A Real World Study Based On The Third Stage Prevention Scheme Of Liver Cancer With "invigorating The Kidney And Producing The Liver"

Objective:A retrospective retrospective cohort study was conducted to explore the clinical efficacy of Li Hanmin's third level prevention plan and conventional comprehensive treatment based on " invigorating the kidney and producing the liver ",and provide evidence-based medical evidence for clinical popularization and application.Methods:1.This study adopts the method of the real world study according to the inclusion and exclusion criteria to study the treatment of Hubei Provincial Traditional Chinese Medical Hospital for treatment of advanced liver cancer patients,divided into routine treatment group and based on the "liver cancer third grade prevention treatment group "invigorating the kidney and producing the liver"(hereinafter referred to as "invigorating the kidney and producing the liver" group)two groups.The conventional comprehensive treatment group was treated by traditional Chinese and Western medicine combined treatment plan,and the treatment group was treated by " invigorating the kidney and producing the liver " treatment group,based on the third level prevention plan of liver cancer based on " invigorating the kidney and producing the liver ".Comprehensive treatment combined with traditional Chinese and Western medicine: Based on the existing HCC third level prevention on the treatment of Western medicine,including antiviral drugs(entecavir,adefovir,lamivudine,telbivudine),liver protection,nutritional support,diuresis,correct electrolyte and other support to symptomatic treatment,the conventional treatment based on syndrome differentiation.Based on the " invigorating the kidney and producing the liver " liver cancer third grade prevention scheme: Based on the existing HCC third level prevention on the treatment of Western medicine,the embodiment of "invigorating the kidney and producing the liver" treatment law of five liver capsule,antitoxic Ruanjian capsule(Hubei pharmaceutical Z20113151)and Zuogui Pill(or other dosage forms Zuoguiwan),or the five party,and antitoxic Ruanjian(mistletoe,dodder,Jiang Huang,Hedyotis diffusa,coix seed,etc.)Zuoguiyin(yam,rehmannia,medlar,Radix Glycyrrhizae,Poria,Cornus officinalis)Decoction decoction,granule and side cutting,syndrome differentiation.With the application of Jiang Huang oral capsule and improve liver regeneration microenvironment to enhance the curative effect of comprehensive treatment of liver cancer,which is based on the "invigorating the kidney and producing the liver" liver cancer third grade prevention scheme 2.The clinical treatment data of two groups were collected 311 copies of medical records;two combinations;extraction from general information: hospital number,name,gender,age,telephone;laboratory and imaging parameters: HBV DNA quantitative(HBV-DNA),total bilirubin(TBIL),albumin(Alb),ALT AST,AFP,PLT,WBC,Child-Pugh,liver function grading,liver cirrhosis,body mass index(BMI),ECOG score,PTA,metastasis,portal vein invasion, tumor number,etc.3.The first hospitalization time was the starting point for the survival period.All cases were discharged through the discharge,the outpatient review and the telephone follow-up to February 1,2018.4.The survival time of two groups of patients was statistically analyzed,and three months and six months survival period were compared and risk factors were analyzed,including univariate and multivariate analysis.For the survival data,the single factor Cox proportional risk regression model was used to analyze the single factor analysis of the P value less than 0.05 into the Cox multi factor model.The Kaplan-Meier analysis was used to calculate the survival rate,and the Log-Rank method was used for the comparison between groups.The test level is alpha =0.05.The statistical calculation was completed by using Microsoft Excel software and statistical software SPSS 23.Results:1.Included in the statistical analysis of patients with advanced hepatocellular carcinoma were 311 cases,including 138 cases in the treatment group,110 cases were male,28 were female;mean age 57.56±11.58;173 cases in the treatment group with combination of TCM and Western medicine,142 cases were male,31 female;mean age 55.61±13.22;no significant difference between two groups in age,gender body mass index in patients with liver cirrhosis,HBV-DNA positive number,total bilirubin,PT,albumin,alpha fetoprotein difference(P>0.05)2.by the end of February 1,2018,selected patients with 34 liver cancer patients survived,the combined treatment group was 13,western medicine group 21;lost 27 patients,the combined treatment group was 16,western medicine group 11;comprehensive treatment group had a median survival of 4.8 months,Chinese and Western medicine with the treatment group,the median survival time was 5.9 months;6 months survival rate of treatment group 3 months,respectively 71.7% and 21.7%;the combination of TCM and Western medicine for 3 months and 6 months survival rates were 83.2% and 36.4%,there was statistical difference between two groups(P<0.05).3.two groups of patients with initial treatment of ALT,AST,total bilirubin,albumin,WBC,platelet,PT,PTA,NLR were not statistically different between(P > 0.05);selected two patients to compare laboratory index after three months from the treatment,two groups of patients after treatment of alanine transaminase,aspartate aminotransferase,total bilirubin,albumin,WBC,platelet,PT,has further increased,PTA decreased.After treatment,compared two groups of alanine aminotransferase,aspartate aminotransferase,albumin,white blood cell,PT,PTA no significant difference(P > 0.05);there were significant differences in total bilirubin? platelet?NLR(P<0.05).4.factors in the group of 311 patients with hepatocellular carcinoma six months survival effects were analyzed by univariate analysis,univariate analysis showed that patients with cirrhosis,treatment,body mass index,Child-Pugh grade,ECOG score,PTA,ALB,metastasis are risk factors for survival in patients with hepatocellular carcinoma six months(gender,age,P<0.05);HBV-DNA,AFP,PLT,WBC,portal vein invasion,tumor number are not risk factors for survival in patients with advanced hepatocellular carcinoma in June period(P<0.05).From the above single factor analysis results,risk factors were selected for multiple factors analysis.Cirrhosis,treatment,Child-Pugh grade,ECOG score and extrahepatic metastasis were independent risk factors for survival time(P<0.05).Conclusions : 1.in our hospital's treatment mode,cirrhosis,treatment modalities,Child-Pugh grading,ECOG score and extrahepatic metastasis are important factors that affect the survival time and prognosis of patients with liver cancer.2.the third grade prevention of liver cancer based on "invigorating the kidney and forming the liver" can effectively prolong the life of the patient.3.,the therapeutic mechanism of third level prevention plan based on " invigorating the kidney and producing the liver " may play a role in liver cancer cells and their liver regeneration microenvironment.