Clinical Observation Of Advanced Gastric Cancer Treated With Yiqi Yangyin Tongluo Decoction Combined With Apatinib

Purpose of the Investigation:To investigate the influence of Yiqi Yangyin Tongluo Decoction combined with Apatini on quality of life,disease-free survival,overall survival and side effects of targeted therapy in patients with advanced gastric cancer,and explore the independent influencing factors affecting the prognosis of advanced gastric cancer,so as to provide new clinical evidence for integrated Chinese and western medicine combined with advanced gastric cancer.Methods of the Investigation:This study collected from December 2018 to September 2019 in the Department of the first affiliated hospital of Anhui medical university,s patients with gastric cancer who compliance with the standard were staged IV,randomly divided into western medicine treatment group and integrated traditional Chinese and western medicine treatment group.The western medicine treatment group was given a single-agent apatinib orally,and the integrated traditional Chinese and western medicine treatment group was combined with Yiqi Yangyin Tongluo Decoction on the basis of the western medicine treatment group.The main observation indicators are the objective response rate,disease control rate,changes in TCM symptom scores,Karnofsky functional status,blood coagulation function,and occurrence of adverse reactions in the two groups of patients after 4 cycles of treatment(28 days as a cycle);secondary observation indicators is the progression free survival and overall survival of the two groups of patients.Results:1.A total of 70 patients were enrolled in this study,including 35 cases in the Western medicine treatment group and 35 cases in the integrated traditional Chinese and Western medicine treatment group.The baseline data of the two groups were not statistically significant.After 4 cycles of treatment,the ORR of the western medicine treatment group was 5.7%,and the DCR was 65.7%.The ORR of the other group was8.6%,and the DCR was 71.4%.The analysis of variance showed that the difference between the two groups was not statistically significant.In terms of Chinese medicine syndrome,the effective rate of the integrated traditional Chinese and western medicine treatment group was 80.0%,which was significantly higher than the effective rate of54.3% in the western medicine treatment group(P=0.039).In terms of changes in KPS,the efficient efficiency of 85.7% of the integrated traditional Chinese and western medicine treatment group is higher than 65.7% of the western medicine treatment group(P=0.021).In terms of coagulation function,the D-D value(P=0.001)and PT value(P<0.001)of the integrated traditional Chinese and western medicine treatment group were lower than those of the western medicine treatment group in the fourth cycle,and the difference was statistically significant.The difference in other indicators was not statistically significant.Before the end of the follow-up,the median progression free survival in the western medicine treatment group was 3.2 ± 0.296 months(95% CI(confidence interval),2.620-3.780),and the median overall survival was 5.3 ± 0.084months(95% CI(confidence interval),5.136-5.464).The median progression free survival in the another group was 4.2±0.049 months(95% CI(confidence interval),4.104-4.296),and the median overall survival was 6.5 ± 0.295 months(95% CI(confidence interval),5.922-7.078).2.During the course of treatment,34 patients(48.6%)had treatment-related adverse reactions,including bone marrow suppression,abnormal liver function,fatigue,hypertension,proteinuria,hand-foot syndrome,and diarrhea.The adverse reactions of the two groups of patients were mainly concentrated in grade Ⅰ-Ⅱ,and the incidence of non-hematological adverse reactions is higher than the incidence of hematological adverse reactions.In general,the incidence and grade of adverse reactions in the integrated traditional Chinese and western medicine treatment group are lower than those in the western medicine treatment group.Among them,the incidence of fatigue and diarrhea in the integrated traditional Chinese and western medicine treatment group was lower than that in the western medicine treatment group(2.9% vs.22.9%;8.6% vs.28.6%),and the difference was statistically significant(P=0.027;P=0.036).The statistical differences in the adverse reactions are not statistically significant.Conclusion:1.Yiqi Yangyin Tongluo Decoction combined with apatinib has obvious advantages over the western medicine treatment group in improving the main TCM symptoms of patients with advanced gastric cancer with deficiency of both qi and yin complicated by stasis type,and improving the physical status of the patients.It can also improve some coagulation function indexes,and prolong the disease-free survival period of the patients and overall survival.2.Yiqi Yangyin Tongluo Decoction can alleviate the side effects of apatinib.Compared with the western medicine treatment group,the side effects such as fatigue,diarrhea are not significant,and it can reduce the incidence and grade of some adverse reactions.It the effect of increasing efficiency and reducing toxicity which has application value in the treatment of advanced gastric cancer.