手术前后大肠癌中医证型变化规律研究

The Research on TCM Syndrome Types Change Rule of Preoperative and Postoperative Colorectal Cancer

目的观察并探讨手术前后大肠癌中医证型变化规律。方法进行前瞻性临床研究设计。观察经病理检查确诊、拟行手术治疗的大肠癌病例146例,分别于术前、术后一周进行中医辨证分型,未进行中医药干预治疗。采集患者一般资料、四诊资料、术后病理检查结果及病理分期等作为观察指标。结果术后辨证大肠癌均以脾虚气滞为最多,随着病情发展,正气耗损,渐渐由实证转为虚证为主虚实夹杂的病症,中晚期大肠癌患者的主要表现为虚证,病期越早虚证越少见。结论大肠癌的手术治疗,在去除部分病邪的同时,可能损伤患者脾胃后天之本,导致疾病进一步的演变。所以笔者认为大肠癌在术前、术后均应于重视健运脾胃、扶助正气,发挥多学科诊治作用。

Objective To observe TCM syndrome types change rule of preoperative and postoperative Colorectal cancer. Methods Prospective clinical study design. We observated 146 cases of colorectal cancer confirmed by pathological examination, which would be on operation. Each one would be recognised on TCM syndrome types during the preoperative and postoperative week of Colorectal cancer, without TCM intervention therapy. Collect patients＇ general information, four diagnostic data and postoperative pathologic examination results and pathological staging as observation index. Results The most TCM syndrome type of the postoperative colorectal cancer is pixu. As development of the illness, loss of healthy atmosphere, TCM syndrome type gradually turn to intermingled deficiency and excess. Middle-late colorectal cancer patients mainly have deficiency syndrome, the earlier disease the fewer deficiency syndrome is. Conclusion The colorectal cancer surgery, while removing part of pathogenic, may damage the healthy atmosphere of patients, lead to the further evolution of the disease. So the author thinks that in preoperative and postoperative colorectal cancer should be took great importance to the health of vital qi of spleen and stomach, assistance, give surport to the role of the multidisciplinary treatment.