摘要
目的利用真实医疗环境中的电子病历系统临床资料和随访数据,评价中医药治疗食管癌的临床疗效。方法收集2014年1月至2018年12月河南省中医院、河南中医药大学第一附属医院、河南省肿瘤医院肿瘤科食管癌患者共计336例,通过建立数据库,根据是否联合中医治疗分为两组,观察组接受西医治疗的基础上联合中医药治疗,对照组仅接受西医治疗,观察比较两组的临床疗效、患者Karnofsky功能状态评分、生命质量调查量表(QLQ-C30)评分及不良反应情况。结果观察组患者客观缓解率(objective response rate,ORR)与对照组比较,差异无统计学意义(P>0.05),但观察组疾病控制率(disease control rate,DCR)高于对照组,差异有统计学意义(P<0.05);观察组3年累积生存率显著高于对照组,差异具有统计学意义;治疗后两组患者KPS、QLQ-C30评分均较治疗前升高(P<0.05),且观察组上述评分升高较对照组更显著;消化道不良反应、神经毒性发生率观察组低于对照组,两组比较差异有统计学意义(P<0.05);而两组患者白细胞降低率、血小板减少率、血红蛋白减少率比较,差异均无统计学意义(P>0.05)。年龄、TNM分期、中医药干预及干预时间均为影响中晚期食管癌患者预后的独立危险因素(P<0.05)。结论中医药联合西医治疗可提高中晚期食管癌的临床疗效,同时可提高患者生活质量,减少西医治疗过程中不良反应的发生。
Objective To evaluate the clinical efficacy of Chinese medicine in the treatment of esophageal cancer by using the clinical data and follow-up data of the electronic medical record system in the real medical environment.Methods From January 2014 to December 2018,a total of 336 esophageal cancer patients were collected from Henan Provincial Hospital of Traditional Chinese Medicine,the First Affiliated Hospital of Henan University of Chinese Medicine,and the Oncology Department of Henan Cancer Hospital.A database of the clinical information of the included patients was established,and then the patients were divided into two groups according to the medication of Chinese medicine or not.The observation group was given the combination of Chinese medicine combined with western medicine,while the control group was treated with western medicine alone.The clinical efficacy,Karnofsky performance status(KPS)score,quality of life questionnaire core-30(QLQ-C30)score and adverse reactions in the two groups were observed.Results There was no significant difference in objective response rate(ORR)between the observation group and the control group(P>0.05),but the disease control rate(DCR)of the observation group was higher than that of the control group(P<0.05).The 3-year cumulative survival rate of the observation group was significantly higher than that of the control group,and the difference was statistically significant.After treatment,KPS scores and QLQ-C30 scores of patients in both groups were increased compared with those before treatment(P<0.05),and the increase of the scores in the observation group was superior to that in the control group.The incidences of gastrointestinal adverse reactions and neurotoxicity in the observation group were lower than those in the control group,and there was statistically significant difference between the two groups(P<0.05).However,there were no significant differences in the rate of leukopenia,thrombocytopenia and decreased hemoglobin between the two groups(P>0.05).The age,TNM stage,Chinese medicine intervention,and intervention time were the independent risk factors affecting the prognosis of patients with advanced esophageal cancer(P<0.05).Conclusion The combined treatment with Chinese medicine and western medicine can enhance the clinical efficacy of advanced esophageal cancer,improve the quality of life of the patients,and reduce the occurrence of adverse reactions in the course of western medicine treatment.
作者
周超锋
张亚玲
岳光星
田青
王赛
郭志忠
ZHOU Chao-feng;ZHANG Ya-ling;YUE Guang-xing;TIAN Qing;WANG Sai;GUO Zhi-zhong(Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou 450053 Henan,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450099 Henan,China;Henan Cancer Hospital,Zhengzhou 450003 Henan,China)
出处
《中医肿瘤学杂志》
2023年第2期66-70,共5页
Journal of Oncology in Chinese Medicine
基金
第二批国家中医临床研究基地科研专项(编号:2019JDZX009)。
