319例胰腺癌中医证候分布规律及影响因素分析

罗美; 田劭丹; 侯丽; 张丁丹; 范秋月; 陈信义

doi:10.3969/j.issn.1006-2157.2023.04.020

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319例胰腺癌中医证候分布规律及影响因素分析

血液与肿瘤 | 更新时间：2023-05-09

- 319例胰腺癌中医证候分布规律及影响因素分析
- Analysis of the distribution rules and influencing factors of traditional Chinese medicine syndromes in 319 patients with pancreatic cancer
- 北京中医药大学学报 2023年46卷第4期页码：584-592
- 作者机构：
  
  北京中医药大学东直门医院　北京　100700
- 作者简介：
  
  罗美，女，在读硕士生
  田劭丹，女，博士，主任医师，副教授，博士生导师，主要研究方向：中西医结合防治恶性肿瘤，E-mail：oliviatsd@126.com
- 基金信息：
  
  “重大新药创制”科技重大专项(2019ZX09201004－002－001)
- DOI：10.3969/j.issn.1006-2157.2023.04.020
  中图分类号： R273
- 收稿：2022-11-17，
  
  网络首发：2023-02-07，
  
  纸质出版：2023-04-30
- 稿件说明：
移动端阅览
罗美, 田劭丹, 侯丽, 等. 319例胰腺癌中医证候分布规律及影响因素分析[J]. 北京中医药大学学报, 2023,46(4):584-592.

LUO Mei, TIAN Shaodan, HOU Li, et al. Analysis of the distribution rules and influencing factors of traditional Chinese medicine syndromes in 319 patients with pancreatic cancer[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023, 46(4): 584-592.
罗美, 田劭丹, 侯丽, 等. 319例胰腺癌中医证候分布规律及影响因素分析[J]. 北京中医药大学学报, 2023,46(4):584-592. DOI： 10.3969/j.issn.1006-2157.2023.04.020.

LUO Mei, TIAN Shaodan, HOU Li, et al. Analysis of the distribution rules and influencing factors of traditional Chinese medicine syndromes in 319 patients with pancreatic cancer[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023, 46(4): 584-592. DOI： 10.3969/j.issn.1006-2157.2023.04.020.

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(

0.05，

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。

Abstract

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

lesion sites

clinical stage

presence of lymph node or distant metastasis

and previous treatment.

Methods

We retrospectively analyzed the medical records of 319 patients with pancreatic cancer. The basic information and syndromes were analyzed. Six common clinical basic syndromes (syndrome of stagnation of qi and blood stasis

syndrome of dampness-heat amassment

syndrome of damp retention due to spleen deficiency

syndrome of yin deficiency of liver and kidney

syndrome of deficiency of both qi and blood

and syndrome of heat-toxin amassment and blood stasis) were selected for syndrome differentiation according to the relevant TCM syndrome diagnosis standards. The distribution rules of TCM syndromes and symptoms were statistically described. A multinomial logistic regression model was used to assess the correlation between TCM syndromes and various factors such as gender

age

the course of disease

lesion sites

clinical stage

lymph node and distant metastasis

and previous treatment.

Results

Patients with pancreatic cancer experienced abdominal pain and abdominal distension as the first symptom

and the primary clinical symptoms were anorexia

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

syndrome of yin deficiency of liver and kidney

syndrome of stagnation of qi and blood stasis

syndrome of deficiency of both qi and blood

and syndrome of heat-toxin amassment and blood stasis. The distribution of TCM syndromes in patients with pancreatic cancer with regard to differences in gender

age

disease course

lesion sites

presence of lymphatic metastasis

and surgery or chemotherapy was significantly different (

0.05

0.01). Syndrome of qi stagnation and blood stasis was positively associated with age and negatively associated with the course of disease. Chemotherapy was a risk factor for syndrome of yin deficiency of liver and kidney. Male was a protective factor for syndrome of deficiency of both qi and blood.

Conclusion

The primary TCM syndromes in patients with pancreatic cancer were syndrome of damp retention due to spleen deficiency and syndrome of dampness-heat amassment. Clinical characteristics

such as gender

age

the course of disease

lesion sites

presence of lymph node metastasis

and chemotherapy were influencing factors for TCM syndromes.

关键词

Keywords

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