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补充性中草药疗法改善台湾胰腺癌患者的生存率:一项基于全国人口的队列研究

Complementary Chinese Herbal Medicine Therapy Improves Survival of Patients With Pancreatic Cancer in Taiwan: A Nationwide Population-Based Cohort Study.

作者信息

Kuo Yi-Ting, Liao Hou-Hsun, Chiang Jen-Huai, Wu Mei-Yao, Chen Bor-Chyuan, Chang Ching-Mao, Yeh Ming-Hsien, Chang Tung-Ti, Sun Mao-Feng, Yeh Chia-Chou, Yen Hung-Rong

机构信息

1 Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.

2 Department of Chinese Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan.

出版信息

Integr Cancer Ther. 2018 Jun;17(2):411-422. doi: 10.1177/1534735417722224. Epub 2017 Aug 3.

Abstract

BACKGROUND

Pancreatic cancer is a difficult-to-treat cancer with a late presentation and poor prognosis. Some patients seek traditional Chinese medicine (TCM) consultation. We aimed to investigate the benefits of complementary Chinese herbal medicine (CHM) among patients with pancreatic cancer in Taiwan.

METHODS

We included all patients with pancreatic cancer who were registered in the Taiwanese Registry for Catastrophic Illness Patients Database between 1997 and 2010. We used 1:1 frequency matching by age, sex, the initial diagnostic year of pancreatic cancer, and index year to enroll 386 CHM users and 386 non-CHM users. A Cox regression model was used to compare the hazard ratios (HRs) of the risk of mortality. The Kaplan-Meier curve was used to compare the difference in survival time.

RESULTS

According to the Cox hazard ratio model mutually adjusted for CHM use, age, sex, urbanization level, comorbidity, and treatments, we found that CHM users had a lower hazard ratio of mortality risk (adjusted HR = 0.67, 95% CI = 0.56-0.79). Those who received CHM therapy for more than 90 days had significantly lower hazard ratios of mortality risk than non-CHM users (90- to 180-day group: adjusted HR = 0.56, 95% CI = 0.42-0.75; >180-day group: HR = 0.33, 95% CI = 0.24-0.45). The survival probability was higher for patients in the CHM group. Bai-hua-she-she-cao (Herba Oldenlandiae; Hedyotis diffusa Spreng) and Xiang-sha-liu-jun-zi-tang (Costus and Chinese Amomum Combination) were the most commonly used single herb and Chinese herbal formula, respectively.

CONCLUSIONS

Complementary Chinese herbal therapy might be associated with reduced mortality among patients with pancreatic cancer. Further prospective clinical trial is warranted.

摘要

背景

胰腺癌是一种难以治疗的癌症,就诊时往往已处于晚期,预后较差。一些患者会寻求中医咨询。我们旨在研究台湾地区胰腺癌患者使用补充性中草药(CHM)的益处。

方法

我们纳入了1997年至2010年间在台湾重大伤病患者数据库中登记的所有胰腺癌患者。通过年龄、性别、胰腺癌初始诊断年份和索引年份进行1:1频率匹配,纳入386名CHM使用者和386名非CHM使用者。使用Cox回归模型比较死亡风险的风险比(HRs)。采用Kaplan-Meier曲线比较生存时间的差异。

结果

根据对CHM使用、年龄、性别、城市化水平、合并症和治疗进行相互调整的Cox风险比模型,我们发现CHM使用者的死亡风险比更低(调整后的HR = 0.67,95% CI = 0.56 - 0.79)。接受CHM治疗超过90天的患者,其死亡风险比显著低于非CHM使用者(90至180天组:调整后的HR = 0.56,95% CI = 0.42 - 0.75;>180天组:HR = 0.33,95% CI = 0.24 - 0.45)。CHM组患者的生存概率更高。白花蛇舌草和香砂六君子汤分别是最常用的单味草药和中药方剂。

结论

补充性中草药疗法可能与降低胰腺癌患者的死亡率有关。有必要进行进一步的前瞻性临床试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f6f/6041895/3a826b3e6dca/10.1177_1534735417722224-fig1.jpg

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