106例胰腺癌患者证候转归情况分析

Analysis of Syndrome Prognosis of 106 Cases of Pancreatic Cancer

目的从胰腺癌发病部位、治疗方式、临床分期三个维度探讨中医证候转归情况。方法通过制定胰腺癌症状证候临床研究登记报告表记录患者的基本信息、临床分期、治疗状况、症状、体征、既往治疗等信息并判定中医证候(包括气虚、血虚、阴虚、阳虚、气滞、血瘀、湿困、气逆、寒凝、内热11个证候),每2个月左右追访1次,共3次。分析不同发病部位、治疗方式、临床分期患者证候转归情况。结果共有106例患者完成了3次追访,76例胰头癌患者证候缓解率前三位为气虚、血瘀、阳虚;30例胰体尾癌患者证候缓解率前三位为寒凝、气虚、湿困;25例化疗配合中药治疗患者证候缓解率前三位为湿热证、气滞证、气逆证;65例单纯中医药治疗患者证候缓解率前三位为湿热证、血虚证、内热证;16例II期患者证候缓解率前三位为阳虚证、血瘀证、气虚证;78例IV期患者证候缓解率前三位为寒凝证、气虚证、血虚证。结论胰腺癌患者随肿瘤位置、临床治疗方式、临床分期不同,各证候预后转归存在不同的变化特点。中药对气虚、血虚、内热、湿困、血瘀、阳虚等证候改善较为明显,气滞、气逆、湿热证难以改善。

Objective To discuss the syndrome prognosis of pancreatic cancer in three dimensions： location,therapy and clinical stage. Methods The registration and report form was designed to record patients’ basic information,clinical stage,therapeutic status,signs,symptoms and previous treatments,and the syndromes in Chinese medicine（ Qi deficiency,blood deficiency,Yin deficiency,Yang deficiency,Qi stagnation,blood stasis,damp encumbrance,Qi counterflow,cold congealing and internal heat are involved） were figured out. The patients were followed up every two months,totally for 3 times. Then the syndrome prognoses of patients with or in different locations,therapies and clinical stages were analyzed. Results There were 106 patients followed up for 3 times in total.Among the 76 patients with pancreatic head carcinoma,the syndromes with three highest remission rates were Qi deficiency,blood stasis,and Yang deficiency. Among the 30 patients with pancreatic body and tail carcinoma,the syndromes with three highest remission rates were cold congealing,Qi deficiency,and damp encumbrance. Among 25 patients with chemotherapy and Chinese medicine,the syndromes with three highest remission rates were damp-heat,Qi stagnation,and Qi counterflow. Among 65 patients with Chinese medicine only,the syndromes with highest three remission rates were damp-heat,blood deficiency,and Qi deficiency. Among 16 patients in stage II,the syndromes with highest three remission rates were Yang deficiency,blood stasis,and Qi deficiency. Among 78 patients in stage IV,the syndromes with highest three remission rates were cold congealing,Qi deficiency,and blood deficiency.Conclusion The prognoses of different syndromes in pancreatic cancer have different variation characteristics. Syndromes like Qi deficiency,blood deficiency,internal heat,damp encumbrance,blood stasis,and yang deficiency seem easy to be improved with Chinese medicine,while Qi stagnation,Qi counterflow and damp-heat not.