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1.中国中医科学院西苑医院肿瘤科,北京 100091
2.北京中医药大学研究生学院,北京 100029
李芮,女,28岁,博士研究生。研究方向:中西医治疗结直肠癌。
杨宇飞,E-mail:yyf93@vip.sina.com
收稿日期:2024-02-28,
纸质出版日期:2025-05-25
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李芮,徐钰莹,刘健,等.基于主方案伞式试验设计的晚期结直肠癌中医动态治疗策略应用现状[J].北京中医药,2025,44(5):666-670.
LI Rui,XU Yuying,LIU Jian,et al.Dynamic traditional Chinese medicine treatment strategies for advanced colorectal cancer based on umbrella trial design centered on master protocols[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(05):666-670.
李芮,徐钰莹,刘健,等.基于主方案伞式试验设计的晚期结直肠癌中医动态治疗策略应用现状[J].北京中医药,2025,44(5):666-670. DOI: 10.16025/j.1674-1307.2025.05.026.
LI Rui,XU Yuying,LIU Jian,et al.Dynamic traditional Chinese medicine treatment strategies for advanced colorectal cancer based on umbrella trial design centered on master protocols[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(05):666-670. DOI: 10.16025/j.1674-1307.2025.05.026.
主方案伞式试验设计以“疾病特征为中心”,应用多种干预措施对同种疾病进行更有效的评估。中医思维的动态治疗策略、个性化诊疗特征与主方案伞式试验设计的理念相契合,将一种疾病的患者辨证为不同证型,根据各证型的病机加以用药。构建基于伞式试验设计方法的中医治疗动态策略,需要适应疾病发展阶段,不单靠中医或西医的简单治疗手段。中医肿瘤临床研究可借鉴伞式试验的设计思路,以晚期结直肠癌示例,在基线时根据辨证论治思路区分亚组,即进入肠癌伞式试验,在该设计方法中,根据中医及西医的治疗侧重分为纯中医、中西医并重及中医辅助西医这三种干预方式。这种试验设计不仅加快了研究进程,还提高了研究的质量和可靠性,减少了所需的样本量。
With the ongoing advancement of precision medicine, innovative trial designs are beginning to supplant traditional clinical trial methodologies. Unlike standard designs, the intervention-centered approach diverges significantly, while the umbrella trial design emphasizes disease characteristics and employs multiple intervention strategies to more effectively assess the same condition. The dynamic treatment strategies inherent in traditional Chinese medicine, along with the principles of personalized diagnosis and treatment, align well with the umbrella experimental design framework. Patients diagnosed with a particular disease are categorized into distinct syndrome types, and treatment is tailored according to the unique pathogenesis associated with each syndrome. Developing a dynamic strategy for traditional Chinese medicine treatment, grounded in the umbrella experimental design, necessitates an adaptation to the disease's progression and cannot rely solely on simplistic treatment approaches from either traditional Chinese medicine or western medicine.
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