Effect Of TCM Intervention On Survival Of Patients After Radical Gastrectomy

ObjectiveTo observe the correlation between traditional Chinese medicine(TCM)and survival time of patients after radical gastrectomy,and to clarify the factors affecting prognosis of patients,and to explore the influence of TCM on survival time and recurrence and metastasis of patients.MethodsBy selecting the hospitalization and out patient follow-up data of patients who suffered radical operation for gastric cancer in the gastrointestinal surgery center from the guangdong provincial hospital of traditional Chinese medicine(the second affiliated hospital of guangzhou university of traditional Chinese medicine)between January 2012 and December 2015,including preoperative base line informations(gender,age,BMI index,Place of residence,preoperative NLR level,preoperative tumor markers level,hemoglobin level,tumor complications);Intraoperative observation indexes(tumor location,operation time,operative approach):Postoperative observation indicators(tumor size,TNM stage,infiltration depth,whether or not to have lymph nodes-vascular and nerve involvement,differentiated degree,pathological pattern,Borrmann type,Lauren type,total lymph node,number of positive lymph nodes,whether chemotherapy intervention or not,chemotherapy regimen and frequency,whether traditional Chinese medicine intervention or not and intervention time whether more than 3 months or not,living condition,time of death or recurrence and metastasis etc.)The included patients were divided into the combined treatment group and the single treatment group according to whether the TCM intervention lasted more than 3 months.Results141 patients were included in this study,including 75 patients in the combined treatment group of traditional Chinese and chemotherapy and 66 patients in the single chemotherapy group.The median survival time of the group of combined treatment of TCM and chemotherapeutics was 45.0 months,and that of the chemotherapy group was 43.0 months,The median tumor-free survival time of the combined treatment group was 42.0 months,and that of the chemotherapy group was 40.0 months.There were no statistically significant differences between the two groups(P>0.05).However,the median total survival time and tumor-free survival time of the TCM combined chemotherapy group were prolonged compared with the chemotherapy group.COX multiple factors regression analysis results suggest that number of positive lymph nodes,TNM staging,nerve invasion or not,infiltrating depth and had no effect on overall survival and disease-free survival.Respectively,"Borrmann classification" is a factor affecting the survival and prognosis of gastric cancer and tumor recurrence and metastasis,and "degree of differentiation" is a factor affecting the recurrence of gastric cancer.There was no significant difference in the total survival time and tumor-free survival time between the combined treatment group of traditional Chinese and chemotherapy and the chemotherapy group,regardless of the types of qi stagnates blood stasis,qi and Yin two empty or liver stomach diastasis type.ConlusionThe results of this study show that TCM combined with chemotherapy had positive effects on improving the total survival time and disease-free survival time of patients with gastric cancer and reducing recurrence and metastasis,and median survival time and tumor-free survival time were increased by about 2 months.However,due to the limited number of cases,no meaningful conclusions were reached.There was no significant difference in prognosis between the two groups.The COX multivariate regression analysis showed that "Borrmann classification" is a factor affecting prognosis and tumor recurrence and metastasis,and "degree of differentiation" is a factor affecting gastric cancer tumor recurrence and metastasis.Therefore,we still need more rigorous prospective randomized controlled studies with large sample size to provide the evidence in higher evidence-based medicine.