| 摘要: |
| 目的：观察健脾补肾解毒法对脾肾亏虚型结直肠癌（colorectal cancer，CRC）术后患者的辅助治疗作用。方法：回顾性分析2021年1月1日至2021年7月31日南京市中医院肿瘤科收治的脾肾亏虚型CRC术后患者112例，将其按照治疗方法分为治疗组57例和对照组55例。对照组采用常规西医化疗方案，治疗组在对照组基础上加用健脾补肾解毒中药方，比较2组患者治疗后中医证候积分、中医证候疗效、无病生存期（disease free survival，DFS）、卡氏功能状态（Karnofsky Performance Status，KPS）评分和治疗后3年内的复发情况。结果：2组治疗前有中医症状者各49人，中医证候疗效总有效率治疗组为91.84%（45/49），对照组为67.35%（33/49），2组比较，差异有统计学意义（P＜0.05）;2组中医证候积分治疗前后组内比较及治疗后组间比较，差异均有统计学意义（P＜0.05）;治疗组患者在接受治疗后，除面浮肢肿症状外，其余中医症状较治疗前均有改善（P＜0.05）;对照组患者经治疗后，仅脘腹作胀、体虚自汗症状较治疗前有所改善（P＜0.05）;2组DFS生存曲线、KPS评分治疗前后组内比较及治疗后组间比较，差异均有统计学意义（P＜0.05）;治疗后复发率治疗组为5.26%（3/57），低于对照组的18.18%（10/55），2组比较，差异有统计学意义（P＜0.05）;治疗后逐年复发率比较，治疗组1年内复发率低于对照组（P＜0.05）。结论：健脾补肾解毒法可有效降低CRC术后复发率，对CRC患者术后生活质量及中医证候的改善也具有正向影响。 |
| 关键词: 结直肠癌术后 脾肾亏虚型 健脾补肾解毒 金陵医派 复发 |
| DOI： |
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| Clinical effect of spleen-strengthening，kidney-tonifying，and detoxicating therapy in treatment of recurrence after surgery for colorectal cancer with spleen-kidney deficiency:A retrospective analysis of 57 cases |
| SHAO Yueling,CHEN Juan,WANG Yu |
| (Nanjing University of Chinese Medicine，Nanjing 210023，Jiangsu，China;Nanjing Hospital of Traditional Chinese Medicine，Nanjing 210022，Jiangsu，China) |
| Abstract: |
| Objective：To investigate the effect of spleen-strengthening，kidney-tonifying，and detoxicating therapy in the prevention and treatment of recurrence and metastasis after adjuvant chemotherapy in patients with colorectal cancer (CRC) with spleen-kidney deficiency undergoing surgery.Methods：A retrospective analysis was performed for 112 patients who were admitted to Department of Oncology，Nanjing Hospital of Traditional Chinese Medicine，from January 1 to July 31 of 2021 and underwent surgery for CRC with spleen-kidney deficiency，and according to the treatment method，they were divided into treatment group with 57 patients and control group with 55 patients.The patients in the control group were given conventional Western medicine chemoradiotherapy regimen，and those in the treatment group were given spleen-strengthening，kidney-tonifying，and detoxicating prescription in addition to the treatment in the control group.The two groups were compared in terms of traditional Chinese medicine (TCM) syndrome score，therapeutic effect on TCM syndromes disease-free survival (DFS)，and Karnofsky Performance Scale (KPS) score after treatment，as well as the status of recurrence up to the last follow-up (July 31，2024).Results：Before treatment，49 patients in each group had TCM symptoms，and there was a significant difference in therapeutic effect on TCM syndromes rate between the treatment group and the control group ［91.84% (45/49) vs 67.35% (33/49)，P < 0.05］.Both groups had a significant change in TCM syndrome score after treatment，and there was a significant difference in this score between the two groups after treatment (P < 0.05).After treatment，the patients in the treatment group had significant improvements in all TCM symptoms except the symptom of puffy face and swollen limbs (P < 0.05)，while those in the control group only had significant improvements in the symptoms of abdominal distention，weakness，and spontaneous sweating (P < 0.05).Both groups had significant changes in DFS survival curve and KPS score after treatment，and there were significant differences in these indicators between the two groups after treatment (P < 0.05).After treatment，the treatment group had a significantly lower recurrence rate than the control group ［5.26% (3/57) vs 18.18% (10/55)，P < 0.05］.Comparison of annual recurrence rates after treatment showed that the treatment group had a significantly lower recurrence rate than the control group within 1 year (P < 0.05).Conclusion：Spleen-strengthening，kidney-tonifying，and detoxicating therapy can significantly reduce the probability of recurrence after CRC surgery and has a positive effect on the improvements in postoperative quality of life and TCM syndrome in CRC patients. |
| Key words: colorectal cancer spleen-kidney deficiency spleen-strengthening and kidney-tonifying Jinling medical school clinical observation |
