摘要
目的 探讨胰腺癌中医证候、症状的分布规律,分析其与患者性别、年龄、病程、病灶部位、临床分期、淋巴结及远处转移情况、既往治疗情况等因素的相关性。方法 回顾性分析319例胰腺癌患者病历资料,进行基本信息及证候统计分析,选择临床常见的6种基本证候(气滞血瘀证、湿热蕴结证、脾虚湿阻证、肝肾阴虚证、气血亏虚证、热毒瘀结证),按照相关中医证候诊断标准进行辨证。描述性统计中医证候及症状分布规律,运用无序多分类logistic回归模型探究证候与性别、年龄、病程、病灶部位、临床分期、淋巴结及远处转移,以及既往治疗情况等的相关性。结果 胰腺癌患者首发症状以腹痛、腹胀较为常见,主要临床症状表现为纳差、乏力、腹痛等。中医证候分布频次从高到低依次是脾虚湿阻证、湿热蕴结证、肝肾阴虚证、气滞血瘀证、气血亏虚证、热毒瘀结证。中医证候在不同性别、年龄、病程、病灶部位,以及是否有淋巴转移、是否接受手术及化学药物治疗(简称“化疗”)等胰腺癌患者中的组间分布差异有统计学意义(P<0.05,P<0.01)。气滞血瘀证与年龄呈正相关,与病程呈负相关;化疗是肝肾阴虚证的危险因素;性别为男性是气血亏虚证的保护因素。结论 胰腺癌患者中脾虚湿阻证和湿热蕴结证较为多见。患者的性别、年龄、病程、病灶部位、是否有淋巴转移、是否接受过化疗等都是中医证候的影响因素。
Objective To investigate the distribution rule of traditional Chinese medicine(TCM)syndromes and symptoms of pancreatic cancer,and to analyze its correlation with various factors,such as gender,age,the course of disease,lesional sites,clinical stage,presence of lymph node or distant metastasis and previous treatment.Methods Retrospectively analyzing the medical records of 319 patients with pancreatic cancer,basic information and syndromes were collected and analyzed.Sixcommon clinical basic syndromes (syndrome of stagnation of qi and blood stasis, syndrome of dampnessheatamassment, syndrome of damp retention due to spleen deficiency, syndrome of yin deficiency ofliver and kidney, syndrome of deficiency of both qi and blood, syndrome of heat-toxin amassment andblood stasis) were selected for syndrome differentiation according to the relevant TCM syndromediagnosis standards. The distribution rules of TCM syndromes and symptoms were statistically described.Multinomial logistic regression model was used to assess the correlation between TCM syndromes andvarious factors such as gender, age, the course of disease, lesional sites, clinical stage, lymph node anddistant metastasis, as well as previous treatment. Results Patients with pancreatic cancer experiencedabdominal pain and abdominal distension as the first symptom, and the primary clinical symptoms wereanorexia, fatigue and abdominal pain. The distribution of TCM syndromes from high to low was:syndrome of damp retention due to spleen deficiency, syndrome of dampness-heat amassment, syndromeof yin deficiency of liver and kidney, syndrome of stagnation of qi and blood stasis, syndrome ofdeficiency of both qi and blood, syndrome of heat-toxin amassment and blood stasis. The distribution ofTCM syndromes in patients with pancreatic cancer of different gender, age, the course of disease, lesionalsites, whether there is lymphatic metastasis, whether to receive surgery and chemotherapy was significant(P<0.05, P<0.01). Syndrome of qi stagnation and blood stasis positively
作者
罗美
田劭丹
侯丽
张丁丹
范秋月
陈信义
LUO Mei;TIAN Shaodan;HOU Li;ZHANG Dingdan;FAN Qiuyue;CHEN Xinyi(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《北京中医药大学学报》
CAS
CSCD
北大核心
2023年第4期584-592,共9页
Journal of Beijing University of Traditional Chinese Medicine
基金
“重大新药创制”科技重大专项(No.2019ZX09201004-002-001)。
关键词
胰腺癌
中医
证候
症状
预后
pancreatic cancer
traditional Chinese medicine
syndrome
symptom
prognosis
