria by chi-square test and Kaplan-Meier method.Results A total of 85 patients with advanced NSCLC were included in the study.according to Cox multivariate regression analysis,the standard model of TCM therapeutic criteria was h(t,x)=h0(t)exp(0.527 tumor size changes+0.711 symptom changes+0.629 KPS changes+0.897 mental changes).According to TCM comprehensive therapeutic criteria,20,33 and 32 cases were effective,stable and ineffective,respectively.The disease control rate was 62.4%,and the survival curve was obviously separated.Modified Recist solid tumors therapeutic criteria was effective,stable and ineffective in 13,23 and 49 cases,respectively.The disease control rate was 42.4%.The difference of price standard was significant(P<0.05).Conclusion-Under the guidance of the relative unification hypothesis of body and spirit,the comprehensive curative effect standard of TCM can guide the rational treatment of advanced NSCLC,provide macro precision treatment,and more reflect the survival prognosis of patients with advanced NSCLC.

关 键 词：形神理论 晚期非小细胞肺癌 中医综合疗效标准 改良RECIST实体瘤疗效标准 中医精准治疗 

分 类 号：R273[医药卫生—中西医结合]