| Objective:The aim of the research is to explore the prognostic factors for advanced colorectal cancer,to evaluate the effects of Chinese intervention on survival,and to summarize the clinical experiences of Yangyufei,based on the retrospective studies of out-patient medical records by Yangyufei.Methods:We enrolled more than4,000out-patient medical records for study from Jan2002to Jan2012and finally chosed61records with the diagnosis of stage IV colorectal cancer and the treatment of Chinese medicine for more than3months,using methods of telephone follow-up and retrospective study.Descriptive analysis was used to evaluate the impacts of TCM on survival.We filtered the variables with Statistically significant difference after univariate survival analysis, and applied them with cox model for multivariate survival analysis.We entered the symptoms,tongue pictures,pulse conditions,TCM types,therapeutic principles and methods,herbs,From the best cases,which survived more than20months and symptoms have been obviously improved,into the case-acquisition system for analysis.Results:1.61cases were selected according to inclusion and exclusion criteria,meanwhile,41cases of male,20cases of female. The minimum age was25years old,maximum age83years,and average age63years. Chinese medicine intervention in the shortest was three months,in the longest was82months, and for an average of9months. There were8cases of death,36cases of survival,17cases lost to follow,by the end of April5th,2012. Among the cases,the median survival time was20months, one year survival rate was87.67%, one and a half years64.83%,two years48.52%,three years40.95%,four years30.28%,and five years was9.72%There are7people in TCM group,54in integrative medicine group. Significant statistical differences of mortality rates were found between two groups according to log-rank test. There was no significant difference of survival time between two groups. The risk of death for the types of Damp heat, liver/spleen discord,blood stasis and poison were higher than other types.2. There are14best cases,which survived more than20months and symptoms have been obviously improved,10cases of male,4cas es of female,totally122visits.The frequency which was greater t han10among the82symptoms were insomnia-early,easy to wake-up,i ncreased frequency of defecation,debilitation,cough,thristy,loose stool,agnosis,Spontaneous sweating,nocturia et al.The greatest f requency of symptoms is nsomnia-early.Red tongue,dark puple tongu e.dark red tongue,light red tongue with teeth marks are in the ma jority.Yellow thick,thin-white,thin-yellow tongue coating with wi ry and string thin pulse are in the majority. TCM types from high to low were:spleen deficiency,whichwas the highest (47.4%),splee n discord, intestine stasis-toxin, phlegm-damp retention, sputum-stasis stagnation, lung-Yin deficiency,damp-heat, kidney-yin defi ciency. Herbs from high to low were:poria,processed baizhu,huangq i,zhigancao,processed cangzhu, chicken’s gizzardskin,jiaosanxian, oldenlandia,huanglian. The lowest frequency of herbs were hehuanpi, shengdahuang,fuping and other31herbs,which were used only once. The top three frequency of cancer detoxification drugs are:olden landia,sculellaria barbata,sophara.The strongest connection drugs were fuling and processed baizhu,taizishen,zhigancao and shenghu angq1.Conclusions:1. TCM has a positive meaning for prolonging the survival time for patients with advanced colorectal cancer,reducing the risk of death.The risk of death could be reduced after long-term TCM therapy.2. The results showed that,there was a relationship between the highest frequency of symptoms,such as insomnia-early,increased frequency of defecation,debilitation,and the highest frequency of spleen-qi deficiency.So it is concluded that strengthen the spleen is the core of therapy.Pathogenesis is spleen, lung-yin and kidney deficiency and phlegm,wet,toxin and blood stasis. |
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