| Part1 The Prospective Cohort Study Of The Recurrence And Metastasis Impact On TheⅡ,ⅢStage Of Colorectal Cancer With TCM Comprehensive TreatmentIn recent years, the incidence of colorectal cancer are increasing, The patient withⅡ,Ⅲstage of colorectal cancer receive Western conventional treatment(radical surgery,and/or postoperative adjuvant chemotherapy, and/or postoperative adjuvant radiation therapy, according to 2009 NCCN clinical guideline), the basic objective is reduce the 1 to 5 year's relapse and metastasis, to improve the cure rate.1 to 3 years after radical surgery of colorectal cancer is the peak of recurrence and metastasis, the patients are cured if they have no relapse and metastasis 5 years after radical surgery. The patients who have relapse and metastasis with advanced stage can not be cured, the median survival time 26 months if they receive the best treatment.At present, the research that whether the TCM Comprehensive Treatment (Chinese herb and Chinese patent medicines more than 1 year) could further reduce the relapse and metastasis and improve the cure rate is drawing both at home and abroad medical specialists'attention.This article applies cohort study, We observe 291 cases ofⅡ,Ⅲstage colorectal cancer patients with radical surgery, on the basis of Western conventional treatment whether use the TCM Comprehensive Treatment,whether affect the patients'relapse and metastasis, trying to provide a reliable basis for the doctors to draw up more optimized treatment for colorectal cancer patients withⅡ,Ⅲstage.Objective:Probe into the clinical value of using the TCM Comprehensive Treatment on the basis of Western conventional treatment to reduce the relapse and metastasis ofⅡ,Ⅲcolorectal cancer patientsMethods:Application prospective cohort study.We collect 291 colorectal cancer patients who with radical surgery inⅡ,Ⅲstage from 2 upper first-class hospitals, including 222 patients whose surgery time form Feb,2000 to Mar,2006, patients from the Beijing Military Region General hospital 115 cases, as the Western conventional treatment group; form the Xi yuan hospital 107 cases, as the integrative Chinese and Western medicine Treatment (on the basis of Western conventional treatment use the TCM Comprehensive Treatment) group 1; and 69 patients of the Xi yuan hospital, the surgery time form Apr,2007 to Feb,2009, as integrative Chinese and Western medicine Treatment group 2. The patients who are in the Western conventional treatment group only receive the Western conventional treatment, including radical surgery, chemotherapy and/or radiotherapy, the integrative Chinese and Western medicine Treatment group use Western conventional treatment and TCM comprehensive treatment (Chinese herb and Chinese patent medicines more than 1 year). Every 3-6 months makes a follow-up visit one time, last 5 years. Observe these three groups'1,2,3,4,5 year's relapse and transfer rate, compare the result between the TCM Comprehensive Treatment group and the Western conventional treatment group.Results:Till to Apr 2010, the last follow up, there are 17 cases lost to follow up of the Western conventional treatment group, the rate is 14.78%(17/115); 10 cases lost to follow up of the integrative Chinese and Western medicine Treatment group 1, the rate is 9.34%(10/107); 2 cases lost to follow up of the integrative Chinese and Western medicin Treatment group 2, the rate is 2.89%(2/69). The 1,2,3,4,5 year's relapse and transfer rate of Western conventional treatment group is 5.10%(5/98),21.42%(21/98),27.55%(27/98),37.76%(37/98) and 40.96%(34/83), the integrative Chinese and Western medicine Treatment group 1 is 0 (0/97), 2.06%(2/97),11.34%(11/97),12.37%(13/97),14.10%(11/78), compare to these two groups' relapse and transfer rate of 2,3,4,5 year's, the difference has statistics significance (P<0.05).The 1,2 year's relapse and transfer rate of the integrative Chinese and Western medicine Treatment group 2 is 1.49%(1/67),6.06%(2/33)。Compare to the integrative Chinese and Western medicine Treatment group 1 the difference has not statistics significance (P>0.05),but compare to the Western conventional treatment group, the 2 year's difference has statistics significance (P<0.05). The median relapse and transfer time of the integrative Chinese and Western medicine Treatment group 1 is 29 months, and the Western conventional treatment group is 21 months, and tthe integrative Chinese and Western medicine Treatment group 2 is 13 months.Conclusions:Using the TCM Comprehensive Treatment on the basis of Western conventional treatment may reduce the relapse and metastasis ofⅡ,Ⅲstage colorectal cancer patients, has great clinical value for improve the cure rate, is worth further studying and promoting. Part 2 The investigation and study of the purpose on taking chinese medicine by patients who didⅡ,Ⅲcolorectal cancer radical surgeryThe colorectal cancer is serious disease that affects our quality of life, health and lives greatly, and the treatment cycle is very long. Early intervention for Chinese medicine prevention and treatment of colorectal cancer has a very important and unique position. There is evidence that Chinese medicine can reduce the stageⅡ,Ⅲcolorectal cancer patients undergoing radical operation (after routine treatment by Western medicine) of recurrence and metastasis . On this basis, Chinese medicine is becoming increasingly popular, the majority of patients with colorectal cancer will be domestic initiative to Chinese medicine hospital governance, medicine use in the follow-up treatment.In this study, the patients were self-completed diary. We investigate the purpose thatⅡ,Ⅲcolorectal cancer patients take the Chinese medicine, whether the patients have met the expected goal, whether the patients feel discomfort after take the Chinese medicine, to observe patients'attitude to Chinese medicine.Objective:Investigate the purpose thatⅡ,Ⅲcolorectal cancer patients take the Chinese medicine.Methods:We collect 55 patients of the Xi yuan hospital, whose surgery time form Apr,2007 to Feb,2009. To provide the patient's diary, ask them complete it by themselves. Description the patients' purpose for 3rd months they take the Chinese medicine.Results:We take back total of 36 patient diaries, serving the purpose of Chinese medicine in order to improve the quality of life 52.78%,30.56% for the prevention of recurrence and metastasis; nearly 75% of patients after taking Chinese herbs that could meet the objective. There 27.78% of patients feel unwell after taking Chinese herbs, mainly diarrhea, stool shapeless.
|
PDF Full Text Request