摘要
目的基于45例接受二线及后续治疗的晚期胃癌患者的临床资料,探讨该类患者的中医、西医临床特征。方法对符合纳入标准的晚期胃癌患者,根据治疗方式分为一线治疗、二线及后续治疗2组,通过组间比较和文献研究归纳总结二线及后续治疗患者的中西医临床特征。结果45例接受二线及后续治疗的晚期胃癌患者男女比例约为3∶1,年龄(57.53±12.96)岁,体质指数(BMI)(21.51±3.89)kg/m^(2),血红蛋白(111.58±17.82)g/L,血清白蛋白(38.78±5.52)g/L,卡氏评分(KPS)集中于80分及以上,分化程度以低分化为主,原发灶以近端胃居多,远处转移以单脏器转移最为常见,与接受一线治疗患者比较,差异无统计学意义(P>0.05);而腺癌占比95.56%,生存时间(440.80±177.42)d,明显高于接受一线治疗患者(P<0.05)。中医证素中,病位证素的组合主要为脾、脾与肝、脾与肾,对应的病性组合分别为气虚证、痰湿证并见,气虚证、气滞证、痰湿证并见,气虚证、阴虚证并见。结论接受二线及后续治疗的晚期胃癌患者中医病位以脾、肝、肾为主,病性证素表现为虚实夹杂,临床宜合理安排扶正、祛邪等治法;与一线治疗患者相比,二线及后续治疗患者的西医特征表现为腺癌为主,印戒细胞癌极少。
Objective To investigate the clinical characteristics of Chinese medicine and western medicine in 45 patients with advanced gastric cancer who received second-line and follow-up treatment based on the clinical data of these patients.Methods Patients with advanced gastric cancer who met the criteria for inclusion in the subject were divided into first-line treatment,secondline treatment and follow-up treatment according to the treatment methods.Through the comparison between groups and literature research,the clinical characteristics of Chinese and western medicine in patients with second-line and follow-up treatment were summarized.Results The male-to-female ratio of 45 patients with advanced gastric cancer who received second-line and subsequent treatments was about 3∶1,the average age was(57.53±12.96)years,the average BMI was(21.51±3.89)kg/m2,and the average hemoglobin was(111.58±17.82)g/L,serum albumin is(38.78±5.52)g/L,KPS score was concentrated at 80 points and above,and the degree of differentiation was mainly poorly differentiated.The primary tumor was mostly in the proximal stomach,and the distant metastasis was the most common single organ metastasis,there was no statistically significant difference compared to the first-line treatment patients(P>0.05);while adenocarcinoma accounted for 95.56%,and the average survival time was(440.80±177.42)days,which was significantly higher than that of the first-line treatment patients(P<0.05).The TCM evidence elements showed the characteristics of pathological combinations of spleen,liver and spleen,and spleen and kidney,and their corresponding pathological combinations were Qi deficiency with phlegm-dampness,Qi deficiency,Qi stagnation with phlegm-dampness,and Qi deficiency with Yin deficiency.Conclusion The pathological sites of 45 patients with advanced gastric cancer receiving second-line and follow-up treatment were mainly spleen,liver and kidney in TCM,and the pathological elements showed a combination of deficiency and excess,so it is advisable to use the treatment method of supporting the antipathogenic Qi and eliminating the pathogenic factors in a reasonable way.Compared with the first-line treatment patients,the western medicine characteristics of the second-line and follow-up treatment patients are mainly adenocarcinoma,but signet ring cell carcinoma is rare.
作者
吴朝旭
侯丽
李潇
南梦蝶
刘常玉
董青
WU Chao-xu;HOU Li;LI Xiao;NAN Meng-die;LIU Chang-yu;DONG Qing(Department of Integrated Traditional Chinese and Western Medicine,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Hematology and Oncology,Dongzhimen Hosptial,Beijing University of Chinese Medicine,Beijing 100700)
出处
《北京中医药》
2023年第3期333-337,共5页
Beijing Journal of Traditional Chinese Medicine
基金
首都卫生发展科研专项重点攻关项目(2016-1-4171)
首都卫生发展科研专项项目(2020-2-4193)。
关键词
晚期胃癌
二线治疗
后续治疗
临床特征
advanced gastric cancer
second-line treatment
follow-up treatment
clinical characteristics
