| ObjectiveBy observing the clinical efficacy,TCM syndromes,quality of life,toxicity and side effects,economic evaluation after using Yiqi Yangyin Tongluo Prescription together with Apatinib and Tegafur to cure patients with advanced gastric cancer,and comprehensively analyzing the median survival of PFS and OS in patients with advanced gastric cancer and the related factors affecting the overall survival period,so as to provide clinical evidence for the treatment of advanced gastric cancer.MethodThis study contains 41 patients with advanced gastric cancer received by First Affiliated Hospital of Anhui Medical University from October 2016 to October 2018,with definite pathological diagnosis,stage IIIB-IV,progressed or relapsed after at least two kinds of systemic chemotherapy,or could not tolerate intravenous chemotherapy,and whose syndrome type belonged to Qi-Yin deficiency and blood stasis type.Receiving Yiqi Yangyin Tongluo Decoction together with Apatinib and Tegafur oral treatment for more than 2 cycles,the clinical efficacy,toxic side effects,quality of life,TCM syndromes and economic indicators were observed.Log-rank test was used to analyze the single factors affecting the overall survival period,and then the independent factors affecting the overall survival period were summarized by COX regression model.Result1.Therapeutic effect: Among the 41 patients included,after 2 cycles of treatment,the objective remission rate was 24.4% and the clinical benefit rate was 90.2%.After 4 cycles of treatment,the objective remission rate was 29.7% and the clinical benefit rate was 89.2%.After 6 cycles of treatment,the objective remission rate was 30.3% and the clinical benefit rate was 91.0%.After 8 cycles of treatment,the objective remission rate was 23.3% and the clinical benefit rate was 80.0%.In terms of the curative effect of TCM syndromes,the effective rate increases with the increase of treatment time,and the effective rate is more than 70%.2.Quality of life: after two cycles of combined treatment,the improvement rate of quality of life was 22.0% and the stability rate was 68.3%.After four cycles of combined treatment,the improvement rate of quality of life was 29.7% and the stability rate was 54.1%.After six cycles of combined treatment,the improvement rate of quality of life was 24.2% and the stability rate was 54.5%.After eight cycles of combined treatment,the improvement rate and stability rate was 33.3% and 50% respectly.The total stabilization rate of the four treatment cycles was more than 75%.3.Toxic side effects: 41 patients mainly suffered from grade I to II toxic side effects.The patients were well tolerated,and no drug withdrawal and chemotherapy-related deaths occurred due to drug toxicity.4.Economic analysis: In the 41 cases included in this study,the average per time cost was 8041.58 yuan,and the average per time cost of traditional Chinese medicine was 314.65 yuan.Then compared with the efficiency of each treatment cycle respectively,the results showed that the effective cost-effectiveness ratio was 287.48,236.18,231.50,301.10,and the cost-effectiveness ratio of traditional Chinese medicine was 12.90,10.59,10.38 and 13.50,respectively.5.PFS,OS and influencing factors: The median progression-free survival and total survival of 41 patients were 10.000±1.019 and 14.000±1.239 respectively.Through COX regression model analysis,it was found that the independent factors affecting the total survival time were the intervention time of traditional Chinese medicine and KPS score.Conclusion1.Yiqi Yangyin Tongluo Decoction together with Apatinib and Tegafur can improve the clinical benefit rate of patients with advanced gastric cancer,significantly improve the TCM syndromes of patients,prolong the overall survival period and slow down the progress of cancer.2.Yiqi Yangyin Tongluo Decoction can reduce the incidence of toxic and side effects in the course of oral treatment of Apatinib and Tegafur,and make the occurrence degree more mild,which can be tolerated by general patients,and improve the quality of life of patients,which is conducive to the follow-up treatment of patients with advanced gastric cancer.3.Through COX regression model analysis,it was found that the intervention time of traditional Chinese medicine and KPS score were independent factors affecting the overall survival time,and they were positively correlated.4.In the aspect of economic evaluation,the overall cost-efficiency ratio of treatment is low,and the proportion of C/E of traditional Chinese medicine is small.Considered its safety and efficacy,it can be further studied and popularized. |
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