基于目标导向的原发性肝癌中医药防治疗效评价体系的构建OA
Construction of a goal-oriented efficacy evaluation system for traditional Chinese medicine in the prevention and treatment of primary liver cancer
中医药在原发性肝癌全周期管理中发挥着重要作用,以肿瘤客观缓解为主要评价指标、以随机对照试验和系统评价/荟萃分析为核心的循证医学评价体系不能充分呈现中医药的特点与优势.本文在现有中医防治原发性肝癌疗效评价现状的基础上,提出构建以分期论治的阶段目标为导向、融合终点性指标与过程性指标的多维评价体系.前者包括总生存期、无复发生存期等现代医学终点指标;后者涵盖中医证候改善、患者报告结局、不良反应缓解率及主方案停药率等短期疗效内容.强调中医药方案的总结应遵循"理论内涵-验案积累-观察性评价-干预性评价"的递进顺序.同时,建议将人工智能方法融入该评价体系,以推动疗效评价的智能化与精准化.
Traditional Chinese medicine(TCM)plays an important role in the full-cycle management of primary liver cancer;however,the current evidence-based evaluation system with the main assessment index of objective tumor remission is mainly centered on randomized controlled trials and systematic reviews/meta-analyses and cannot fully reflect the characteristics and advantages of TCM.Based on the current status of TCM efficacy evaluation in the prevention and treatment of liver cancer,this article proposes the construction of a multi-dimensional evaluation system that is oriented by stage-specific treatment goals and integrates outcome indicators with process indicators.Outcome indicators include modern medical endpoints such as overall survival and recurrence-free survival,and process indicators include short-term outcomes such as the improvement in TCM syndrome,patient-reported outcomes,the remission rate of adverse events,and the discontinuation rate of the core regimen.It is emphasized that the development of standardized TCM regimens should follow the order of theoretical connotation,accumulation of proven cases,observational evaluation,and interventional evaluation.Furthermore,it is recommended to incorporate artificial intelligence approaches into this evaluation system,so as to promote the intelligent and precise assessment of TCM efficacy.
张宁;陆荫英
中国人民解放军总医院肝病医学部,北京 100039||南方医科大学中医药学院,广州 510515中国人民解放军总医院肝病医学部,北京 100039
肝肿瘤中医药疗法实体肿瘤疗效评价标准
Liver NeoplasmsTraditional Chinese Medicine TherapyResponse Evaluation Criteria in Solid Tumors
《临床肝胆病杂志》 2026 (5)
1009-1014,6
国家科技重大专项(2024ZD0526200) National Science and Technology Major Project(2024ZD0526200)
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