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上海中医药大学附属市中医医院(上海 200071)
张博,男,博士,主治医师,主要从事中医药防治恶性肿瘤临床与研究工作。*
田建辉,教授,博士研究生导师; E-mail:tjhhawk@shutcm.edu.cn
李雁,教授,博士研究生导师;E-mail:yan.xiaotian@ shutcm.edu.cn
纸质出版日期:2024-12-10,
收稿日期:2024-04-14,
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张博,周奕阳,张敏峰,等.扶正祛邪方对肺癌患者无进展生存期的影响[J].上海中医药杂志,2024,58(12):114-118.
ZHANG Bo,ZHOU Yiyang,ZHANG Minfeng,et al.Effect of Fuzheng Quxie Formula on progression⁃free survival in lung cancer patients[J].Shanghai Journal of Traditional Chinese Medicine,2024,58(12):114-118.
张博,周奕阳,张敏峰,等.扶正祛邪方对肺癌患者无进展生存期的影响[J].上海中医药杂志,2024,58(12):114-118. DOI: 10.16305/j.1007-1334.2024.2404061.
ZHANG Bo,ZHOU Yiyang,ZHANG Minfeng,et al.Effect of Fuzheng Quxie Formula on progression⁃free survival in lung cancer patients[J].Shanghai Journal of Traditional Chinese Medicine,2024,58(12):114-118. DOI: 10.16305/j.1007-1334.2024.2404061.
目的
2
回顾性分析扶正祛邪方对肺癌患者无进展生存期(PFS)的影响,探讨影响肺癌预后的相关因素。
方法
2
收集肺癌患者的病历数据并进行随访,根据扶正祛邪方的使用情况分为治疗组(在常规治疗的基础上加用扶正祛邪方)、对照组(仅采用常规治疗),采用倾向性评分匹配(PSM),分析匹配前后两组患者的PFS并借助Kaplan-Meier法计算无进展生存率;用log-rank法进行单因素分析,然后采用多因素Cox回归分析,探讨影响肺癌患者PFS的相关因素。
结果
2
①本研究共收集1 134例肺癌患者的病历数据,PSM前对照组为373例、治疗组为761例,PSM后对照组、治疗组各208例。②PSM前后,治疗组平均PFS时间均较对照组延长[
HR
=0.724,95%
CI
(0.614~0.846),
P
<
0.001;
HR
=0.5,95%
CI
(0.387~0.646),
P
<
0.001];PSM前后,治疗组I期患者的平均PFS时间均较对照组I期患者延长[
HR
=0.203,95%
CI
(0.138~0.298),
P
<
0.001;
HR
=0.219,95%
CI
(0.128~0.374),
P
<
0.001]。③单因素分析结果显示,性别、年龄、吸烟史、家族史、手术、化学疗法、分期、扶正祛邪方干预是影响肺癌患者PFS的相关因素(
P
<
0.05);多因素回归分析结果显示,低龄[
HR
=1.04,95%
CI
(1.02~1.06),
P
<
0.001]、扶正祛邪方干预[
HR=
0.97,95%
CI
(0.14~0.36),
P
<
0.001]是影响肺癌PFS的独立保护因素,吸烟[
HR
=0.58,95%
CI
(1.20~2.90),
P
=0.006]、分期[
HR
=0.83,95%
CI
(0.81~1.28),
P<
0.001]是影响肺癌PFS的独立危险因素。④随访期间,两组患者均未见明显不良反应发生。
结论
2
扶正祛邪方是肺癌患者生存预后的保护性因素,有助于预防复发转移,延长肺癌患者的PFS,且对早期肺癌患者的影响更为显著,有良好的应用前景。
Objective
2
To retrospectively analyze the effect of Fuzheng Quxie Formula (a decoction for strengthening the body's resistance and dispelling pathogenic factors) on the progression-free survival (PFS) in lung cancer patients and to explore the factors affecting the prognosis of lung cancer.
Methods
2
Clinical data from lung cancer patients were collected, and follow-up was conducted with them. Patients were divided into a treatment group (receiving the Fuzheng Quxie Formula in addition to conventional treatment) and a control group only (receiving conventional treatment) based on the use of the Fuzheng Quxie Formula. Propensity score matching (PSM) was used to compare PFS between the two groups before and after matching. Kaplan-Meier analysis was used to calculate PFS rates. Univariate analysis was conducted using the log-rank test. Multivariate Cox regression analysis was then used to identify factors affecting PFS in lung cancer patients.
Results
2
①A total of 1 134 lung cancer patients data were collected in this study, with 373 cases in the control group and 761 cases in the treatment group before PSM. After PSM, both the control and treatment groups had 208 cases each. ②The average PFS time in the treatment group was significantly longer than that in the control group before and after PSM [
HR
=0.724, 95%
CI
(0.614-0.846),
P
<
0.001;
HR
=0.5, 95%
CI
(0.387-0.646),
P
<
0.001]. Specifically, stage Ⅰ patients in the treatment group had a longer average PFS time than those in the control group before and after PSM [
HR
=0.203, 95%
CI
(0.138-0.298),
P
<
0.001;
HR
=0.219, 95%
CI
(0.128-0.374),
P
<
0.001]. ③Univariate analysis results showed that gender, age, smoking history, family history, surgery, chemotherapy, cancer staging, and the Fuzheng Quxie Formula intervention were significant related factors affecting PFS in lung cancer patients (
P
<
0.05). Multivariate regression analysis results showed that younger age [
HR
=1.04, 95%
CI
(1.02-1.06),
P
<
0.001] and the Fuzheng Quxie Formula intervention [
HR
=0.97, 95%
CI
(0.14-0.36),
P
<
0.001] were independent protective factors affecting PFS in lung cancer patients, while smoking [
HR
=0.58, 95%
CI
(
1.20-2.90),
P
=0.006] and cancer staging [
HR
=0.83, 95%
CI
(0.81-1.28),
P
<
0.001] were independent risk factors affecting PFS in lung cancer patients. ④No significant adverse reactions were observed in either group during the follow-up period.
Conclusions
2
The Fuzheng Quxie Formula is a protective factor for the survival prognosis of lung cancer patients. It helps to prevent recurrence and metastasis, thereby prolonging PFS, particularly in early-stage lung cancer patients, and shows promising potential for clinical application.
肺癌扶正祛邪方无进展生存期中医药疗法生存分析回顾性研究
lung cancerFuzheng Quxie Formulaprogression-free survivaltraditional Chinese medicine therapysurvival analysisretrospective study
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