【目的】分析早期肺癌术后患者血清总胆固醇 （TC） 、甘油三酯 （TG） 等血脂水平与其生存预后的相关性，并统计扶正祛 邪方对早期肺癌术后患者血清血脂水平的影响，以探索扶正祛邪方改善早期肺癌术后患者生存预后的内在因素。 【方法】回 顾性分析2010年7月～2015年12月在上海市中医医院就诊的257例早期肺癌术后患者血清TC、TG水平与其生存预后的相关 性，统计扶正祛邪方治疗前后早期肺癌术后患者血清TC、TG水平的变化情况；前瞻性分析了2017年1月～2021年4月在上 海市中医医院服用扶正祛邪方的281例早期肺癌术后患者 （治疗组） 和上海市肺科医院只临床随访不治疗的287例早期肺癌术 后患者 （对照组） 的1年、2年、3年和4年无病生存率及血清TC、TG水平的变化情况。 【结果】（1） 回顾性研究部分：早期肺癌 术后患者治疗前的TC与患者的无进展生存期 （PFS） 具有相关性，TC高值组的患者具有更长的PFS；早期肺癌术后患者治疗 前的TG水平与患者的PFS无明显相关性，但对于近期生存的影响，TG高值组患者具有更高的近期生存率，对于远期生存的 影响，TG低值组患者拥有更高的远期生存率。 （2） 前瞻性研究部分：①截止至末次随访时间2021年4月1日，2组患者中治疗 组有9例复发，对照组有24例复发。治疗组1年、2年、3年和4年无病生存率分别是99.3%、96.8%和95.7%和95.7%，优于 对照组的97.6%、92.3%和89.2%和87.1% （P＜0.05） ，表明扶正祛邪方干预的早期肺癌术后患者复发和转移较对照组明显减 少，无病生存率明显提高。②治疗后，治疗组的血清TC、TG水平均较治疗前升高 （P＜0.05） ，而对照组均无明显变化 （P＞ 0.05） ；组间比较，治疗组对血清TC、TG水平的升高作用均明显优于对照组 （P＜0.05） ，说明扶正祛邪方可以一定程度调节 患者的血脂水平。 【结论】通过治疗前血脂与早期肺癌术后患者PFS预后的相关性分析发现，TC高值组的肺癌患者具有更长 的PFS；扶正祛邪方可调节早期肺癌术后患者的血脂水平，故推测扶正祛邪方可能是通过调控患者血脂水平，从而达到改善 早期肺癌患者生存预后的效果。

Objective To explore the correlation between serum lipid levels of total cholesterol （TC） and triglyceride （TG） and the survival prognosis in postoperative patients with early lung cancer，and to observe the effect of Fuzheng Quxie Prescription on serum lipid levels in postoperative patients with early lung cancer，so as to explore the mechanism of Fuzheng Quxie Prescription in improving the survival prognosis of postoperative patients with early lung cancer. Methods The correlation of serum TC and TG levels with survival prognosis of 257 postoperative patients with early lung cancer admitted in Shanghai Municipal Hospital of Traditional Chinese Medicine from July 2010 to December 2015 was retrospectively analyzed. The changes of serum TC and TG levels in postoperative patients with early lung cancer before and after treatment with Fuzheng Quxie Prescription were statistically analyzed. From January 2017 to April 2021，a prospective analysis of the one-year，two-year，three- year and four-year disease-free survival rates and serum TC and TG levels was carried out in 281 postoperative patients with early lung cancer treated with Fuzheng Quxie Prescription orally in Shanghai Municipal Hospital of Traditional Chinese Medicine （treatment group） and in 287 postoperative patients with early lung cancer who were followed up in clinic while had no medciation in Shanghai Pulmonary Hospital （control group） . Results （1） The retrospective study showed that pre-treatment TC level was correlated with progression-free survival （PFS） in postoperative patients with early lung cancer，and the patients with high TC level had longer PFS. There was no significant correlation between pre-treatment TG level and PFS in postoperative patients with early lung cancer. The patients with high TG level had higher short-term survival rate while the patients with low TG level had higher long-term survival rate. （2） The prospective study showed that there were nine cases of recurrence in the treatment group and 24 cases of recurrence in the control group till the last follow-up time on April 1，2021. The one-year， two-year，three-year and four-year disease-free survival rates in the treatment group were 99.3%，96.8%， 95.7% and 95.7%，respectively，which were superior to 97.6%，92.3%，89.2% and 87.1% in the control group （P＜0.05），indicating that the recurrence and metastasis in the postoperative patients with early lung cancer treated by Fuzheng Quxie Prescription were significantly reduced when compared with the control group，and the disease-free survival rate was significantly improved. After treatment，the serum levels of TC and TG in the treatment group were increased when compared with those before treatment（P＜0.05） while the control group showed no obvious changes（P＞0.05） . The intergroup comparison showed that the increase of serum TC and TG levels in the treatment group was superior to that in the control group （P＜0.05），indicating that Fuzheng Quxie Prescription had regulatory effect on the blood lipid level of patients to a certain extent. Conclusion The analysis of the correlation between pre-treatment blood lipids and PFS prognosis in postoperative patients with early lung cancer indicated that lung cancer patients with high TC level had longer PFS；Fuzheng Quxie Prescription can regulate the blood lipid level of postoperative patients with early lung adenocarcinoma. It is speculated that Fuzheng Quxie Prescription may improve the survival prognosis of postoperative patients with early lung cancer probably by regulating the blood lipid level of the patients.

R273.342

国家自然科学基金面上项目（编号：81973795）；上海医学创新发展基金项目（编号：WL-HBQN-2021010K，WL-HBQN- 2021009K，WL-HBQN-2022015K）；上海市进一步加快中医药传承创新发展三年行动计划 （2021～2023年）项目[编号：ZY （2021-2023） -0211]；上海市浦江人才项目 （编号：2020PJD057）