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基于辨证论治的中医草药治疗可提高不可切除肝细胞癌患者的总生存率。

Chinese medicine herbal treatment based on syndrome differentiation improves the overall survival of patients with unresectable hepatocellular carcinoma.

作者信息

Man Ya-Nan, Liu Xiao-Hui, Wu Xiong-Zhi

机构信息

Zhong-Shan-Men Inpatient Department, National Clinical Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300171, China.

出版信息

Chin J Integr Med. 2015 Jan;21(1):49-57. doi: 10.1007/s11655-014-1767-9. Epub 2014 Dec 24.

Abstract

OBJECTIVE

To investigate the effects of Chinese medicine (CM) herbal treatment based on syndrome differentiation on patients with unresectable hepatocellular carcinoma (HCC).

METHODS

A total of 94 patients with unresectable HCC were reviewed between June 2008 and June 2011. Survival analysis was performed between patients who received CM with/without non-curative antitumor treatments of Western medicine (WM) (CM group, 30 cases) and patients who were not treated with CM but with non-curative antitumor treatments of WM or supportive treatment alone (non-CM group, 64 cases). Then, survival analysis was performed between patients treated with CM combined with non-curative antitumor treatments of WM (combination therapy group, 25 cases) and patients with non-curative antitumor treatments of WM alone (non-curative antitumor treatments group of WM, 52 cases). The survival analysis was performed by Kaplan-Meier method and prognostic factors for overall survival (OS) were assessed by the Cox proportional hazards regression model.

RESULTS

The median survival time (MST), 1- and 2-year survival rates of the CM group and the non-CM group were 36 months, 76.7%, 56.1% and 12 months, 48.4%, 26.6%, respectively. The Log-rank test revealed significant difference between the two groups in OS (P<0.01). Cox proportional multivariate analysis revealed that CM was an independent favorable prognostic factor for OS. The MST, 1- and 2-year survival rates of combination therapy group and non-curative antitumor treatments group of WM were 36 months, 76.0%, 55.5% and 13 months, 55.8%, 30.8%, respectively. There was significant difference in OS between the two groups (P=0.004).

CONCLUSIONS

CM herbs based on syndrome differentiation have positive effects on survival of patients with unresectable HCC. Furthermore, combination therapy of CM and WM are recommended in HCC treatment.

摘要

目的

探讨中医辨证论治中药治疗不可切除肝细胞癌(HCC)患者的疗效。

方法

回顾性分析2008年6月至2011年6月期间94例不可切除HCC患者。对接受中药联合/不联合非根治性西医抗肿瘤治疗的患者(中药组,30例)和未接受中药治疗但仅接受非根治性西医抗肿瘤治疗或支持治疗的患者(非中药组,64例)进行生存分析。然后,对接受中药联合非根治性西医抗肿瘤治疗的患者(联合治疗组,25例)和仅接受非根治性西医抗肿瘤治疗的患者(西医非根治性抗肿瘤治疗组,52例)进行生存分析。采用Kaplan-Meier法进行生存分析,并通过Cox比例风险回归模型评估总生存(OS)的预后因素。

结果

中药组和非中药组的中位生存时间(MST)、1年和2年生存率分别为36个月、76.7%、56.1%和12个月、48.4%、26.6%。Log-rank检验显示两组OS差异有统计学意义(P<0.01)。Cox比例多因素分析显示中药是OS的独立有利预后因素。联合治疗组和西医非根治性抗肿瘤治疗组的MST、1年和2年生存率分别为36个月、76.0%、55.5%和13个月、55.8%、30.8%。两组OS差异有统计学意义(P=0.004)。

结论

中医辨证论治中药对不可切除HCC患者的生存有积极影响。此外,推荐在HCC治疗中采用中西医结合治疗。

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