| Objective:TCM plays an important role in the treatment of tumors.This study aims to improve the quality of life and overall clinical status of malignant tumor patients under the guidance of Clinical state medicine,as well as provides a reliable clinical basis by using the concepts and methods of Clinical state medicine for treating malignant tumors.Methods:This study was conducted in two parts.The first part is literature research.Through a systematic review of the epidemiology of malignant tumors,the understanding of Chinese medicine and Western medicine and the progress of treatment methods,combining with the concepts,methods and main content framework of Clinical state medicine,this study discusses the methods and possibilities of promoting the quality of life,reducing emotional symptoms and improving overall clinical status of malignant tumor patients by using Clinical state medicine.Meanwhile,based on the method of evidence-based medicine,through establishing strict criteria for inclusion and exclusion,this study implements meta-analysis of improving the quality of life and emotional status of cancer patients,using a combination of Chinese medicine and psychotherapy.Hence,it provides an evidence for the implementation of Clinical state medicine.The second part is clinical research.This part contains a prospective random-controlled design in clinical research,including 100 patients who have been clinically diagnosed with malignant tumors and admitted to the Oncology Department of Shenzhen Traditional Chinese Medicine Hospital.Base on the conventional Western medicine treatment,the control group received the therapy combined with syndrome differentiation and treatment in TCM,the treatment group was treated with Clinical state medicine intervention methods.This treatment includes the prescription of"monarch,minister,assistant and guide(jun chen zuo shi)" of Clinical state medicine and the Chinese medicine of psychotherapy behavior intervention.The intervention period of both groups is for 2 months.The World Health Organization Quality of Life Scale-Brief Form Questionnaire,Overall Clinical Status Scale,Lists of Traditional Chinese Medicine Symptoms Scale,and Hamilton Rating Scale for Depression were assessed at baseline,2 weeks,1 month and 2 months after treatment.Statistical analysis was performed using SPSS20.0.The difference between the two sides was statistically significant.In the meta-analysis study:(1)TCM intervention study contains 16 studies,with 1084 participants;5 TCM psychotherapy intervention studies contain 293 participants;3 evaluations with Karnofsky Performance Status Scale contain 268 participants.(2)Compared with Western medicine alone,TCM combined with chemotherapy can significantly improve the efficiency of treatment,combined with OR=1.58(95%CI:1.24,2.03).The difference in efficiency between the two groups is statistically significant.The overall efficiency of in the group of TCM combining chemotherapy was significantly better than the chemotherapy alone group.(3)Compared with chemotherapy alone,the combination of TCM and psychotherapy's intervention can significantly improve the efficiency of treatment.The combined effect rate is OR=7.22(95%CI:2.14,138.7)The difference in efficiency between the two groups was statistically significant,indicating that the total clinical efficacy of Chinese medicine combined with psychotherapy intervention was higher than that of chemotherapy alone.(4)Compared with chemotherapy alone,TCM combined with psychological behavior intervention can significantly improving the quality of life of patients.The combined effect rate is OR=2.69(95%CI:1.40,5.17).The total effective difference between the two groups in improving the patients' quality of life is statistically significant,indicating that TCM combined with psychotherapy's intervention is more effective in improving patients' quality of life than chemotherapy alone.In the clinical study:(1)A total of 100 patients who met the inclusion criteria were enrolled in the study.They were randomly divided into TCM syndrome group(control group,n=50)and a Clinical state medicine group(treatment group,n=50).After 2 months of treatment,2 patients in the control group and 2 patients in the treatment group were dropped(all due to inability to contact).Eventually each group contain 48 patients.(2)There were no significant differences in the general characteristics(age,gender)and clinical features(tumor type,KPS,overall status,TCM symptoms,quality of life scores,HAMD)between the two groups(p>0.05).The two groups are shown to be homogeneous and comparable.(3)After 2 months of treatment,the treatment group was better than the control group at the five fields:KPS(Z=-3.856,p=0.000),overall status(Z=-4.837,p=0.000),HAMD(Z=-2.329,p=0.020)The symptoms of TCM(Z=-2.239,p=0.025)and quality of life(Z=-2.307,p=0.021).The difference was statistically significant,indicating that the Clinical state medical intervention is able to comprehensively improve the patients' quality of life,emotional status,physical symptoms of malignant tumor patients,and ultimately improve the overall clinical status of patients.(4)Comparison inside a group before and after KPS treatment:comparison with Bonferroni pairwise comparisons indicated:Except for the comparison between baseline and after two weeks which was statistically insignificant,the rest were found to be statistically significant(p<0.05).(5)Comparison inside a group before and after overall clinical status treatment:Bonferroni pairwise comparisons indicated:The differences between the baseline and the treatment were statistically significant(p<0.05).(6)Comparison inside a group before and after TCM symptoms treatment:Bonferroni pairwise comparisons indicated:There was no statistical significance in the difference between the baseline and the two weeks after treatment(p>0.05).There was no statistical significance in the difference between treating for 1 month and for 2 months(p>0.05).The difference in other comparisons were statistically significant(p<0.05).(7)Comparison inside a group in terms of quality of life before and after treatment:Bonferroni pairwise comparison indicated:There was no statistical significance in the comparison between treating for 2 weeks and 1 month(p>0.05)and the comparison between treating for 1 month and 2 months(p>0.05).The rest were statistically significant(p<0.05).(8)Comparison inside a group before and after the treatment with HAMD:Bonferroni pairwise comparison indicated:There was no statistical significance in the comparison between treating for two weeks and 1 month(p>0.05)and the comparison between treating for 1 month and 2 months(p>0.05).The rest were statistically significant(p<0.05).Conclusion:Combined with the application of Clinical state medicine treatment methods,which can effectively improve patients' quality of life,emotional status and reducing physical symptoms,thereby significantly improving the overall clinical status of patients.The change of score in the overall clinical status is a sensitive indicator of the improvement of symptoms in patients diagnosed with malignant tumors. |
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