摘要
目的探讨晚期结直肠癌中医证型分布规律及其与临床病理特征的关系。方法选取2015年5月—2021年8月期间上海中医药大学附属曙光医院430例晚期结直肠癌患者资料进行回顾,按照中医证型诊断标准筛选出具有脾虚证、肾虚证、湿热证及相兼证共366例患者,分析不同中医证型与性别、年龄、病变部位、病理类型、转移方式、转移部位、治疗、疾病无进展生存期(Progression Free survival,PFS)的关系。结果回顾分析430例晚期结直肠癌患者中医证型分布后,发现脾虚证占79.07%,肾虚证占42.79%,湿热证占31.16%,脾虚兼湿热证占28.84%,肾虚兼湿热证占17.21%,脾肾两虚证占39.53%,脾肾两虚兼湿热证占16.28%,其他证占14.88%。晚期结直肠癌患者中男性、高龄(≥60岁)、左半结肠、腺癌更多。转移以血道转移为主,出现远端部位转移以脾虚证最多占89.62%,而肾虚证次之占45.36%。比较晚期结直肠癌各中医证型患者中位疾病无进展生存期发现:湿热证(8.47个月)、脾虚兼湿热证(7.73个月)、肾虚兼湿热证(6.21个月)、脾肾两虚兼湿热证(5.69个月)、脾肾两虚证(5.59个月)、脾虚证(5.51个月)、肾虚证(4.89个月)。结论晚期结直肠癌患者最常见中医证型是:脾虚证、肾虚证、脾肾两虚证、湿热证、脾虚兼湿热证。出现远端转移以脾虚证最多,脾虚证患者最易转移至肝,而肾虚证最易转移至肺。生存期较长的是湿热证、脾虚兼湿热证、肾虚兼湿热证患者。应用中医药治疗超过3个月的患者生存期更长。本研究通过对晚期结直肠癌患者进行回顾性研究,总结了常见中医证型分布情况,为晚期结直肠癌的中医药治疗提供一定循证依据。
Objective To investigate the distribution of traditional Chinese medicine(TCM)syndromes in the pa⁃tients with advanced colorectal cancer and its relationship with clinical and pathological features.Methods The data of 430 patients with advanced colorectal cancer treated in Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine from May 2015 to August 2021 were reviewed.A total of 366 patients with spleen deficiency,kidney defi⁃ciency,dampness-heat,and combined syndromes were screened according to the diagnostic criteria of TCM syndrome.The relationship of different syndromes with sex,age,lesion site,pathological type,metastasis mode,metastasis site,treatment,and progression-free survival(PFS)was analyzed.Results Among the 430 patients with advanced colorectal cancer,the patients with spleen deficiency,kidney deficiency,dampness-heat,spleen deficiency and dampness-heat,kidney deficien⁃cy and dampness-heat,spleen-kidney deficiency,spleen-kidney deficiency and dampness-heat,and other syndromes accounted for 79.07%,42.79%,31.16%,28.84%,17.21%,39.53%,16.28%,and 14.88%,respectively.advanced colorectal cancer mainly occurred in males,the elderly(≥60 years old),with lesions in the left colon,and in the form of adenocarcinoma.The main metastasis pathway was blood route metastasis,with distal metastasis mainly occurred in the pa⁃tients with spleen deficiency(89.62%)and kidney deficiency(45.36%).The median PFS of advanced colorectal cancer was 8.47,7.73,6.21,5.69,5.59,5.51,and 4.89 months in the patients with dampness-heat,spleen deficiency and dampness-heat,kidney deficiency and dampness-heat,spleen-kidney deficiency and dampness-heat,spleen-kidney deficiency,spleen deficiency,and kidney deficiency syndromes,respectively.Conclusion The common TCM syndromes in the patients with advanced colorectal cancer were spleen deficiency,kidney deficiency,spleen-kidney deficiency,damp⁃ness-heat,and spleen deficiency and dampness-heat.Spleen deficiency was the most common TCM syndrome in the pa�
作者
杨越
郭亚芳
余明华
曾艺鹏
黄云胜
徐成兴
张长明
刘宁宁
YANG Yue;GUO Ya-fang;YU Ming-hua;ZENG Yi-peng;HUANG Yun-sheng;XU Cheng-xing;ZHANGChang-ming;LIU Ning-ning(Department of Traditional Chinese Medicine,Shanghai Pudong Hospital,Fudan University Affiliated Pudong Medical Center,Shanghai 201399;Department of Oncology,Shanghai Pudong Hospital,Fudan University Affiliated Pudong Medi-cal Center,Shanghai 201399;Department of Oncology,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203)
出处
《世界中西医结合杂志》
2023年第10期2048-2054,共7页
World Journal of Integrated Traditional and Western Medicine
基金
浦东新区卫生系统优秀青年医学人才项目资助(PWRq2022-45)
复旦大学附属浦东医院重点专科建设项目资助(Zdzk2021-04)
上海市卫健委科研项目(202040120)
复旦大学附属浦东医院院级课题项目资助(YJ2021-05
YJ2020-20)
复旦张江临床医学创新基金项目资助(KP7202111)。
关键词
晚期结直肠癌
中医证型
分布规律
回顾性研究
Advanced Colorectal Cancer
TCM Syndrome
Distribution Law
Retrospective Study
