Retrospective Cohort Study Of Patients With Primary Hepatocellular Carcinoma Treated With Moving Qi And Resolving Phlegm And Masses

Purpose:The treatment method of moving qi and resolving phlegm and masses in terms of traditional Chinese medicine(TCM)has been widely used in clinical practice of primary hepatocellular carcinoma and its therapeutic effect is observed and evaluated by its influence on survival time of patients with primary hepatocellular carcinoma through a retrospective cohort study.Method:205 medical records of patients with primary hepatocellular carcinoma were collected from the following 7 hospitals from January 2012 to December 2016 by a retrospective cohort study.These patients were divided into two cohorts,one cohort with conventional medicine(A group)and the other one with integrated method of conventional medicine and traditional Chinese medicine of moving qi and resolving phlegm and masses(B group).Survival time was compared between two groups,and also compared under different TNM stage.According to conventional medicine measure difference,survival time was compared again under Surgical Treatment,RFA,TACE.At the same time,recurrence and metastasis rate were compared between two groups.15 prognosis factors were selected,and analyzed by the Cox regression method.The dangerous factors and protective factors were screened out,providing references for future treatment of HCC.Result:The meidan survival time was compared,with 10 months in group A,and 16 months in group B.The difference was statistically significant(P < 0.01).(2)Comparison based on different stages of tumor: Stage?: median survival time of group A was 20 months,and it was 30 months in group B.The meidan survival time was compared between two groups,Log-Rank test P < 0.05,suggesting that the difference was statistically significant,and Bresolw test P>0.05,suggesting that the difference was not statistically significant.So patients in group B can get better improvement in terms of long-term survival rate than those in group A.There was no difference with regard to recent survival rate between the two groups.Stage ?:the median time of group A was12 months,and it was 19 month in group B.The meidan survival time was compared between two groups,Log-Rank test and Breslow test showed significant difference(P <0.01),the survival time of the group B was longer.Stage ?:the median time of group A was 9 months,and it was 12 months in group B.The meidan survival time was compared between two groups,Log-Rank test and Breslow test showed significant difference(P <0.01),the survival time of the group B was longer.(3)In the group A,there were 39 cases of recurrence and metastasis patients,and 30 cases in group B.The recurrence and metastasis rate was compared between two groups,suggesting that the group A was higher than the group B in recurrence and metastasis rate(P < 0.05).(4)Different conventional medicine measures: a:Surgical Treatment:the median survival time of the group A was 13 months,and it was 18 months in the group B.The meidan survival time was compared between two groups,Log-Rank test P < 0.05,Breslow test P > 0,05,So patients in group B can get better improvement in terms of long-term survival rate than those in group A.There was no difference with regard to recent survival rate between the two groups.b: RFA: the median survival time of the group A was 14 months,and it was 18 months in the group B.The meidan survival time was compared between two groups,Log-Rank test P>0.05,Breslow test P<0,05,So patients in group B can get better improvement in terms of short-term survival rate than those in group A.c:TACE: the median survival time of the group A was 8months,and it was 14 months in the group B.The meidan survival time was compared between two groups,both the Log-rank test and the Breslow test showed the differences were statistically significant(P <0.01),the survival time of the group B was longer.(5)Liver cirrhosis,tumor size,tumor thrombus,Child-pugh stage,tumor TNM stage are dangerous prognostic factors for primary HCC(B > 0),and Chinese medicine treatment and RFA are protective factor for prognosis of HCC(B<0).Conclusion:1.Treatment of the integrated medicine could significantly improve patients' survival time compared with conventional therapy(including TACE).The integrated medicine is proved to be influential to the long-term survival rate rather than recent survival rate compared with conventional medicine in Surgical Treatment.And the integrated medicine is proved to be influential to the recent-term survival rate rather than long-term survival rate compared with conventional medicine in RFA.2.Patients in group B have longer survival time than the group A in stage??.But in stage ?,patients in group B can get better improvement in terms of long-term survival rate than those in group A in stage ??.There was no difference with regard to recent survival rate between the two groups.3.The group A was higher than the group B in recurrence and metastasis rate.4.Liver cirrhosis,tumor size,tumor thrombus,Child-pugh stage,tumor TNM stage are dangerous prognostic factors for primary HCC,and Chinese medicine treatment and RFA are protective factor for prognosis of HCC.