基于真实世界的百合固金汤对非小细胞肺癌放疗患者长期预后的影响  

Effects of Baihe Gujin Decoction on the Long-term Prognosis of NSCLC Patients with Radiotherapy Based on Real World

作　　者：郑鑫蓥 张惠勇[1] 黄星 邱磊 方庆亮 鹿振辉[1] 王蕾[1] ZHENG Xinying;ZHANG Huiyong;HUANG Xing;QIU Lei;FANG Qingliang;LU Zhenhui;WANG Lei(Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032

出　　处：《中国中医药信息杂志》2024年第10期142-148,共7页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：上海市自然科学基金(23ZR1463900);上海市卫生行业临床专项(20214Y0377);上海市医学创新研究专项(21Y11922400)。

摘　　要：目的评价真实世界中百合固金汤对非小细胞肺癌(NSCLC)放疗患者远期生存的影响。方法分别收集上海中医药大学附属龙华医院和美国国立癌症研究所SEER数据库中NSCLC放疗患者作为中西医结合(TCM+CWM)队列和常规西医(CWM)队列。采用倾向评分匹配(PSM)平衡组间混杂因素,Kaplan-Meier曲线和Cox回归模型评估百合固金汤对NSCLC放疗患者生存结局的影响。结果PSM后2组共获得190例组间均衡样本。总生存期(OS)分析显示,TCM+CWM队列的OS明显高于CWM队列(P=0.004);亚组分析显示,百合固金汤对于年龄≥65岁(P=0.027)、男性(P=0.010)、T3~T4期(P<0.001)、N2~N3期(P=0.026)、M1期(P<0.001)、未接受化疗(P<0.001)、未接受手术(P<0.001)的特征人群更具优势;多因素Cox回归进一步显示,治疗分组(P=0.003)、T分期(P=0.003)和M分期(P=0.002)可能是NSCLC放疗患者OS的独立预后因素。结论百合固金汤可能改善NSCLC放疗患者的长期预后。Objective To evaluate the effects of Baihe Gujin Decoction on long-term survival in patients with non-small cell lung cancer(NSCLC)receiving radiotherapy(RT)in the real world.Methods Retrospective data from patients with NSCLC receiving RT in the Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine(TCM)and data from patients in the Surveillance,Epidemiology and End Results(SEER)database were collected and grouped as the TCM+conventional Western medicine(CWM)cohort and CWM cohort,respectively.Propensity score matching(PSM)was used to balance confounders between groups.Kaplan-Meier curve and Cox regression model were used to estimate the effects of Baihe Gujin Decoction on survival outcomes of patients receiving RT.Results Totally 190 samples with a balance between groups were obtained using PSM.Overall survival(OS)analysis showed that the TCM+CWM cohort had significantly longer OS than the CWM cohort(P=0.004).Subgroup analysis showed that the Baihe Gujin Decoction was more advantageous in the characteristic population of age≥65 years(P=0.027),male(P=0.010),T3-T4 stage(P<0.001),N2-N3 stage(P=0.026),M1 stage(P<0.001),not receiving chemotherapy(P<0.001),and not undergoing surgery(P<0.001).Multivariate Cox regression confirmed that treatment group(P=0.003),T(P=0.003)and M stages(P=0.002)may be the independent prognostic factors for OS of NSCLC patients treated with RT.Conclusion Baihe Gujin Decoction probably can improve the long-term prognosis in NSCLC patients treatment with RT.

关 键 词：真实世界研究 非小细胞肺癌 放疗 百合固金汤 生存期 

分 类 号：R273.42[医药卫生—中西医结合]