2024 年第 6 期 第 0 卷

中医药治疗晚期大肠癌的临床效果研究

Clinical effect of traditional Chinese medicine in the treatment of advanced colorectal cancer

作者：赵兰美张蕾陈嘉璐黄帅欧阳怡然宋卿

英文作者：Zhao Lanmei Zhang Lei Chen Jialu Huang Shuai Ouyang Yiran Song Qing

单位：南京中医药大学附属苏州市中医医院肿瘤科，苏州215000

英文单位：Department of Oncology Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine Suzhou 215000 China

关键词：大肠癌；中医综合治疗；中医证候；Karnofsky功能状态评分；无进展生存期

英文关键词：Colorectalcancer；TraditionalChinesemedicinetreatment；TraditionalChinesemedicinesyndrome；Karnofskyphysicalstatusscore；Progressionfreesurvival

• 摘要：

• 目的 探讨中医药治疗晚期大肠癌的临床效果。方法 回顾性选取2015年1月至2022年12月于南京中医药大学附属苏州市中医医院就诊的338例晚期大肠癌患者为研究对象。按照治疗方法不同将患者分为中医组（180例）和中西医组（158例），中医组以中医综合治疗为主，未采用任何化疗、靶向治疗及免疫治疗；中西医组以化疗为主，配合中医综合治疗。2个月为1个周期，2组均连续治疗2个周期。观察2组在主要临床症状、Karnofsky功能状态（KPS）评分、临床疗效及无进展生存期（PFS）方面的差异。结果 2组性别分布、年龄、发病部位、病理类型、分化程度、分期、转移部位、KPS评分、中医证型比较差异均无统计学意义（均P＞0.05）。治疗后中医组乏力、纳差、腹胀、腹痛、便秘、便溏发生率均低于中西医组（均P＜0.05）；中医组KPS评分改善优于中西医组，差异有统计学意义（P＜0.001）。中西医组总有效率高于中医组［84.8%（134/158）比73.3%（132/180）］，差异有统计学意义（P＜0.05）。中西医组PFS较中医组延长了3个月，差异有统计学意义（Log-rank χ2=4.729，P=0.030）。结论 通过中医综合治疗或中医综合治疗联合化疗均可以提高临床效果、改善临床症状和KPS评分、延长PFS。单纯中医治疗可以更好地改善临床症状和KPS评分，而中西医联合治疗在延长PFS方面具有优势。

• Objective To investigate the clinical effect of traditional Chinese medicine in the treatment of advanced colorectal cancer. Methods A total of 338 patients with advanced colorectal cancer who were treated in Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from January 2015 to December 2022 were retrospectively selected as the research objects. According to different treatment methods, the patients were divided into traditional Chinese medicine group (180 cases) and traditional Chinese and western medicine group (158 cases). The traditional Chinese medicine group was mainly treated with traditional Chinese medicine, without any chemotherapy, targeted therapy and immunotherapy. In the traditional Chinese and western medicine group, chemotherapy was given priority to, combined with traditional Chinese medicine comprehensive treatment. Two months was a cycle, and the two groups were treated for 2 consecutive cycles. The main clinical symptoms, Karnofsky performance status (KPS) score, clinical efficacy and progression free survival (PFS) were compared between the two groups. Results There was no significant difference in gender distribution, age, site of disease, pathological type, degree of differentiation, stage, metastatic site, KPS score and traditional Chinese medicine syndrome type between the two groups (all P>0.05). After treatment, the incidences of fatigue, poor appetite, abdominal distension, abdominal pain, constipation and loose stool in the traditional Chinese medicine group were lower than those in the traditional Chinese and western medicine group (all P<0.05). The improvement of KPS score in the traditional Chinese medicine group was better than that in the traditional Chinese and western medicine group (P<0.001). The total effective rate of the traditional Chinese and western medicine group was higher than that of the traditional Chinese medicine group ［84.8%（134/158） vs 73.3%（132/180）］(P<0.05). The PFS of the traditional Chinese and western medicine group was 3 months longer than that of the traditional Chinese medicine group (Log-rank χ2=4.729， P=0.030). Conclusions  Comprehensive treatment of traditional Chinese medicine or comprehensive treatment of traditional Chinese medicine combined with chemotherapy can improve the clinical effect, clinical symptoms and KPS score, and prolong PFS. Traditional Chinese medicine treatment alone can better improve clinical symptoms and KPS score, while the combination of traditional Chinese medicine and western medicine has advantages in prolonging PFS.