宫颈癌中医证候特点及演变规律系统综述

Cervical Cancer Patients With Traditional Chinese Medicine Syndrome and Evolution of Research and Analysis

[主要目的]分析宫颈癌中医证候特点及演变规律。[资料来源]在辽宁中医药大学附属第一医院病案室,选取2009年1月至2011年6月辽宁中医药大学附属第一医院肿瘤科宫颈癌患者病历。[选择文献量及依据]①研究类型:临床观察。②研究对象:经细胞涂片或病理诊断为宫颈癌;中医四诊资料全面;同一患者多次入院证候发生变化时重复纳入,无明显变化时仅纳入第一次入院情况。③诊断分型:肝郁气滞型,乏力,口干,口苦,心烦,舌红,苔薄白,脉弦细;肝郁脾虚型,乏力,腹痛,腹胀,眠差,恶心,便溏,胸闷,舌淡红,边有齿痕,苔薄白,脉沉细;湿热下注型,腹痛,纳差,尿频,尿痛,便秘,舌暗红,苔黄,脉滑;脾肾阳虚型,乏力,腹胀,腰痛,下肢浮肿,纳差,尿少,排尿困难,便秘,眠差,口干,舌淡红,苔薄白,脉沉细。④评价指标:KPS评分、死亡率等各项指标。共48例(57例次)住院宫颈癌患者原始病历。[数据提炼规则及应用方法]采用描述性统计分析方法,统计临床表现,入院功能状态评分(含死亡出院病例)。功能状态:采用Karnofsky功能状态评分标准(卡氏,KPS,百分法)。采用SPSS17.0统计软件。采用Microsoft Excel 2003软件建立数据库,统计临床症状频率及出现频次并排序。[数据综合得出结果与结论]主要临床症状及体征出现频率排序:乏力,纳差,苔薄白,腹痛,腹胀,下肢浮肿,舌暗红,下肢疼痛,舌红,舌淡红,便秘,脉沉细等。辨证分型:57例次辨证为肝郁气滞11例次(19.30%),肝郁脾虚13例次(22.81%),湿热下注19例次(33.33%),脾肾阳虚14例次(24.56%)。次要临床表现出现频率排序:皮肤淤点、自汗、少苔、呕吐、呼吸困难、带下异常、脉细数、脉弦滑、胁肋胀痛、小便失禁、畏冷、发热、便血、脉弦、胸痛、尿痛等;次要临床表现辨证分型:3种兼证,血瘀证5例次、血证7例次、痰饮证13例次。从临床症状、体征、KPS评分统计分析死亡率,湿热下注和脾肾阳虚死亡率较高。[未来展望]随着科技发展,未来中医药治疗将以创伤少、可持续,改善患者不良状态,提高生存质量,延长生存期为主要目标。

[Objective]To analyze clinical data of cervical cancer syndrome and law.[Source]First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine medical record room,select the First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine Oncology cervical cancer patient records from January 2009 to June 2011.[Select literature and Basis] ①The type of research： a retrospective study of clinical data.②Research object： smear or pathological diagnosis of cervical cancer;the four diagnostic comprehensive information;included in the admission card when the same patient several times repeated climate change,no significant changes in the inclusion of only the first admission.③Diagnostic classification： liver qi stagnation,fatigue,dry mouth,mouth pain,irritability,red tongue,thin white fur,wiry pulse;stagnation and spleen deficiency,fatigue,abdominal pain,bloating,poor sleep,nausea,loose stools spleen and kidney yang,chest tightness,pink tongue with scalloped edges,thin white fur,pulse;damp,abdominal pain,loss of appetite,frequent urination,painful urination,constipation,dark red tongue,yellow fur,slippery pulse;deficiency syndrome,fatigue,bloating,back pain,lower extremity edema,anorexia,scanty urine,difficulty urinating,constipation,poor sleep,dry mouth,pink tongue,thin white fur,pulse.④evaluation： KPS score,mortality indicators.48 cases（57 cases） hospitalized patients with cervical cancer original medical records.[Data refinement rules and Application methods] Using descriptive statistical analysis method,the clinical manifestations of patients with cervical cancer statistics,score on the functional status of patients admitted to hospital and discharged by the death cases.Functional status： Karnofsky performance status Standard（card＇s KPS Percentages）.SPSS17.0 statistical software for statistical analysis of the mortality of patients after treatment.The establishment of a database using Microsoft Excel 2003 software,the frequency of clinical symptoms,the arrangement of the frequency of symptoms.[Data integration results and conclusions] Main clinical symptoms and signs were fatigue,anorexia,thin white fur,abdominal pain,bloating,lower extremity edema,dark red tongue,lower extremity pain,red,pink tongue,constipation,pulse such as the frequency of sequence.According to the main clinical signs and symptoms of cervical cancer patients,57 cases of patients with syndromes are divided into the liver Qi stagnation,11 cases（19.30%）,liver depression and spleen deficiency syndrome in 13 cases（22.81%）,hot and humid place cards 19 patients（33.33%）,spleen deficiency syndrome in 14 cases（24.56%）.Secondary clinical manifestations of skin petechiae,spontaneous,less moss,vomiting,difficulty breathing,abnormal vaginal discharge,rapid pulse,slippery pulse string,flank pain,urinary incontinence,chills,fever,blood in the stool,pulse string,chest pain,dysuria,frequency of occurrence in order of priority.According to the secondary manifestations of patients with cervical cancer,derived by differentiation syndrome,blood stasis 5 cases,the Blood 7 cases,13 cases of phlegm card.From clinical symptoms,signs,KPS score and mortality analysis,hot and humid place cards and spleen deficiency syndrome higher mortality rate.[Future Prospects]With the development of science and technology for the study of cervical cancer in either Chinese or Western medicine are in continuous development and innovation.Chinese medicine treatment in the future will be less invasive,sustainability,better for patients with cervical cancer to help.