解毒方作为肝细胞癌根治术后早期复发辅助治疗的疗效：一项倾向评分匹配研究
Efficacy of Jiedu formula as adjuvant therapy for early recurrence of hepatocellular carcinoma after radical surgery: a propensity score matching study.
作者信息
Qiuting Feng, Jiajia H U, Song Y U, Huirong Zhu, Simo Cheng, Xiaofeng Zhai
机构信息
School of Traditional Chinese Medicine, Naval Medical University, Shanghai 200433, China.
2 Oncology department, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
出版信息
J Tradit Chin Med. 2025 Apr;45(2):443-449. doi: 10.19852/j.cnki.jtcm.2025.02.019.
OBJECTIVE
To investigate the clinical efficacy of using a Jiedu formula as an adjunctive therapy in patients with hepatocellular carcinoma (HCC) after hepatectomy.
METHODS
In total, 354 patients were included in this study. All patients were categorized into the traditional herbal medicine (THM) group (115) or the non-THM treatment (nTHM) group (239), with the Jiedu formula administered twice a day to the patients in the THM group. The primary outcome was recurrence-free survival (RFS). Univariate and multivariate Cox regression analyses were performed to identify the prognostic factors associated with RFS. Then, the high risk of recurrence among patients was identified, and propensity score matching (PSM) and RFS analysis were performed to analyze the prognostic factors for the outcomes of patients at a high risk of recurrence in different groups.
RESULTS
The one, two, three, and five-year RFS rates of the THM and nTHM groups were 76.4% 66.1%, 65.5% 48.8%, 57.9% 39.9%, and 43.9% 29.2%, respectively. The results of the Multivariate Cox analysis showed that giant tumors [hazard ratio (), 1.54, 0.04], poor degree of differentiation, microsatellite, or microvascular invasion (, 1.29, = 0.09) increased the risk of recurrence. In the population with a high risk of recurrence, after PSM, the one, two, three, and five-year survival rates were 70.6% 68.0%, 63.0% 43.1%, 59.6% 33.3%, and 41.9% 26.4%, respectively.
CONCLUSION
In this study, THM was found to be an effective agent for adjuvant therapy for HCC to prevent early recurrence of HCC after hepatic resection.
目的
探讨解毒方作为辅助治疗手段在肝细胞癌（HCC）肝切除术后患者中的临床疗效。
方法
本研究共纳入354例患者。所有患者被分为传统草药治疗（THM）组（115例）和非传统草药治疗（nTHM）组（239例），THM组患者每天服用解毒方两次。主要结局指标为无复发生存期（RFS）。进行单因素和多因素Cox回归分析以确定与RFS相关的预后因素。然后，确定患者中复发高危人群，并进行倾向评分匹配（PSM）和RFS分析，以分析不同组中复发高危患者结局的预后因素。
结果
THM组和nTHM组的1年、2年、3年和5年RFS率分别为76.4%对66.1%、65.5%对48.8%、57.9%对39.9%和43.9%对29.2%。多因素Cox分析结果显示，巨大肿瘤[风险比（HR），1.54，P = 0.04]、低分化程度、微卫星或微血管侵犯（HR，1.29，P = 0.09）会增加复发风险。在复发高危人群中，PSM后1年、2年、3年和5年生存率分别为70.6%对68.0%、63.0%对43.1%、59.6%对33.3%和41.9%对26.4%。
结论
本研究发现，传统草药治疗是HCC辅助治疗的有效手段，可预防肝切除术后HCC的早期复发。
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