扶正祛邪方对肺癌患者无进展生存期的影响  

Effect of Fuzheng Quxie Formula on progression‑free survival in lung cancer patients

作　　者：张博 周奕阳[1] 张敏峰 徐力立 骆莹滨 吴建春[1] 王伟昱 田建辉[1] 李雁[1] ZHANG Bo;ZHOU Yiyang;ZHANG Minfeng;XU Lili;LUO Yingbin;WU Jianchun;WANG Weiyu;TIAN Jianhui;LI Yan(Shanghai 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：《上海中医药杂志》2024年第12期114-118,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81973795);上海医学创新发展基金会项目(WL-HBQN-2021010K,WL-HBQN-2021009K,WL-HBQN-2022015K);上海市卫健委上海市进一步加快中医药传承创新发展三年行动计划项目[ZY(2021-2023)-0211];上海市人力资源和社会保障局、上海市科委上海市浦江人才项目(2020PJD057)。

摘　　要：目的回顾性分析扶正祛邪方对肺癌患者无进展生存期(PFS)的影响,探讨影响肺癌预后的相关因素。方法收集肺癌患者的病历数据并进行随访,根据扶正祛邪方的使用情况分为治疗组(在常规治疗的基础上加用扶正祛邪方)、对照组(仅采用常规治疗),采用倾向性评分匹配(PSM),分析匹配前后两组患者的PFS并借助Kaplan-Meier法计算无进展生存率;用log-rank法进行单因素分析,然后采用多因素Cox回归分析,探讨影响肺癌患者PFS的相关因素。结果①本研究共收集1134例肺癌患者的病历数据,PSM前对照组为373例、治疗组为761例,PSM后对照组、治疗组各208例。②PSM前后,治疗组平均PFS时间均较对照组延长[HR=0.724,95%CI(0.614~0.846),P<0.001;HR=0.5,95%CI(0.387~0.646),P<0.001];PSM前后,治疗组I期患者的平均PFS时间均较对照组I期患者延长[HR=0.203,95%CI(0.138~0.298),P<0.001;HR=0.219,95%CI(0.128~0.374),P<0.001]。③单因素分析结果显示,性别、年龄、吸烟史、家族史、手术、化学疗法、分期、扶正祛邪方干预是影响肺癌患者PFS的相关因素(P<0.05);多因素回归分析结果显示,低龄[HR=1.04,95%CI(1.02~1.06),P<0.001]、扶正祛邪方干预[HR=0.97,95%CI(0.14~0.36),P<0.001]是影响肺癌PFS的独立保护因素,吸烟[HR=0.58,95%CI(1.20~2.90),P=0.006]、分期[HR=0.83,95%CI(0.81~1.28),P<0.001]是影响肺癌PFS的独立危险因素。④随访期间,两组患者均未见明显不良反应发生。结论扶正祛邪方是肺癌患者生存预后的保护性因素,有助于预防复发转移,延长肺癌患者的PFS,且对早期肺癌患者的影响更为显著,有良好的应用前景。Objective To retrospectively analyze the effect of Fuzheng Quxie Formula(a decoction for strengthening the body's resistance and dispelling pathogenic factors)on the progression-free survival(PFS)in lung cancer patients and to explore the factors affecting the prognosis of lung cancer.Methods Clinical data from lung cancer patients were collected,and follow-up was conducted with them.Patients were divided into a treatment group(receiving the Fuzheng Quxie Formula in addition to conventional treatment)and a control group only(receiving conventional treatment)based on the use of the Fuzheng Quxie Formula.Propensity score matching(PSM)was used to compare PFS between the two groups before and after matching.Kaplan-Meier analysis was used to calculate PFS rates.Univariate analysis was conducted using the log-rank test.Multivariate Cox regression analysis was then used to identify factors affecting PFS in lung cancer patients.Results①A total of 1134 lung cancer patients data were collected in this study,with 373 cases in the control group and 761 cases in the treatment group before PSM.After PSM,both the control and treatment groups had 208 cases each.②The average PFS time in the treatment group was significantly longer than that in the control group before and after PSM[HR=0.724,95%CI(0.614-0.846),P<0.001;HR=0.5,95%CI(0.387-0.646),P<0.001].Specifically,stageⅠpatients in the treatment group had a longer average PFS time than those in the control group before and after PSM[HR=0.203,95%CI(0.138-0.298),P<0.001;HR=0.219,95%CI(0.128-0.374),P<0.001].③Univariate analysis results showed that gender,age,smoking history,family history,surgery,chemotherapy,cancer staging,and the Fuzheng Quxie Formula intervention were significant related factors affecting PFS in lung cancer patients(P<0.05).Multivariate regression analysis results showed that younger age[HR=1.04,95%CI(1.02-1.06),P<0.001]and the Fuzheng Quxie Formula intervention[HR=0.97,95%CI(0.14-0.36),P<0.001]were independent protective factors affecting PFS in lung can

关 键 词：肺癌 扶正祛邪方 无进展生存期 中医药疗法 生存分析 回顾性研究 

分 类 号：R273[医药卫生—中西医结合]