The type of Traditional Chinese Medicine syndrome predicts prognosis and chemotherapeutic outcomes in colorectal cancer
The type of Traditional Chinese Medicine syndrome predicts prognosis and chemotherapeutic outcomes in colorectal cancer
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中医证型预测结直肠癌的预后和化疗效果
DOI：
10.1016/j.eujim.2019.101026
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发表时间：
2020-01-01
影响因子：
2.5
通讯作者：
Zhou, Yan
中科院分区：
文献类型：
--
作者：
Li, Dan;Wang, Weimin;Zhou, Yan
简介：如果要提供有效的医疗保健，通过确定预后因素来识别和定位可以从干预中受益的患者越来越重要。方法：选取2006 - 2010年在结直肠癌数据库中登记并有详细临床资料的470例结直肠癌患者，按中医辨证分型进行分类。CRC患者分为脾虚证、寒热瘀阻证、瘀位阻证、脾肾阳虚证、肝肾阴虚证、气血两虚证。采用Kaplen-Meier法计算各中医证型的累积生存曲线，采用考克斯回归分析进一步分析中医证型与预后及化疗疗效的相关性。考克斯回归分析模型、单因素和多因素分析证实中医证型是预测结直肠癌患者预后的独立因素;实证患者通过术后辅助化疗可显著延长总生存期。实证患者可从术后辅助化疗中获益。而且，在六种中医证型中，虚证患者的预后最好。
Introduction: Identifying and targeting patients who can benefit from an intervention by determining the prognostic factors is increasingly important if effective healthcare is to be provided. This study analyzed whether Traditional Chinese Medicine (TCM) syndrome differentiation could be used to determine prognosis and chemotherapeutic efficacy in colorectal cancer (CRC) patients.Methods: A total of 470 patients registered on the CRC database between 2006 and 2010 and with detailed clinical data were categorised according to TCM syndrome differentiation. Patients with CRC were divided into spleen deficiency syndrome, stagnation of cold-heat syndrome, stasis position resistance syndrome, spleen-kidney yang deficiency syndrome, liver-kidney yin deficiency syndrome, dual deficiency of qi and blood syndrome. Kaplen-Meier method was used to calculate the cumulative survival curve of TCM syndrome types and the COX regression analysis further analyzed the correlation between TCM syndrome types and prognosis and chemotherapeutic efficacy.Results: The survival rate of patients with deficiency syndrome was higher than that of patients with excess syndrome, and the survival rate of patients with dual deficiency of qi and blood syndrome was higher than other types. The COX regression analysis model, single factor and multi-factor analysis confirmed that TCM syndrome type was an independent factor in predicting the prognosis of patients with CRC; excess syndrome patients can significantly prolong their overall survival through postoperative adjuvant chemotherapy.Conclusions: The prognosis of CRC patients with deficiency syndrome was better than patients with excess syndrome. Patients with excess syndrome could benefit from postoperative adjuvant chemotherapy. Moreover, patients with deficiency syndrome have the best prognosis among the six TCM syndrome types.