基于回顾性分析探讨中药治疗大肠癌的用药规律  

Study on Medication Principles in the Treatment of Colorectal Cancer based on Retrospective Analysis

作　　者：刘佳琴 蒋盛昶[1] 曹如柔 曾雯 张宁静 滕然 刘科 陶子豪 蒋益兰[1] LIU Jia-qin;JIANG Sheng-chang;CAO Ru-rou;ZENG Wen;ZHANG Ning-jing;TENG Ran;LIU Ke;TAO Zi-hao;JIANG Yi-lan(The Affiliated Hospital of Hunan Academy of Chinese Medicine,Changsha Hunan 410006,China;The Graduate School of Hunan University of Chinese Medicine,Changsha Hunan 410208,China;Liuyang Hospital of Traditional Chinese Medicine,Liuyang Hunan 410300,China)

机构地区：[1]湖南省中医药研究院附属医院,湖南长沙410006 [2]湖南中医药大学研究生院,湖南长沙410208 [3]浏阳市中医医院,湖南浏阳410300

出　　处：《中医药导报》2020年第16期108-111,共4页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：临床医疗技术创新引导项目(2017SK50403);中央引导地方科技发展专项资金项目(2017CT5029)。

摘　　要：目的:通过回顾性分析,总结大肠癌的中医辨证分型及用药规律,为大肠癌的临床治疗提供参考。方法:回顾性分析湖南省中医药研究院附属医院2013年1月至2017年6月住院的367例大肠癌患者的病历资料,包括患者的性别、发病年龄、肿瘤原发部位、病理类型、根治术后患者的无病生存期及5年生存率、带瘤患者的无进展生存期及总生存期、中医辨证分型及中医处方,建立Microsoft Excel数据库,进行中医处方用药频数分析、中药用药规律总结等。结果:367例患者中男209例,女158例,平均年龄为60.62岁;结肠癌197例(发病部位从高到低依次为升结肠、乙状结肠、降结肠、横结肠),直肠癌170例;国际临床TNM分期[原发肿瘤(tumor),区域淋巴结(regional lymph nodes),远处转移(distant metastasis)]为Ⅰ期20例,Ⅱ期79例,Ⅲ期49例,Ⅳ期219例,共行根治术104例;病理类型以腺癌为主;根治术后患者的无病生存期为(36.64±31.02)月,5年生存率为79.81%(83/104);晚期带瘤患者的总生存期为(28.62±20.31)月,无进展生存期(13.53±8.36)月;纯中药治疗组的总生存期为(8.31±4.52)月,配合中医药治疗组的总生存期为(33.48±27.62)月;对其中医辨证分6类,其中以瘀毒内阻证及脾虚气滞证为主,收集的中药处方共使用251味中药,用药总频数为6275次(不包括甘草和炙甘草),包括19类药物(以补虚药、清热药和活血化瘀药为主)。结论:大肠癌的中医证型以瘀毒内阻证及脾虚气滞证为主,其中药治疗以扶正补虚、清热解毒、活血化瘀为主,配合中医药治疗可延长大肠癌根治术后患者的无病生存期和5年生存率及晚期带瘤患者的无进展生存期和总生存期。Objective: Through retrospective analysis, to summarize the TCM syndrome differentiation and drug use rules of colorectal cancer(CRC), and to provide certain reference for the clinical treatment of colorectal cancer. Methods: Clinical data of 367 patients with CRC who were admitted to The Affiliated Hospital of Hunan Academy of Chinese Medicine between January 2013 and June 2017 were retrospectively analyzed, includi ng patients’ sex, age, primary tumor site, pathological type, disease-free survival and 5-year survival rate of patients after radical operation, progression-free survival and overall survival of patients with tumor, TCM syndrome differentiation and the law of TCM medication, and the frequency of Chinese medicine prescription drugs were analyzed and summarized through the establishment of Microsoft Excel database. Results: Among them, there were 209 males and 158 females, and the average age diagnosed was 60.62 years old. There were197 cases of colon cancer(ascending colon, sigmoid colon, descending colon, transverse colon) and 170 cases of rectal cancer. International clinical TNM staging(primary tumor tumor, regional lymph nodes, distant metastasis)was divided into 20 patients in stageⅠ, 79 patients in stageⅡ, 49 patients in stage Ⅲ and 219 patients in stag e Ⅳ, with a total of 104 patients undergoing radical mastectomy. The pathological type was mainly adenocarcinoma. The disease-free survival after radical operation was(36.64 ±31.02) months, and the 5-year survival rate was 79.81%(83/104). The total survival time of patients with tumor was(28.62±20.31) months, and the progression-free survival time was(13.53±8.36) months. The total survival time of the pure Chinese medicine treatment group was(8.31±4.52) months, and that of the cooperate with TCM treatment group was(33.48±27.62)months. There are six types of TCM syndromes, including internal obstruction of blood stasis and spleen deficiency and qi stagnation. 251 herbs were used in the collected TCM prescriptions with a total frequ

关 键 词：大肠癌 用药规律 中医药 回顾性研究 

分 类 号：R273[医药卫生—中西医结合]