Clinical Observation Of Fuzi Lizhong Decoction Combined With Chemotherapy On Patients With Advanced Metastatic Colorectal Cancer Of Spleen Kidney Yang Deficiency Type

Objective: Objective To observe the clinical effect of Fuzi Lizhong decoction combined with chemotherapy on patients with advanced metastatic colorectal cancer of spleen kidney yang deficiency type,and to observe its effect on progression free survival.Methods: Methods: from January 2018 to December 2020,134 patients with advanced metastatic colorectal cancer(including rectum)diagnosed by western medicine and 42 patients with simple western medicine chemotherapy were selected from the Department of oncology,Department of Gastroenterology and gastrointestinal surgery of the First Affiliated Hospital of University of traditional Chinese medicine.The short-term efficacy of the two groups was observed,the progression free survival was followed up,and Kaplan-Meie was used R for survival analysis,log rank analysis for comparison and univariate analysis.Results: 1.A total of 200 eligible cases were included in this study.Through the historical cases and telephone follow-up,26 dead cases and 25 lost cases were identified,and the deletion rate was 12.5%.2.Baseline data: there was no significant difference in age,gender,past history,tumor location,pathological type and metastasis location between Fuzi Lizhong decoction combined with chemotherapy group and chemotherapy group alone(P > 0.05)3.Short term efficacy: Objective remission rate(ORR)and disease control rate(DCR)of Fuzi Lizhong decoction combined with chemotherapy group were 53.0% and 80.5%,respectively;Orr and DCR of simple chemotherapy group were 35.7% and 78.5%,respectively;the total effective rate of Fuzi Lizhong decoction combined with chemotherapy group was significantly higher than that of simple chemotherapy group(P < 0.05),but there was no significant difference between the two groups(P > 0.05).4.PFS: The median PFS of fuzhilizhong decoction combined with chemotherapy group was 7.7 months(95% CI: 7.1-9.1 months),and that of chemotherapy group was 6.5 months(95% CI: 5.1-9.3 months).Fuzi Lizhong decoction combined with chemotherapy group prolonged 1.2 months.However,Kaplan Meier analysis showed that there was no significant difference in PFS curve between the two groups(P > 0.05).There were 134 patients in Fuzi Lizhong decoction combined with chemotherapy group,12 patients aged 18 to40 years old,and the median PFS was 9.6 months(95% CI: 5.9-11.7 months),121 patients aged 40 to 80 years old,and the median PFS was 7.6 months(95%CI: 6.93-9.1 months).The median PFS was 3.6 months(95% CI: 2.1-5.2months)in the western medicine group and 6.8 months(95% CI: 5.1-8.4months)in the western medicine group.The difference was statistically significant(P < 0.05).The median PFS was 8.1 months(95% CI: 6.9-11.8months).The median PFS was 9.2 months(95% CI: 5.5-11.8 months).The median PFS was 7.3 months(95% CI: 6.2-10.8 months).The median PFS was7.5 months(95% CI: 6.60-8.3 months).After statistical test,the difference was statistically significant(P < 0.05).In the Fuzi Lizhong decoction combined with chemotherapy group,the median PFS of patients with liver and lung metastasis was 8.1 months(95% CI: 7.3-9.3 months).The median PFS for other site metastases(including peritoneal metastases)was 5.8 months(95% CI: 4.2-8.4 months).The median PFS of liver and lung metastases in chemotherapy group was 7.0 months(95% CI: 5.3-9.3 months).The median PFS for other site metastases(including peritoneal metastases)was 4.0 months(95% CI: 3.4-6.5months).The difference was statistically significant(P < 0.05).5.TCM syndrome score: after treatment,the total TCM syndrome score of the two groups were improved(P < 0.05).The total effective rate of Fuzi Lizhong decoction combined with chemotherapy group was 70.37%,and that of chemotherapy group was 35.71%.Fuzi Lizhong decoction combined with chemotherapy group was significantly better than that of chemotherapy group in TCM syndrome total score and syndrome curative effect evaluation,and the difference was statistically significant(P < 0.05);Conclusions: Fuzi Lizhong decoction combined with chemotherapy in the treatment of advanced metastatic colorectal cancer can improve the shortterm curative effect,and has good clinical application value.The longer the accumulation time of traditional Chinese medicine,the longer the progression free survival of elderly patients with colorectal cancer,the difference was statistically significant.