中医药干预对78例进展期胃癌生存期影响的单因素和多因素分析

目的 为多学科协作时代评价中医干预对进展期胃癌的临床价值及治疗时机选择提供依据。方法 回顾性分析78例进展期胃癌患者的临床资料，采用Kaplan-Meier法计算1年、3年生存率，采用单因素分析（Log-rank检验）观察相关因素对生存期的影响，对单因素分析有统计学意义的影响因素进行多因素分析（Cox回归分析）。结果 单因素分析显示，年龄、性别对进展期胃癌生存期的影响无统计学意义（P＞0.05），根治手术、足程化学治疗、TNM分期、中医干预、中医干预时机及中药服用时间对生存期的影响均具有统计学意义（P＜0.05）；多因素分析显示，根治手术、足程化学治疗、TNM分期、中医干预、中药服用时间对进展期胃癌生存期的影响均具有统计学意义（P＜0.05），其中TNM分期是进展期胃癌生存期的独立危险因素，而根治手术、足程化学治疗以及中医干预为其保护因素。结论 中医干预可以提高进展期胃癌患者的生存期，且长时间中医干预有利于患者长期生存。

Effect of TCM Intervention on Survival Time of Patients with Advanced Gastric Carcinoma: Univariate and Multivariate Analyses of 78 Cases

Objective To investigate the clinical value of traditional Chinese medicine (TCM) intervention in patients with advanced gastric carcinoma, and to provide a basis for the selection of treatment timing in the era of multidisciplinary collaboration. Methods A retrospective analysis was performed for the clinical data of 78 patients with advanced gastric carcinoma. The Kaplan-Meier method was used to calculate 1- and 3-year survival rates; a univariate analysis (log-rank test) was used to identify influencing factors for survival time, and a multivariate analysis (Cox regression analysis) was performed for the influencing factors with statistical significance. Results The univariate analysis showed that age and sex did not have significant influence on the survival time of patients with advanced gastric carcinoma (P>0.05), while radical surgery, full-course chemotherapy, TNM stage, TCM intervention, timing of TCM intervention, and TCM medication time had significant influence on survival time (P<0.05). The multivariate analysis showed that radical surgery, full-course chemotherapy, TNM stage, TCM intervention, and TCM medication time had significant influence on the survival time of patients with advanced gastric carcinoma (P<0.05), among which TNM stage was an independent risk factor for survival time, while radical surgery, full-course chemotherapy, and TCM intervention were protective factors. Conclusion TCM intervention can improve the survival time of patients with advanced gastric carcinoma, and long-term TCM intervention can bring benefits to long-term survival of such patients.