| 中医药对原发性肝癌微波消融后生存状态影响的回顾性队列研究 |
| 投稿时间：2016-07-10 修订日期：2016-08-02 点此下载全文 |
| 引用本文：王建彬,杨宇飞,韩志宇,程志刚,于晓玲,梁萍.中医药对原发性肝癌微波消融后生存状态影响的回顾性队列研究[J].医学研究杂志,2017,46(1):49-52 |
| DOI：
10.11969/j.issn.1673-548X.2017.01.014 |
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| 基金项目:国家科技部科技支撑计划项目（2013BAI01B01） |
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| 中文摘要:目的 探讨中医药治疗对原发性肝癌微波消融后患者生存状态的影响。方法 以消融时间在2008年1月1日~2010年7月31日间的原发性肝癌微波消融治疗后患者为研究对象，随访中详细记录患者使用中药情况，根据服用中药时间分高暴露、低暴露和无暴露3个队列。结果 总共入组336例，失访31例，纳入统计305例，其中男性253例，女性52例；患者年龄56.24±11.19岁；高暴露队列105例、低暴露队列93例、无暴露队列107例。3组在性别、年龄、病灶数目、病灶大小、最大直径、基础肝病类型、病理分化程度、Child分级等方面差异无统计学意义（P>0.05）。高暴露、低暴露及无暴露组的总的复发、转移率分别为69.2%（74/107）、50.5%（47/93）、61.9%（65/105），低暴露组的1、2年复发、转移率与无暴露组相比差异有统计学意义（P值分别为0.014、0.009），高暴露组的1年复发、转移率与无暴露组相比差异有统计学意义（P=0.025），2年的复发、转移率虽低于无暴露组，但差异无统计学意义（P=0.131）。高暴露组与低暴露组相比，1、2年的复发、转移率均差异无统计学意义（P值分别为0.880、0.306）。3组总的病死率分别为39.3%（42/107）、30.1%（28/93）、28.6%（30/105）。3组的1年生存率均>90%，差异无统计学意义（P>0.05），高暴露组3年的累计生存率与无暴露组相比差异有统计学意义（P=0.043）。多因素Cox回归分析表明，服用中药为保护因素，低暴露与高暴露的相对危险度分别为0.648、0.693，回归系数分别为-0.434、-0.367。结论 对于微波消融术后的原发性肝癌患者，联合中医药治疗可以减少微波消融治疗后的复发转移，并由此提高3年生存率。 |
| 中文关键词:原发性肝癌 微波消融治疗 中医药治疗 队列研究 |
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| A Retrospective Cohort Study of Traditional Chinese Medicine on Primary Liver Cancer after Percutaneous Microwave Ablation |
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| Abstract:Objective To investigate the efficiency of traditional Chinese medicine (TCM) on the survival of primary liver cancer (PLC) after percutaneous microwave ablation (PMWA). Methods From January 2008 to July 2010, patients with PLC received PMWA were reviewed retrospectively. Patients received TCM treatment by syndrome differentiation voluntarily or not, also with or without a traditional patent medicine. According to the time of TCM treatment, the patients were classified into high exposure group, low exposure group and non-exposure group. Results In all 336 patients, 31 of them were lost to follow-up. The high exposure, low exposure and non-exposure group contained 105, 93 and 107 respectively. The recurrence and metastasis rates of 1-year and 2-year of the low exposure group were lower significantly compared to that of the non-exposure group (P=0.014 and 0.009). In high exposure group, the recurrence and metastasis rates of 1-year were lower significantly compared with the non-exposure (P=0.025). The 3-year overall survival rate of the high exposure group was lower significantly compared with the non-exposure group (P=0.043). Conclusion The treatment of TCM may reduce the recurrence and metastasis of PLC after PMWA, and improve the 3-year survival rate. |
| keywords:Primary liver cancer (PLC) Percutaneous microwave ablation(PMWA) Traditional Chinese medicine(TCM) Cohort study |
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