摘要
目的:探索胃癌中医证型与临床因素的相互关系及证的动态性演变规律,以期指导临床和提示预后。方法:采用临床流行病学调查方法收集325例胃癌患者的病历简况和四诊资料,并分为脾虚、肝胃不和、瘀阻胃络、胃热阴虚、痰湿凝滞和气血两虚6个证型。应用单因素方差分析、卡方检验与秩和检验分析证型和临床相关因素(年龄、性别、Karnofsky评分和临床分期等)的关系。结果:脾虚证型在胃癌证型中占主导地位。肝胃不和证型多出现在早期胃癌,行根治术的较多,少转移,且多见于女性患者。痰湿凝滞证型和瘀阻胃络证型多见于中晚期胃癌,Karnofsky评分低。气血两虚证型为晚期胃癌证型,生存质量差,多存在复发和转移。胃热阴虚证型在胃癌证型中所占比例不大,临床相关因素对其影响较小。结论:胃癌中医证型与临床因素呈现相关性。胃癌的中医证型存在动态性演变规律。
Objective： The research is aimed at investigating the developing rule and the relationship between syndrome differentiation in traditional Chinese medicine （TCM） and clinical factors of gastric cancer, so that it can be helpful to the clinical work and indicating the prognosis.
Methods. We collected the medical records and the information of four diagnostic methods of 325 cases of gastric cancer sufferers in the way of clinical epidemiological survey, and divided them into 6 syndromes including dysfunction of spleen, disharmony of liver and stomach, blood stagnation in stomach, yin deficiency of stomach, phlegm dampness stagnation and deficiency of both qi and blood. Then we used univariate analysis of variance, rank sum test and chi square test to analyse the relationship between syndrome differentiation and clinical-related factors such as age, gender, Karnofsky score and clinical stage, etc.
Results： The syndrome of dysfunction of spleen plays the primary role in the disease. Disharmony of liver and stomach always happens in early stage of stomach cancer, usually more often in radical operation cases and less in metastasis ones. It also has a high proportion in female. Phlegm dampness stagnation and blood stagnation in stomach usually can be seen in middle or advanced stage of the disease, which have lower Karnofsky score. Deficiency of both qi and blood is the syndrome of stomach cancer in advanced stage, which results in lower living quality, and with high rate of relapse and metastasis. Syndrome of yin deficiency of stomach has lower proportion in stomach cancer cases, and the clinical-related factors have low influence on it.
Conclusion： Syndrome in TCM of gastric cancer is relevant to some clinical factors and varies in progress.
出处
《中西医结合学报》
CAS
2007年第4期398-402,共5页
Journal of Chinese Integrative Medicine
基金
上海市重点学科建设资助项目(No.Y0302)
关键词
胃癌
中医
临床因素
单因素分析
gastric cancer
traditional Chinese medicine
clinical factor
univariate analysis
