恶性肿瘤中医证形分布调查与研究
|
摘要
目的调查恶性肿瘤中医证型分布的特点及相关影响因素。方法采用横断面调查研究方法,编制统一调查表。对516例恶性肿瘤患者的年龄、性别、中医四诊资料、临床TNM分期、治疗状况等进行面对面调查,总结中医证型,运用描述性统计及卡方检验进行统计学分析,找出恶性肿瘤患者中医证型分布规律并分析其与TNM分期、治疗的相关性。结果经统计,恶性肿瘤中医常见类型为6个,分别为脾肾气虚、肝肾阴虚、阴阳两虚、气滞血瘀、湿热毒结、痰湿内蕴,证型构成比依次为脾肾气虚(33. 88%)>气滞血瘀(28. 12%)>肝肾阴虚(14. 15%)>湿热毒结(12. 71%)>痰湿内蕴(5. 79%)>阴阳两虚(4. 75%),经统计学检验,各组证型构成比差异有统计学意义(χ2=420. 67,P <0. 05)。中医证型分布在恶性肿瘤不同TNM分期,证型分布与分期及治疗方式均具有相关性,χ2值分别为73. 30和56. 31,P值均小于0. 05。结论脾肾气虚、气滞血瘀、肝肾阴虚、湿热毒结、痰湿内蕴、阴阳两虚为恶性肿瘤6大主要证候,其证型分布与恶性肿瘤TNM分期和治疗情况密切相关。
Objective To investigate the distribution characteristics of TCM syndrome of malignant tumor and the related factors. Methods The cross-section research was adopted to compile the unified survey form. In the aspects of age,gender,TCM four diagnostic data,Clinical TNM stages and the treatment status,516 patients of malignant tumor were investigated and the TCM syndromes were analyzed. Using the descriptive statistical method and chi-square test,the data were analyzed statistically and the distribution law on TCM syndromes of malignant tumor was figured out as well as its correlation with TNM stages and treatment. Results In statistical analysis,there were 6 common types of malignant tumor,i.e. spleen and kidney qi deficiency,liver and kidney qi deficiency,liver and kidney yin deficiency,yin and yang deficiency,qi and blood stagnation,interaction of damp,heat and toxin as well as internal accumulation of phlegm damp. In terms of the proportions,the sequence of these syndromes was spleen and kidney qi deficiency( 33. 88%) > qi and blood stagnation( 28. 12%) > liver and kidney yin deficiency( 14. 15%) > interaction of damp,heat and toxin( 12. 71%) > internal accumulation of phlegm damp( 5. 79%) > yin and yang deficiency( 4. 75%). After statistical test,the differences were significant among the syndrome proportions( χ2= 420. 67,P < 0. 05). TCM syndrome distributions of malignant tumor were different significantly in TNM stages,before treatment and after treatment,χ2 values were 73. 30 and 56. 31,P < 0. 05. Conclusion Kidney qi deficiency,qi and blood stagnation,liver and kidney yin deficiency,interaction of damp,heat and toxin,internal accumulation of phlegm damp as well as yin and yang deficiency are 6 major syndromes of malignant tumor and the syndrome distribution is closed related to TNM stages and treatment conditions of malignant tumor.
Objective To investigate the distribution characteristics of TCM syndrome of malignant tumor and the related factors. Methods The cross-section research was adopted to compile the unified survey form. In the aspects of age,gender,TCM four diagnostic data,Clinical TNM stages and the treatment status,516 patients of malignant tumor were investigated and the TCM syndromes were analyzed. Using the descriptive statistical method and chi-square test,the data were analyzed statistically and the distribution law on TCM syndromes of malignant tumor was figured out as well as its correlation with TNM stages and treatment. Results In statistical analysis,there were 6 common types of malignant tumor,i.e. spleen and kidney qi deficiency,liver and kidney qi deficiency,liver and kidney yin deficiency,yin and yang deficiency,qi and blood stagnation,interaction of damp,heat and toxin as well as internal accumulation of phlegm damp. In terms of the proportions,the sequence of these syndromes was spleen and kidney qi deficiency( 33. 88%) > qi and blood stagnation( 28. 12%) > liver and kidney yin deficiency( 14. 15%) > interaction of damp,heat and toxin( 12. 71%) > internal accumulation of phlegm damp( 5. 79%) > yin and yang deficiency( 4. 75%). After statistical test,the differences were significant among the syndrome proportions( χ2= 420. 67,P < 0. 05). TCM syndrome distributions of malignant tumor were different significantly in TNM stages,before treatment and after treatment,χ2 values were 73. 30 and 56. 31,P < 0. 05. Conclusion Kidney qi deficiency,qi and blood stagnation,liver and kidney yin deficiency,interaction of damp,heat and toxin,internal accumulation of phlegm damp as well as yin and yang deficiency are 6 major syndromes of malignant tumor and the syndrome distribution is closed related to TNM stages and treatment conditions of malignant tumor.
引文
[1]张瑶,贾英杰.基于脏腑辨证的前列腺癌中医治疗进展概述[J].河北中医,2017,39(2):308-312.
[2]卢会琴,夏黎明,祝永福.癌因性疲乏的中医治疗进展[J].中医药临床杂志,2014,26(18):1100-1102.
[3]王中琪,王桂军.食管癌中医治疗进展[J].中华针灸电子杂志,2014,3(5):26-28.
[4]张水宝,何小鹤,范宏宇,等.肺癌的中医治疗进展[J].中医研究,2016,29(12):70-72.
[5]江南雪,熊墨年,唐晓玲.原发性肝癌的中医治疗进展[J].实用中西医结合临床,2016,16(10):84-86.
[6]周祺.胃癌的中医治疗进展[J].湖北中医杂志,2015,37(8):71-73.
[7]中华人民共和国卫生部医政司.中国常见恶性肿瘤诊治规范[M]. 2版.北京:北京医科大学、中国协和医科大学联合出版社,1991.
[8]Sobin LH,Wittekind C. TNM classification of malignant tumours[M]. 7thed. Oxford:Wiley-Blackwell,2009.
[9]沈自尹,王文健.中医虚证辨证参考标准[J].中西医结合杂志,1986,6(10):598.
[10]朱文峰.中医诊断学[M].北京:中国中医药出版社,2002:168-169,171-172.
[11]周仲英.中医内科学[M].北京:中国中医药出版社,2002:18-19.
[12]程海波,吴勉华.周仲英教授“癌毒”学术思想探析[J].中华中医药杂志,2010,25(6):866-869.
[13]安广宇,王敏.恶性肿瘤的过度治疗及其防范[J].医学与哲学,2013,34(11B):12-14.
[2]卢会琴,夏黎明,祝永福.癌因性疲乏的中医治疗进展[J].中医药临床杂志,2014,26(18):1100-1102.
[3]王中琪,王桂军.食管癌中医治疗进展[J].中华针灸电子杂志,2014,3(5):26-28.
[4]张水宝,何小鹤,范宏宇,等.肺癌的中医治疗进展[J].中医研究,2016,29(12):70-72.
[5]江南雪,熊墨年,唐晓玲.原发性肝癌的中医治疗进展[J].实用中西医结合临床,2016,16(10):84-86.
[6]周祺.胃癌的中医治疗进展[J].湖北中医杂志,2015,37(8):71-73.
[7]中华人民共和国卫生部医政司.中国常见恶性肿瘤诊治规范[M]. 2版.北京:北京医科大学、中国协和医科大学联合出版社,1991.
[8]Sobin LH,Wittekind C. TNM classification of malignant tumours[M]. 7thed. Oxford:Wiley-Blackwell,2009.
[9]沈自尹,王文健.中医虚证辨证参考标准[J].中西医结合杂志,1986,6(10):598.
[10]朱文峰.中医诊断学[M].北京:中国中医药出版社,2002:168-169,171-172.
[11]周仲英.中医内科学[M].北京:中国中医药出版社,2002:18-19.
[12]程海波,吴勉华.周仲英教授“癌毒”学术思想探析[J].中华中医药杂志,2010,25(6):866-869.
[13]安广宇,王敏.恶性肿瘤的过度治疗及其防范[J].医学与哲学,2013,34(11B):12-14.