Retrospective Cohort Study On The Treatment Of Primary Liver Cancer With Liver Depression And Spleen Deficiency By Combination Of Traditional Chinese And Western Medicine In Real World

Objective: Through retrospective analysis,to explore the clinical efficacy of Chinese and western combined treatment compared with simple western treatment in liver qi and spleen deficiency type primary liver cancer,so as to provide data support and reference for the more effective treatment of liver Qi and spleen deficiency type primary liver cancer by integrated Chinese and western medicine.Method: We collected outpatients and inpatients from Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine and Xinjiang Uygur Autonomous Region People’s Hospital from January 2012 to October2020.Using the design of cohort study,"syndrome differentiation into liver depression and spleen deficiency type,and receiving TCM treatment for at least three months within one year of enrollment" was taken as the exposure factor.Patients eligible for this condition were assigned to the Chinese and Western treatment cohort group(n=160),while patients not eligible for this condition were assigned to the Western treatment cohort group(n=189).The overall survival time of patients in the two cohorts was compared through regular follow-up survey,and the first,third and five-year survival rates were calculated.Multivariate risk proportional regression model was used to analyze prognoses related factors.To explore the effectiveness of both treatments.Results: The OS of Chinese and western treatment cohort was 18 months,and that of Western treatment cohort was 17 months,the difference was statistically significant [HR = 0.769,95%CI(0.611-0.965),P < 0.05].The 3rd and 5th year survival rates of Chinese and western treatment cohort were significantly higher than those of Western treatment cohort(21.25%,34/160 VS 10.05%,19/189),(7.5%,12/160 VS 2.12%,4/189)were statistically significant(3 years: χ~2 = 8.456,P = 0.004;5 years: P = 0.02).Compared with Western medicine treatment group,the survival time in surgical treatment,ablation,chemotherapy,hepatitis and PS 0-1 subgroups was longer in the Chinese and western treatment cohort,and the differences were statistically significant(P < 0.05).AFP≥400g/L and maximum lesion diameter ≥5cm were independent risk factors.Surgery,radiation,intervention and traditional Chinese medicine were protective factors,and traditional Chinese medicine treatment as protective factors [HR = 0.787,95%CI(0.620-0.996),P < 0.05] could reduce the risk of death of primary liver cancer by 21.3%.Conclusion: Chinese and western treatment cohort can prolong the survival of liver cancer patients with liver depression and spleen deficiency,and the benefits are more obvious in the patients with surgical treatment,ablation,chemotherapy,hepatitis and PS 0-1.Chinese and western treatment cohort can reduce the risk of death in patients with primary liver cancer of liver depression and spleen deficiency type.