| Objective: Taking the patients with stage Ⅱ-Ⅲ A non-small cell lung cancer(NSCLC)after radical resection and adjuvant radiotherapy and chemotherapy as the object of study,the patients with qi and yin deficiency syndrome differentiation were first diagnosed as the patients with deficiency of both qi and yin.To evaluate the effect of traditional Chinese medicine treatment on disease-free survival time(DFS),and analyze the prognostic factors.Methods: Using a retrospective study,Included in the period from January 2011 to December 2018 in Shanghai University of traditional Chinese Medicine affiliated /Yueyang Integrated traditional Chinese and Western Medicine Hospital Oncology Department,Shanghai University of traditional Chinese Medicine affiliated / Longhua Hospital Oncology Department,Shanghai chest Hospital Department of Integrated traditional Chinese and Western Medicine.Outpatients and inpatients who were diagnosed as stage Ⅱ-Ⅲ A postoperative NSCLC,and who had completed postoperative adjuvant radiotherapy and chemotherapy(at least 4 courses of treatment),According to whether or not to accept syndrome differentiation of traditional Chinese medicine,they were divided into two groups: TCM group(TCM syndrome differentiation is deficiency of both qi and yin)and control group(routine regular follow-up).There were 227 cases,116 cases in TCM group and 111 cases in control group.The data of general situation,incidence,treatment,recurrence and metastasis and survival of patients were recorded and statistically analyzed by SPSS25.0.The main outcome measures were disease-free survival time(DFS).Outcome: 1.In the traditional Chinese medicine group(TCM syndrome differentiation of qi and yin deficiency type),99 cases had tumor recurrence and metastasis,while 111 cases in the control group had recurrence and metastasis.The median survival time(month)of disease-free survival in the traditional Chinese medicine group was 30.90(95% confidence interval: 24.91-36.88).The median diseasefree survival time(month)in the control group was 20.03(95% confidence interval:14.71-25.35).According to the statistical analysis of Kaplan-Meier,the median disease-free survival time of the two groups was significantly different from that of the two groups by log-rank method(P < 0.05).The median disease-free survival time of the control group was 20.03(95% confidence interval: 14.71-25.35).2.The 1-,2-and 3-year disease-free survival rates in the traditional Chinese medicine group were 77%,60% and 46%,respectively,while those in the control group were 62%,47% and 31%,respectively.There was significant difference in 3-year disease-free survival rate between the two groups(P < 0.05).3.Some important risk factors affecting the prognosis of NSCLC patients,such as sex,age,smoking history,pathological type,clinical stage and treatment duration of traditional Chinese medicine were analyzed.Smoking history(P < 0.007)and TNM stage(P < 0.012)were the risk factors affecting the prognosis of disease-free survival,while traditional Chinese medicine treatment(P = 0.002)was the independent protective factor affecting the prognosis of disease-free survival.4.The disease-free survival time of 116 patients with deficiency of both qi and yin after chemotherapy of stage Ⅱ-Ⅲ A NSCLC in traditional Chinese medicine group was analyzed.Log-rank univariate analysis,sex,age,smoking history,pathological diagnosis,clinical stage,postoperative adjuvant chemotherapy,oral decoction of traditional Chinese medicine,intravenous preparation of traditional Chinese medicine,P > 0.05,all had no effect on the disease-free survival time.The Cox proportional risk regression model was used for multivariate analysis,and the calibration level was 0.05 and the exclusion test level was 0.1.it was tested that the duration of traditional Chinese medicine treatment was an independent protective factor for prognosis(P < 0.05).The duration of traditional Chinese medicine treatment was the influencing factor of diseasefree survival,and the calibration level was 0.05 and the exclusion test level was 0.1.Conclusion:The patients with NSCLC with deficiency of both qi and yin after radiotherapy and chemotherapy in stage Ⅱ-Ⅲ A can effectively prolong the diseasefree survival time by receiving TCM treatment with follow-up syndrome differentiation.The treatment of traditional Chinese medicine can be used as an auxiliary maintenance therapy for postoperative radiotherapy and chemotherapy in patients with stage Ⅱ-Ⅲ A qi-yin deficiency NSCLC. |
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