胃癌中医证型与临床相关因素的多因素分析

Multifactor analysis of syndrome differentiation in traditional Chinese medicine and clinical correlative factors in gastric cancer

探索胃癌中医证型与临床因素的相互关系及证的动态性演变规律,以期指导临床和提示预后。方法:采用临床流行病学调查方法收集325例胃癌患者的病历简况和四诊资料,并分为脾虚、肝胃不和、瘀阻胃络、胃热阴虚、痰湿凝滞和气血两虚6个证型。应用多因素Logistic回归分析证型和临床相关因素(年龄、性别、Karnofsky评分和临床分期等)的关系。结果:脾虚证型在胃癌证型中占主导地应。肝胃不和证型多出现在早期胃癌,多见于女性患者。痰湿凝滞证型和气血两虚证型的Karnofsky评分低,生存质量差。胃热阴虚证型和瘀阻胃络证型未显示出与所研究临床因素的相关性。结论:胃癌中医证型与临床因素呈现一定的相关性。

Objective： The research is aimed at investigating the developing rule and the relationship between syndrome differentiation in traditional Chinese Medicine （TCM） and clinical factors of gastric cancer so as to guide clinical work and indicate prognosis. Methods： We collected the medical records and the information of four diagnostic methods of 325 cases of gastric cancer sufferers in the way of clinical epidemiological survey, and divided them into 6 syndromes including dysfunction of spleen, disharmony of liver and stomach, blood stagnation in stomach, yin deficiency of stomach, phlegm dampness stagnation and deficiency of both qi and blood. Then we used logistic regression analysis to analyze the relationship between syndrome differentiation and clinical-related factors such as age, gender, Karnofsky score and clinical stage, etc. Results. The syndromespleen dysfunction is a dominant one among the syndromes of stomach cancer. Disharmony of liver and stomach always happens in early stage of stomach cancer and is frequently seen in women. Patients with syndrome of phlegm dampness stagnation or deficiency of both qi and blood have lower Karnofsky score and poorer living quality. Syndromes of blood stagnation in stomach and yin deficiency of stomach show no relationship with the clinical factors in this research. Conclusion： Syndrome differentiation in TCM of gastric cancer is related to some clinical factors to a certain extent.