胃癌前病变“痰”“湿”证素特征研究
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摘要
目的:基于证素辨证对胃癌前病变(PLGC)"痰、湿"证素进行证候分析,初步建立相应的中医临床诊断规范。方法:采用横断面调查法,随机选择PLGC患者142例,运用证素理论,对提取的"痰、湿"证素单元进行调查登记探讨,研究PLGC"痰""湿"证素特征。结果:PLGC病位证素主要分布在胃、肝、脾、肾、心、胆、心神、肺等,病性证素主要分布在气滞、阳虚、气虚、湿、血瘀、痰、热、食积等;PLGC症状归纳为10组公因子,其中4组为有效公因子(F1～F4)。在PLGC中,病性证素"痰"的证素特征以形体肥胖、胸闷、咽部异物感、吐痰、舌苔腻、脉滑为主,病性证素"湿"的证素特征以环境潮湿、肢体酸重或困重、头蒙如裹、口黏腻、便溏、舌苔腻、脉滑为主。结论:明确PLGC"痰""湿"证素特征,可为临床辨别PLGC"痰""湿"证候提供参考依据。
Objective: To do dialectical syndrome analysis for the syndrome elements of ‘phlegm' and ‘dampness' extracted from precancerous lesions of gastric cancer(PLGC), and to establish the corresponding clinical diagnostic criteria for TCM preliminarily. Methods: Using cross-sectional survey method, 142 patients with PLGC were randomly selected. According to the theory of syndrome elements, the extracted syndrome elements of ‘phlegm' and ‘dampness' were investigated and registered, and the characteristics of the syndrome elements of ‘phlegm' and ‘dampness' were studied. Results: PLGC syndrome elements for disease location were mainly distributed in the stomach, liver, spleen, kidney, heart, gallbladder, heart spirit, lung,etc. The syndrome elements for disease nature were mainly distributed in qi stagnation, yang deficiency, qi deficiency, dampness,blood stasis, phlegm, heat, indigestion, etc.; PLGC symptoms were devided into 10 groups of common factors, of which 4 groups were effective common factors(F1～F4). In PLGC, ‘phlegm', as a symptom factor of disease nature, is mainly characterized by body obesity, chest tightness, foreign body sensation in the pharynx, spitting, pulse slip, and tongue greasy. And ‘dampness',as another symptom factor of disease nature, is mainly characterized by environmental wetness, heavy or trapped feeling of the body, dizziness in the head, sticky mouth, loose stool, greasy tongue, and slippery pulse. Conclusion: This paper has made clear the characteristics of ‘phlegm' and ‘dampness' syndrome elements in PLGC, which can be used as a reference for clinical identification of ‘phlegm' and ‘dampness' syndromes of PLGC.
Objective: To do dialectical syndrome analysis for the syndrome elements of ‘phlegm' and ‘dampness' extracted from precancerous lesions of gastric cancer(PLGC), and to establish the corresponding clinical diagnostic criteria for TCM preliminarily. Methods: Using cross-sectional survey method, 142 patients with PLGC were randomly selected. According to the theory of syndrome elements, the extracted syndrome elements of ‘phlegm' and ‘dampness' were investigated and registered, and the characteristics of the syndrome elements of ‘phlegm' and ‘dampness' were studied. Results: PLGC syndrome elements for disease location were mainly distributed in the stomach, liver, spleen, kidney, heart, gallbladder, heart spirit, lung,etc. The syndrome elements for disease nature were mainly distributed in qi stagnation, yang deficiency, qi deficiency, dampness,blood stasis, phlegm, heat, indigestion, etc.; PLGC symptoms were devided into 10 groups of common factors, of which 4 groups were effective common factors(F1～F4). In PLGC, ‘phlegm', as a symptom factor of disease nature, is mainly characterized by body obesity, chest tightness, foreign body sensation in the pharynx, spitting, pulse slip, and tongue greasy. And ‘dampness',as another symptom factor of disease nature, is mainly characterized by environmental wetness, heavy or trapped feeling of the body, dizziness in the head, sticky mouth, loose stool, greasy tongue, and slippery pulse. Conclusion: This paper has made clear the characteristics of ‘phlegm' and ‘dampness' syndrome elements in PLGC, which can be used as a reference for clinical identification of ‘phlegm' and ‘dampness' syndromes of PLGC.
引文
[1]房静远,刘文忠,李兆申,等.中国慢性胃炎共识意见.胃肠病学,2013,18(1):24-36
[2]朱文锋.证素辨证学.北京:人民卫生出版社,2008
[3]黎敬波,马力.中医临床常见症状术语规范.北京:中国医药科技出版社,2005
[4]中华人民共和国国家标准.中医临床诊疗术语.北京:中国标准出版社,1997
[5]李灿东.中医诊断学.北京:中国中医药出版社,2016
[6]王海燕,黎元元,谢雁鸣,等.基于文本挖掘的胃癌前病变当代中医药学术团队研究热点及趋势分析.中华中医药杂志,2016,31(4):1198-1201
[7]申春悌,陈启光,张华强,等.建立病证结合疗效评价体系的思路和方法.中国中医基础医学杂志,2006,12(10):749-751
[8]田锋亮,李延萍.慢性萎缩性胃炎的中医证治.河南中医,2017,37(12):2133-2135
[9]谭兆峰,齐元富,夏蕾,李秀荣.从痰论治肿瘤疾病.中医学报,2018,33(11):2053-2056
[10]程海波,吴勉华,周红光.周仲瑛从癌毒辨治恶性肿瘤的经验.北京中医药,2009,28(11):844-846
[11]蔡悦青,魏炜,姜莉云.慢性萎缩性胃炎中医证型分布规律的文献研究.中国民族民间医药,2018,27(1):16-18
[12]袁立红.保和丸加味联合西药治疗胃食管反流病痰浊中阻证的疗效观察.沈阳:辽宁中医药大学,2011
[13]柯志颖.“痰”病证治理论探讨及临床应用研究.北京:北京中医药大学,2007
[14]王忆勤,郎庆波,李果刚,等.慢性胃炎中医湿证证候诊断标准研究.中国中西医结合杂志,2005,25(11):975-979
[15]孟虹,贺宪民,范思昌,等.慢性胃炎中医证型辨证标准初探.上海中医药杂志,2004,38(2):32-34
[2]朱文锋.证素辨证学.北京:人民卫生出版社,2008
[3]黎敬波,马力.中医临床常见症状术语规范.北京:中国医药科技出版社,2005
[4]中华人民共和国国家标准.中医临床诊疗术语.北京:中国标准出版社,1997
[5]李灿东.中医诊断学.北京:中国中医药出版社,2016
[6]王海燕,黎元元,谢雁鸣,等.基于文本挖掘的胃癌前病变当代中医药学术团队研究热点及趋势分析.中华中医药杂志,2016,31(4):1198-1201
[7]申春悌,陈启光,张华强,等.建立病证结合疗效评价体系的思路和方法.中国中医基础医学杂志,2006,12(10):749-751
[8]田锋亮,李延萍.慢性萎缩性胃炎的中医证治.河南中医,2017,37(12):2133-2135
[9]谭兆峰,齐元富,夏蕾,李秀荣.从痰论治肿瘤疾病.中医学报,2018,33(11):2053-2056
[10]程海波,吴勉华,周红光.周仲瑛从癌毒辨治恶性肿瘤的经验.北京中医药,2009,28(11):844-846
[11]蔡悦青,魏炜,姜莉云.慢性萎缩性胃炎中医证型分布规律的文献研究.中国民族民间医药,2018,27(1):16-18
[12]袁立红.保和丸加味联合西药治疗胃食管反流病痰浊中阻证的疗效观察.沈阳:辽宁中医药大学,2011
[13]柯志颖.“痰”病证治理论探讨及临床应用研究.北京:北京中医药大学,2007
[14]王忆勤,郎庆波,李果刚,等.慢性胃炎中医湿证证候诊断标准研究.中国中西医结合杂志,2005,25(11):975-979
[15]孟虹,贺宪民,范思昌,等.慢性胃炎中医证型辨证标准初探.上海中医药杂志,2004,38(2):32-34