To Explore The Efficacy Of The Guben Xiaoji Method In The Treatment Of Advanced Gastric Cancer And The Characteristics Of The Beneficiary Population Based On Real-world Experienc

Objective:Through Meta analysis of clinical literature and real-world research,this project preliminarily evaluated the clinical efficacy and safety of Guben Xiaoji method combined with chemotherapy in the treatment of gastric cancer,so as to provide scientific basis for the treatment of gastric cancer with trad itional Chinese medicine.Methods:(1)Meta analysis of clinical literature:the literatures about the tr eatment of gastric cancer with traditional Chinese medicine collected in the d atabases of CNKI,VIP and Wanfang in the past 20 years were searched,and screened according to the inclusion and exclusion criteria.Finally,41 articles involving 3286 cases were included.Using RevMan5.3 software for statistical analysis,with survival rate,TCM syndrome score,KPS score,blood routine,liver and kidney function,common adverse reactions as observation indicators,literature Meta analysis to evaluate the efficacy and safety of traditional Chi nese medicine combined with chemotherapy in the treatment of gastric cancer.(2)Clinical real-world study:gastric cancer patients from the inpatient depar tment of Hunan traditional Chinese Medicine Cancer diagnosis and treatment C enter in the past 10 years were selected according to the inclusion criteria an d exclusion criteria,and finally 61 cases were included.PFS,OS,disease cont rol rate,TCM syndrome score,quality of life,KPS score and weight change were observed.According to "survival time≥18 months",the patients were div ided into "benefit group" and "non-benefit group".The survival benefit and pr ognosis were analyzed by SPSS26.0 statistical software.Results:(1)Literature study:①the survival rate,TCM syndrome improveme nt,KPS score improvement and disease control rate in the traditional Chinese medicine combined with chemotherapy group were higher than those in the si mple chemotherapy group(P<0.0001).②The leukopenia rate,thrombocytopeni a rate,liver and kidney function damage and fatigue in the traditional Chines e medicine combined with chemotherapy group were lower than those in the s imple chemotherapy group(P<0.0001).(2)Clinical real world study:①outco me index:after 2 courses of treatment with Guben Xiaoji method combined w ith chemotherapy,the disease control rate was 68.85%,the proportion of patie nts with stable or increased body weight was 72.13%,and the improvement ra te of KPS score was 68.85%.The total effective rate of TCM syndrome impro vement was 63.93%,the 12-month survival rate was 78.69%,the 18-month sur vival rate was 65.57%,the 24-month survival rate was 40.98%.After 2 course s of treatment with Guben Xiaoji method and chemotherapy,the levels of CA 72-4,CA19-9 and CEA were significantly lower than those before treatment.②PFS:the average PFS was 11.314±0.343 months.KPS score,pathological ty pe and intervention time of traditional Chinese medicine were all independent factors affecting PFS.③OS:the average OS was 29.043±0.658 months,and t he intervention time of traditional Chinese medicine was an independent factor affecting OS,and the difference was statistically significant(P<0.05).④Ad verse reactions:the incidences of leukopenia,thrombocytopenia,nausea and vo miting,fatigue and liver and kidney damage were 32.79%,24.59%,26.23%,32.79%and 11.48%,respectively.⑤The results of logistic regression analysis s howed that when other factors were the same,Guben Xiaoji method combined with chemotherapy had better curative effect on gastric cancer patients<60 years old,middle and high differentiation degree,stasis-toxin internal knot sy ndrome and deficiency of both qi and blood syndrome(P<0.05).Conclusion:(1)Traditional Chinese medicine combined with chemotherapy can effectively prolong the survival time of patients with gastric cancer,improve disease control rate,improve patients’ quality of life,and reduce chemothera py-related side effects.(2)The independent factors affecting PFS included KP S score,pathological classification and intervention time of traditional Chinese medicine.The independent factor affecting OS is the intervention time of tra ditional Chinese medicine.(3)Gastric cancer patients with deficiency of both qi and blood and internal binding syndrome of blood stasis and toxin are the dominant groups who benefit from the treatment of Guben Xiaoji prescription.