早期肺癌术后患者血脂与预后的相关性分析及扶正祛邪方对早期肺癌术后患者血脂水平的影响  

Analysis of the Correlation Between Blood Lipids and Prognosis ofPostoperative Patients with Early Lung Cancer and the Effect ofFuzheng Quxie Prescription on Blood Lipid Levels ofPostoperative Patients with Early Lung Cancer

作　　者：张博 徐力立 骆莹滨 吴建春[1] 周奕阳[1] 王伟昱 田建辉[1] 李雁[1] ZHANG Bo;XU Li-Li;LUO Ying-Bin;WU Jian-Chun;ZHOU Yi-Yang;WANG Wei-Yu;TIAN Jian-Hui;LI Yan(Municipal Hospital of Traditional Chinese Medicine Affiliated to 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,上海200071

出　　处：《广州中医药大学学报》2024年第9期2347-2354,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(编号:81973795);上海医学创新发展基金项目(编号:WL-HBQN-2021010K,WL-HBQN-2021009K,WL-HBQN-2022015K);上海市进一步加快中医药传承创新发展三年行动计划(2021~2023年)项目[编号:ZY(2021-2023)-0211];上海市浦江人才项目(编号:2020PJD057)。

摘　　要：【目的】分析早期肺癌术后患者血清总胆固醇(TC)、甘油三酯(TG)等血脂水平与其生存预后的相关性,并统计扶正祛邪方对早期肺癌术后患者血清血脂水平的影响,以探索扶正祛邪方改善早期肺癌术后患者生存预后的内在因素。【方法】回顾性分析2010年7月~2015年12月在上海市中医医院就诊的257例早期肺癌术后患者血清TC、TG水平与其生存预后的相关性,统计扶正祛邪方治疗前后早期肺癌术后患者血清TC、TG水平的变化情况;前瞻性分析了2017年1月~2021年4月在上海市中医医院服用扶正祛邪方的281例早期肺癌术后患者(治疗组)和上海市肺科医院只临床随访不治疗的287例早期肺癌术后患者(对照组)的1年、2年、3年和4年无病生存率及血清TC、TG水平的变化情况。【结果】(1)回顾性研究部分:早期肺癌术后患者治疗前的TC与患者的无进展生存期(PFS)具有相关性,TC高值组的患者具有更长的PFS;早期肺癌术后患者治疗前的TG水平与患者的PFS无明显相关性,但对于近期生存的影响,TG高值组患者具有更高的近期生存率,对于远期生存的影响,TG低值组患者拥有更高的远期生存率。(2)前瞻性研究部分:①截止至末次随访时间2021年4月1日,2组患者中治疗组有9例复发,对照组有24例复发。治疗组1年、2年、3年和4年无病生存率分别是99.3%、96.8%和95.7%和95.7%,优于对照组的97.6%、92.3%和89.2%和87.1%(P<0.05),表明扶正祛邪方干预的早期肺癌术后患者复发和转移较对照组明显减少,无病生存率明显提高。②治疗后,治疗组的血清TC、TG水平均较治疗前升高(P<0.05),而对照组均无明显变化(P>0.05);组间比较,治疗组对血清TC、TG水平的升高作用均明显优于对照组(P<0.05),说明扶正祛邪方可以一定程度调节患者的血脂水平。【结论】通过治疗前血脂与早期肺癌术后患者PFS预后的相关性分析发现,TC高值组的肺癌患者Objective To explore the correlation between serum lipid levels of total cholesterol(TC)and triglyceride(TG)and the survival prognosis in postoperative patients with early lung cancer,and to observe the effect of Fuzheng Quxie Prescription on serum lipid levels in postoperative patients with early lung cancer,so as to explore the mechanism of Fuzheng Quxie Prescription in improving the survival prognosis of postoperative patients with early lung cancer.Methods The correlation of serum TC and TG levels with survival prognosis of 257 postoperative patients with early lung cancer admitted in Shanghai Municipal Hospital of Traditional Chinese Medicine from July 2010 to December 2015 was retrospectively analyzed.The changes of serum TC and TG levels in postoperative patients with early lung cancer before and after treatment with Fuzheng Quxie Prescription were statistically analyzed.From January 2017 to April 2021,a prospective analysis of the one-year,two-year,three-year and four-year disease-free survival rates and serum TC and TG levels was carried out in 281 postoperative patients with early lung cancer treated with Fuzheng Quxie Prescription orally in Shanghai Municipal Hospital of Traditional Chinese Medicine(treatment group)and in 287 postoperative patients with early lung cancer who were followed up in clinic while had no medciation in Shanghai Pulmonary Hospital(control group).Results(1)The retrospective study showed that pre-treatment TC level was correlated with progression-free survival(PFS)in postoperative patients with early lung cancer,and the patients with high TC level had longer PFS.There was no significant correlation between pre-treatment TG level and PFS in postoperative patients with early lung cancer.The patients with high TG level had higher short-term survival rate while the patients with low TG level had higher long-term survival rate.(2)The prospective study showed that there were nine cases of recurrence in the treatment group and 24 cases of recurrence in the control group till the last fo

关 键 词：血脂水平 早期肺癌术后 生存预后 扶正祛邪方 

分 类 号：R273.342[医药卫生—中西医结合]