Objective:To evaluate the effect of integrated traditional Chinese and western medicine treatment on the overall survival of patients with advanced pancreatic adenocarcinoma. MethodsBy adopting non-randomized simultaneous case-control method, patients with advanced pancreatic adenocarcinoma were divided into traditional Chinese medicine (TCM) group and non-TCM group according to whether they received TCM or not; Patients with advanced pancreatic adenocarcinoma were divided into integrated treatment group and western medicine treatment group according to whether they received standard anti-tumor western medicine treatment (chemotherapy and/or radiotherapy). Taking the overall survival (OS) as the main efficacy evaluation index, Cox multivariate regression analysis was used to analyze the factors influencing the survival time of advanced pancreatic adenocarcinoma, and Kaplan-Meier method was used to estimate the median survival time, and the impact of integrated traditional Chinese and western medicine treatment on the survival time of patients with advanced pancreatic adenocarcinoma was evaluated.  Results:①A total of 305 patients with advanced pancreatic adenocarcinoma were included, with 157 cases in the TCM group and 148 cases in the non-TCM group; 245 patients were treated with standard anti-tumor western medicine treatment (chemotherapy and/or radiotherapy), 127 cases in the integrated treatment group and 118 cases in the western medicine treatment group. ②The median OS of the TCM group was 14.9 months, significantly longer than that of the non-TCM group, which was 9.6 months (P<0.001, HR=0.471,95% CI:0.361~0.613); The median OS was 14.1 months in the integrated treatment group, which was significantly longer than 9.7 months in the western medicine treatment group (P<0.001, HR=0.491,95% CI:0.367~0.658). ③The 1-, 2-, 3-, and 5-year survival rates were 41%, 23%, 16% and 11% in the TCM group while those of non-TCM group were 18%, 11%, 6% and 3% respectively, with statistically significant difference (P<0.001); The 1-, 2-, 3-, and 5-year survival rates in the integrated treatment group were 37%, 19%, 12% and 8% respectively, while those in the western medicine treatment group were 16%, 10%, 5% and 1% respectively, with statistically significant difference (P<0.001). ④Multivariate analysis showed that age (P=0.003), KPS score (P<0.001), surgery (p<0.001), chemotherapy (P<0.01) and TCM (P<0.001) were independent prognostic factors affecting the survival of patients with advanced pancreatic adenocarcinoma, and age and chemotherapy were non-protective independent prognostic factors. ⑤The incidence of leukopenia, neutropenia, thrombocytopenia, nausea and vomiting in the integrated treatment group was lower than that in the western medicine treatment group (P<0.05). Meanwhile, the incidence of grade Ⅲ~Ⅳ leukopenia and thrombocytopenia in the integrated treatment group was lower than that in the western medicine treatment group (P<0.05).  Conclusion:Traditional Chinese herbal medicine treatment is an independent prognostic factor affecting the survival of patients with advanced pancreatic adenocarcinoma; integrated traditional Chinese and western medicine treatment can prolong the overall survival of patients with advanced pancreatic adenocarcinoma, and reduce the incidence of leukopenia, thrombocytopenia, nausea and vomiting after chemotherapy.