大肠癌证素与临床表现多因素相关性研究

The multi-factorcorrelational research of colorectal cancer syndrome factor and clinicalmanifestations

目的探讨证素在大肠癌各诊断、分期中的分布规律，分析各证素与临床表现的相关性，为进一步研究大肠癌证素的分布组合规律提供依据。方法收集2011年1月至2011年12月江苏省中医院住院并确诊为大肠癌的患者，根据相关标准，提取脾、大肠、肾、肝、气虚、气滞、湿、热、血瘀、毒、阳虚、阴虚、血虚13个常见证素，采用回顾性研究方法分析证素分布情况；采用SPSS17．0软件分析证素与临床表现的相关性。结果便溏、消瘦、失眠多梦、舌红、苔白、脉数6项与证素肝相关；舌暗、舌淡、苔白、苔黄、脉沉、脉滑、脉濡7项与证素脾相关；大便脓血、舌淡、脉细、脉涩4项与证素大肠相关；消瘦、便溏、疲乏、苔白、苔腻、脉滑、脉数、苔细裂8项与证素肾相关；大便脓血、消瘦、疲乏、舌红、苔白、苔黄6项与证素气虚相关；舌红与湿相关；舌暗等与证素血瘀相关；吞酸、舌暗、齿痕、苔自、苔黄、脉沉、脉滑、脉濡8项与证素气滞相关；疲乏、舌淡、齿痕、舌红、苔薄、苔白、脉沉、脉弦、脉滑、脉弱10项与证素血虚相关；舌红与证素热相关；脉涩与证素毒相关。结论大肠癌证素以气虚、脾、气滞为多见。在纳入研究的13项大肠癌证素中，有1l项得到了与其相关的临床表现，而相关临床表现对证素的诊断权值有待进一步研究。

Objective To study the distribution rule of syndrome factors in each diagnosis and staging of colorectal cancer, to Analyze the relationship between the syndrome factors and the clinical presentations of colorectal cancer, and then to provide a basis for further studying of the distribution and combination rule of syndrome factors in colorectal cancer. Methods The clinical data of patients with colorectal cancer was collected from Jiangsu Province Hospital of Traditional Chinese Medicine 2011.1-2011.12. According to the related standard, the spleen, large intestine, kidney, liver, qi deficiency, qi stagnation, wet, heat, blood stasis, poison, yang deficiency, yin deficiency, and blood deficiency altogether 13 common syndrome factors of colorectal cancer were selected. Retrospective study method was adopted to study the distribution of syndrome factors. And SPSS 17.0 statistical software was used to analyze the relationship between the syndrome factors and the clinical presentations of colorectal cancer. Results 6 clinical presentations include loose stool had a relationship with syndrome factor of liver; 7 clinical presentations include dark tongue had a relationship with syndrome factor of spleen; 4 clinical presentations include blood stool had a relationship with syndrome factor of large intestine; 8 clinical presentations include emaciation had a relationship with syndrome factor of kidney; 6 clinical presentations include tired with qi deficiency; red tongue with wet syndrome factor; 2 clinical presentations include dark tongue had a relationship with blood stasis syndrome factor; 8 clinical presentations include pantothenic acid had a relationship with qi stagnation syndrome factor; 10 clinical presentations include pale tongue had a relationship with blood deficiency syndrome factor; red tongue had a relationship with heat syndrome factor; unsmooth pulse had a relationship with poison syndrome factor. Conclusions The syndrome factors of qi deficiency, spleen and qi stagnation are more common in colorectal cancer. 11 in 13 syndrome factors have several relative clinical presentations. But the diagnosis of syndrome factor based on clinical presentations need further study.