乳腺癌中医分型与血流动力学特征的关系

Correlation Between Traditional Chinese Medical Syndrome Types and Hemodynamic Features in Breast Cancer Patients

【目的】探索乳腺癌血流动力学特点与乳腺癌患者中医辨证分型之间的关系,从肿瘤血管微观特征方面为中医辨证提供科学的、客观的定量分析指标。【方法】通过超声造影技术联合常规彩色多普勒超声技术,对58例不同中医证型(分为3型)且临床确诊为乳腺癌的患者的血流动力学特点进行比较分析。【结果】乳腺癌肝郁痰凝与正虚毒炽证型间的血流峰速比较,差异有显著性意义(P<0.05)。起始增强时间比较:冲任失调与肝郁痰凝证型间差异有显著性意义(P<0.05)。达峰时间比较:冲任失调与肝郁痰凝证型间比较,差异有显著性意义(P<0.05);冲任失调与正虚毒炽证型间差异也有显著性意义(P<0.05)。在曲线斜率方面,肝郁痰凝与正虚毒炽证型间差异有显著性意义(P<0.05)。乳腺癌患者中医证型分级与各血流动力学指标的相关性分析提示,证型分级仅与血流峰速呈正相关(r=0.245,P<0.05),与其他血流动力学指标无明显相关性。【结论】乳腺癌血流动力学指标在各中医分型中的分布有一定差异;乳腺癌患者证型分级与部分血流动力学指标存在相关性,血流动力学指标可以为中医辨证提供科学的定量分析指标。

Objective To supply scientific and objective evidence for the standardized differentiation of traditional Chinese medical （TCM） syndrome types of tumor by exploring the correlation of TCM syndrome types and hemodynamic features in breast cancer. Methods Contrast-enhanced ultrasonography combined with conventional color Doppler ultrasound was used for the analysis of hemodynamic features in 58 patients confirmed as breast cancer which were differentiated as three TCM syndrome types. Results The peak systolic velocity （PSV） in breast cancer patients with liver stagnation and phlegm accumulation differed from that in patients with deficiency of healthy Qi and abundance of toxicity （ P 〈 0.05 ）. The contrast-enhanced starting time and the peak-arriving time in patients with disorder of thoroughfare and conception vessels differed from those in patients with liver stagnation and phlegm accumulation （ P 〈 0.05 ）. The peak-arriving time in patients with disorder of thoroughfare and conception vessels also differed from that with deficiency of healthy Qi and abundance of toxicity （ P 〈 0.05 ）. For the ascending slope, the difference was significant between the syndrome of liver stagnation and phlegm accumulation and the syndrome of deficiency of healthy Qi and abundance of toxicity （P 〈 0. 05 ）. The results of Rank correlation analysis demonstrated that only tumor PSV was positivly correlated with syndrome types differentiation （ r = 0. 245, P 〈 0. 05 ）. Conclusion Hemodynamic features of breast cancer patients vary with the syndrome types. Some tumor hemodynamic features in breast cancer are correlated with the syndrome differentiation, which will supply scientific evidence for the standardized differentiation of TCM syndrome.