| Objectiv： Carries on case to the Chinese medicine Academy of science Guang’an Gate Chinese medicine hospital III and IV time ovarian cancer patient-comparison review research. According to the method of treatment of clinical using, is divided into the pure Chinese medicine group and cooperation of Chinese and Western medicine group the ovarian cancer patient. Compared two groups of in total age, median survival time changes, changes in quality of life, common dialectical treatment toxicity, treatment methods and analysis of commonly used categories and other aspects of traditional Chinese medicine. Analysis of characteristics and advantages of TCM treatment for ovarian cancer, provide the basis for clinical decisionsMethods:Review analysis in January2000to October2012III/IV time ovarian cancer patient146cases of Guang’an Gate Hospital being hospitalized. And pure Chinese medicine group55cases, cooperation of Chinese and Western medicine group91cases. Pure traditional Chinese medical treatment group uses TCM injection+the dialectical traditional Chinese medicine treatment, the cooperation of Chinese and Western medicine group uses the western medicine chemotherapy+TCM injection and dialectical traditional Chinese medicine treatment. The telephone makes a follow-up visit patient survival. SPSS software analyses two sets of patients’living conditions and influencing factors, quality of life, treatment toxicity. P<0.05is the difference has the statistical significance.Results:(1)146ovarian cancer patient OS single factor analyses and COX regression analysiss:Compared to the period of stage iii and iv a statistically significant difference (P=0.005). Compared to the distant metastasis of lymph node metastasis and a statistically significant difference (P=0.006). And in the distant place shift, liver shift does not have liver shift to have the statistics difference (P=0.010). The KPS grading≥70minute grades<70to be divided the comparison to have the statistics difference with KPS (P=0.000). The age>65year and age<65year has the statistics difference (P=0.004). Group treatment of brain metastases from lung metastases, bone metastasis, and no effect on OS (P>0.05). COX regression analysis of OS shows poor prognosis factors of hepatic metastases, brain metastases. There is risk of death in patients with liver metastases for patients with liver metastasis-free0.533times times (HR=0.533). The death risk for patients with brain metastases in patients with brain metastasis-free0.275times times (HR=0.275). KPS score high (≥70points) scoring lower KPS is the risk of death in patients with (<70min)4.422times times (HR=4.422).(2)146ovarian cancer patient TTP single factor analyses and COX multi-factor analyzing:In stage iii and iv, KPS≥70points and<70points, age>65and<65years old, distant metastasis of lymph node metastasis and without liver metastasis and liver metastasis respectively, a statistically significant difference (P=0.007, and P=0.000, and P=0.122, and P=0.002, and P=0.001). Group therapy and the presence of bone metastases, brain metastases, lung does not affect transfers for TTP (P>0.05). COX multivariate analysis of TTP show KPS rating of protection factors. Risk factors of hepatic metastases, brain, in which group the progress of liver metastasis risk is no hepatic metastases section1.824times times. Brain metastasis risk group to progress time without brain metastases4.787times times group.(3) CA125with tumors the size of relevance, and lifetime relationships, and dialectical relationship between:Correlation between tumor size and CA125:tumor size and CA125Spearman rank correlation coefficient for0.241,P=0.004, that CA125tumor size being related. CA125and lifetime relationships:CA125≥1000, CA125,100～500and when the CA125is normal when a statistically significant difference (P<0.05). CA125to CA125and500-1000for25～100no statistically significant differences (P>0.05). CA125and dialectical type:type of deficiency of both Qi and Yin CA125>1000by up to10per cent, at34.48%. When CA125to500～1000, the highest proportion of Yang-deficiency of spleen and kidney in10cases,20.41%. When the CA125is100～500, highest proportion of deficiency of spleen in21cases,35.59%.(4) treatment comparison:tumor remission rate with no statistically significant differences in the two groups (P=0.056). Simple group vs group with combination of TCM and Western medicine of traditional Chinese medicine its CR, PR, SD1.8%vs1.1%,0%vs3.3%, and61.8%vs40.7%, respectively. Simple Chinese medicine tumor control rates better than the Group63.6%vs45.1%with combination of traditional Chinese and Western medicine, both groups had statistically significant differences (P=0.029).(5) quality of life improvement comparison:The pure Chinese medicine group (KPS grading) improvement and symptom improvement surpasses the cooperation of Chinese and Western medicine group (P=0.000and P=0.000) to have the statistics difference in the quality of life, the improvement rate is72.8%vs27.5%and57.3%vs7.7%. Body weight improvement, two groups of not significant differences (P=0.453>0.05).(6) the treatments cause the hematology toxic aspect:Toxicity that the hemoglobin, the white blood cell and a granular cell create is heavy in pure Chinese medicine group (P=0.010, P=0.000and P=0.000), between two groups has the statistics difference. No statistically significant differences in liver and renal (P>0.05). Two groups before and after treatment with CA125, CEA fell, by respectively32.7%vs35.2%,3.6%vsl.1%, stable respectively32.7%vs35.2%,49.1%vs59.3%no significant difference (P=0.202, and P=0.189).(7) two groups of expense comparisons:The pure Chinese medicine group and cooperation of Chinese and Western medicine group in the hospitalized number of days not significant difference (P=0.10), respectively is26.60±11.070vs30.12±14.059. Treatment charges for medicine has the significant difference (P=0.009), respectively is1.62E4±9373.721vs2.25E4±13095.946. Treats all-in cost to have statistics difference (P=0.003), respectively is2.41E4±11702.680vs3.23E4±17150.232.(8) the pure traditional Chinese medical treatment malignant tumor, the disappearing law primarily, the blood circulation removing extravasted blood class medicine presents the number of times to be most, In the cooperation of Chinese and Western medicine group, gives priority to tonic method, is good for the spleen a kind of medicine to present the number of times to be most. These can instruct us better the treatment malignant tumor on clinical.(9) in two groups position life MOS, two groups of1years and5years of survival rate and disease progress time (TTP):Two groups of MOS not significant differences (P=0.942), respectively is the20.000±8.497month vs13.000±1.857month.146cases,76cases of survivor1year survival rate was52.05%, the survivors in13,5years survival rate was8.9%. Because the sample size are few, two groups of case numbers not to be imbalanced, the pure Chinese medicine group slightly is higher than the cooperation of Chinese and Western medicine group in1year and5years of survival rate. In two groups the position TTP not significant difference (P=0.314), respectively is3months of vsl month, pure Chinese medicine group PFS slightly surpasses the cooperation of Chinese and Western medicine group. Result:(1)The pure Chinese medicine group surpasses the cooperation of Chinese and Western medicine group in disease inverse amplification factor (P<0.05), the disease alleviation rate aspect does not have the difference (P>0.05).(2) OS in two groups, the median TTP was no difference (P>0.05). In expense, pure Chinese medicine group is lower than the cooperation of Chinese and Western medicine group. The pure Chinese medicine group improves the patient quality of life considerably, the smaller treatment side reaction, a better basic inverse amplification factor, few hospitalized number of days. Establishment of COX regression analysis, adverse prognostic factors of hepatic metastases, brain.(3)CA125and tumor size, lifetime and dialectical cavity parting have the relevance.(4)the pure Chinese medicine dialectical theory governs the treatment malignant tumor, gives priority to the disappearing law, the blood circulation removing extravasted blood class medicine presents the number of times to be most. In the cooperation of Chinese and Western medicine group, gives priority to tonic method, is good for the spleen a kind of medicine to present the number of times to be most. These can instruct us better the treatment malignant tumor on clinical. |
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