256例原发性胃癌中医证候特点及演变规律

Analysis on TCM Syndrome Characteristics and Evolution of 256 Cases with Primary Gastric Cancer

目的:分析及探讨原发性胃癌的中医证候特点及演变规律。方法:采用回顾性研究,对256例胃癌患者按照未手术、术后无病、术后复发或转移进行频次分析,分别按照证候表现聚类分析,并对聚类分析结果进行中医辨证。结果:纳差、乏力、腹痛、腹部压痛、舌红、苔白、脉细(51.56%～75.39%)为胃癌患者最常见的证候表现。总体上胃癌的中医证候特点可概括为脾胃气虚及肝郁,兼有痰湿、胃热、肝胃不和、脾胃失和、肝郁化热、胃气上逆、胃阴虚、湿热蕴脾、脾不统血、气血两虚、脾虚湿困;未手术患者以脾胃气虚兼肝郁胃热为主;术后无病期患者以脾胃气虚为主;术后复发或转移患者以脾胃气虚、肝郁兼痰湿为主。结论:脾胃气虚证贯穿疾病始终,在疾病发展的各个阶段,中医证候存在动态演变。

Objective：To analyse and discuss the characteristics and evolution of gastric cancer on traditional Chinese medicine syndrome.Methods：Retrospective study method was used,256 cases of gastric cancer patients were classified according to no surgery,no disease afer surgery,tumor recurrence or metastasis after surgery by frequency statistics and clustering analysis and syndrome differentiation was made.Results：The most common syndrome performances of patients with gastric cancer were reducing appetite,fatigue,abdominal pain,abdominal tenderness and reddish tongue,white tongue fur,thin pulse（51.56%～75.39%）.On the whole,the characteristics of traditional Chinese medicine syndrome of gastric cancer can be summarized as both deficiency of spleen and stomach and liver depression,accompanied with phlegmdampness,stomach heat,disharmony between liver and stomach,disharmony between spleen and stomach,liver depression transforming into heat,stomach qi upward reversal,stomach-Yin deficiency,damp-heat retention spleen,uncontrol blood of spleen,deficiency of qi and blood,water retention due to hypofunction of spleen.Patients who have no surgery were given priority to deficiency of spleen and stomach,accompanied with both liver despression and stomach heat;no disease in postoperative period were given priority to deficiency of spleen and stomach;tumor recurrence or metastasis in postoperative period were given priority to both deficiency of spleen and stomach and liver desppression,accompanied with phlegmdampness.Conclusion：Deficiency of spleen and stomach is always in the process of the development of the disease and there is a dynamic evolution of the TCM syndrome.