Wu Li-Na, Xie Yan-Ming, Liu Huan, Zhang Yin, Lu Qi, Zhuang Yan
Institute of Basic Research in Clinical Chinese Medicine, China Academy of Chinese Medical Sciences Beijing 100700, China Wangjing Hospital of China Academy of Chinese Medical Sciences Beijing 100102, China.
Institute of Basic Research in Clinical Chinese Medicine, China Academy of Chinese Medical Sciences Beijing 100700, China.
Zhongguo Zhong Yao Za Zhi. 2020 Mar;45(5):1174-1179. doi: 10.19540/j.cnki.cjcmm.20190620.501.
In order to explore the characteristics of traditional Chinese medicine(TCM) syndromes and medications in patients with colonic malignant tumors in China, the clinical data of patients with colonic malignant tumors from the information system of 33 Grade-A tertiary hospitals in China from 2001 to 2016 were extracted and a descriptive analysis was conducted on their disease characteristics, syndrome distribution, drug characteristics and treatment status. A total of 22 691 patients with colonic malignancies nationwide were included in the analysis, with male to female ratio of 1.59∶1, median age of 62 years, susceptible age of 50-79 years. Postoperative patients with colonic malignant tumors accounted for 47.10%, and patients with liver metastases reached 36.02%. Among the 520 patients with colonic malignant tumors, the top three TCM syndromes were: spleen deficiency syndrome(21%), Qi and Yin deficiency syndrome(17%) and liver and stomach disharmony syndrome(15%). The most frequently used Western medicine for patients with colonic malignant tumors was anti-metabolite cytotoxicity(61.23%), most frequently used in combination with platinum-based cytotoxic drugs(support degree 42.40%).The top three Western medicines were oxaliplatin(42.26%), leucovorin injection(38.58%) and dexamethasone(34.67%). The most frequently used traditional Chinese medicine type was heat-clearing and detoxifying drugs(39.59%), most frequently used in combination with Qi replenishing and body resistance strengthening drugs(support degree 12.72%). The top three traditional Chinese medicines were compound Kushen Injection(14.62%), Shenqi Fuzheng Injection(10.18%) and Aidi Injection(6.48%). This study shows that spleen and Qi deficiency may be the dominant syndrome of colonic malignant tumor, and chemotherapy is one of the main treatment methods. Traditional Chinese medicine has shown unique advantages in alleviating the toxic and side effects of chemotherapy and preventing recurrence and metastasis, so integrated TCM and Western medicine can significantly improve the clinical efficacy.
为探究我国结肠恶性肿瘤患者的中医证候及用药特点，提取了我国33家三级甲等医院信息系统中2001年至2016年结肠恶性肿瘤患者的临床资料，并对其疾病特征、证候分布、用药特点及治疗状况进行了描述性分析。纳入分析的全国结肠恶性肿瘤患者共22691例，男女比例为1.59∶1，年龄中位数为62岁，好发年龄为50 - 79岁。结肠恶性肿瘤术后患者占47.10%，肝转移患者达36.02%。在520例结肠恶性肿瘤患者中，中医证候前三位依次为：脾虚证（21%）、气阴两虚证（17%）、肝胃不和证（15%）。结肠恶性肿瘤患者最常用的西药为抗代谢类细胞毒性药物（61.23%），最常与铂类细胞毒性药物联合使用（支持度42.40%）。西药前三位依次为奥沙利铂（42.26%）、亚叶酸钙注射液（38.58%）、地塞米松（34.67%）。最常用的中药类型为清热解毒药（39.59%），最常与补气扶正药联合使用（支持度12.72%）。中药前三位依次为复方苦参注射液（14.62%）、参芪扶正注射液（10.18%）、艾迪注射液（6.48%）。本研究表明，脾虚和气虚可能是结肠恶性肿瘤的主要证候，化疗是主要治疗手段之一。中医在减轻化疗毒副作用、预防复发转移方面显示出独特优势，中西医结合可显著提高临床疗效。
