解毒消瘤方提高B细胞非霍奇金淋巴瘤患者无进展生存期的回顾性队列研究  

A retrospective cohort study of Jiedu Xiaoliu Formula improving progression-free survival in patients with B-cell non-Hodgkin’s lymphoma

作　　者：胡明 狄前程 胡琦[1] 冯晓卫 魏聪敏 李军民 赵维莅 HU Ming;DI Qiancheng;HU Qi;FENG Xiaowei;WEI Congmin;LI Junmin;ZHAO Weili(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071;Department of Traditional Chinese Medicine,Zhengzhou Yihe Hospital;Ruijin Hospital,Shanghai Jiao Tong University)

机构地区：[1]上海中医药大学附属市中医医院,上海200071 [2]河南郑州颐和医院中医科 [3]上海交通大学附属瑞金医院

出　　处：《现代中医临床》2023年第1期31-37,共7页Modern Chinese Clinical Medicine

基　　金：上海市中医药管理局资助项目(No.B01B1);上海市科学技术委员会资助项目(No.18401903900)。

摘　　要：目的观察解毒消瘤方对B细胞非霍奇金淋巴瘤(B-NHL)患者无进展生存期(PFS)的影响。方法将357例B-NHL患者根据接受解毒消瘤方治疗时间是否大于3个月,分为对照组214例,中医组143例,倾向性评分匹配(PSM)后对照组118例,中医组118例。观察PFS和中位无进展生存期(mPFS)、Kaplan-Meier累计PFS率、危险比(HR)。结果PSM后,中医组与对照组的mPFS分别为76(45.48,106.52)个月和50(28.16,71.85)个月(χ2=6.82,P=0.009)。2年Kaplan-Meier累计PFS率中医组高于对照组,差异有统计学意义(P<0.05)。2组低危Ⅰ~Ⅱ期B-NHL患者,中医组mPFS为76(14.72,137.28)个月,对照组mPFS为78(38.05,117.95)个月,中医组低于对照组,差异有统计学意义(P<0.05)。有侵袭性B-NHL患者中,中医组mPFS未达到,对照组mPFS为36(26.73,45.26)个月,2组间比较差异有统计学意义(P<0.05)。采用Cox回归分析不同亚组HR,结果显示:中医组与对照组相比HR=0.91(P>0.05)。其中,男性、不低于60岁、侵袭性、Ⅲ~Ⅳ期、B症状、血清乳酸脱氢酶(LDH)升高、基础疾病,ECOGE评分1~2分、放化疗、弥漫大B细胞淋巴瘤(DLBCL)对B-NHL患者进展风险的影响具有统计学意义(P<0.05)。结论解毒消瘤方可延缓体力状态良好、低危Ⅰ~Ⅱ期、有侵袭性B-NHL患者PFS。Objective To observe the effect of Jiedu Xiaoliu Formula(Toxin-Resolving and Tumor-Removing Formula) on progression-free survival(PFS) in patients with B cell non-Hodgkin’s lymphoma(B-NHL).Methods 357 patients with B-NHL were divided into the control group(214 cases) and TCM group(143 cases). After propensity score matching(PSM), 118 cases remained in both groups. The PFS, median progression free survival(mPFS), Kaplan Meier cumulative PFS rate and hazard ratio(HR) were observed.Results After PSM, the mPFS of the TCM group and control group were 76(45.48,106.52) months and 50(28.16, 71.85) months, respectively(χ~2=6.82, P=0.009). The Kaplan Meier cumulative PFS rate in the TCM group was higher than that in the control group in two years, with a statistically significant difference(P<0.05). The mPFS of the two groups of low-risk patients with B-NHL in stages I to II was 76(14.72, 137.28) months in the TCM group and 78(38.05, 117.95) months in the control group. The difference was statistically significant(P<0.05). In patients with invasive B-NHL, the mPFS in the TCM group was not reached, while that in the control group was 36(26.73, 45.26) months. The difference between the two groups was statistically significant(P<0.05). Cox regression analysis was used to analyze HR of different subgroups. The result showed that HR of the TCM group was 0.91(P>0.05) compared with that of the control group. Factors including male, no less than 60 years old, invasive, stage III-IV, B symptoms, elevated LDH, underlying health conditions, ECOGE score of 1-2, radiotherapy and chemotherapy, and DLBCL had statistically significant effects on the risk of progression of B-NHL patients(P < 0.05).Conclusion Jiedu Xiaoliu Formula can delay PFS in patients with good physical condition, low-risk stage I-II, and invasive B-NHL.

关 键 词：B细胞非霍奇金淋巴瘤 解毒消瘤方 邪去则正安 无进展生存期 

分 类 号：R273[医药卫生—中西医结合]