216例辅助化学治疗期乳腺癌患者中医证候分布和演变规律研究

Distribution and Evolution of Traditional Chinese Medicine Syndromes in Patients with Breast Cancer during Adjuvant Chemotherapy:A Study of 216 Cases

目的探讨辅助化学治疗期乳腺癌患者的中医证候及其变化规律。方法采集216例辅助化学治疗期乳腺癌患者的四诊信息,通过聚类分析结果结合专家经验归纳出中医证候的分布和演变规律。结果化学治疗开始前患者多表现为脾虚与肝郁两证,第2周期化学治疗结束后患者表现为脾气虚证、肝郁化火证、心肝实热证,第4周期化学治疗结束后患者表现为肝、脾、胃三脏阴血不足为主的证候,第6周期化学治疗结束后患者出现心、肝、脾、胃等多脏腑不足的证候。结论在辅助化学治疗期,患者中医证型总体以虚证为主;在化学治疗前期,主要为肝脾两脏的气病;随着化学治疗的延续,由阳病转为阴病;后期患者逐渐表现为类似五脏羸弱的证候。

Objective To investigate the distribution and evolution of traditional Chinese medicine （TCM） syndromes in patients with breast cancer during adjuvant chemotherapy. Methods The information ob- tained by four diagnostic methods was collected from 216 patients with breast cancer during adjuvant chem- otherapy. The distribution and evolution of TCM syndromes were summarized based on cluster analysis re- sults and expert experience. Results Patients mostly showed spleen deficiency and stagnation of liver qi before chemotherapy, exhibited spleen-qi deficiency, liver depression transforming into fire, and excessive heat in the heart and liver after the second cycle of chemotherapy, showed syndromes mainly including yin- blood deficiency of the liver, spleen, and stomach after the fourth cycle of chemotherapy, and had deficien- cy of multiple organs including the heart, liver, spleen, and stomach after the sixth cycle of chemOthera- py. Conclusion For patients with breast cancer, the TCM syndromes mainly include deficiency syndrome during adjuvant chemotherapy; qi diseases of the liver and spleen are the dominant syndromes in the early phase of chemotherapy;yang disease is transformed into yin disease as the chemotherapy proceeds~ syn- dromes similar to weak five viscera gradually appear in the late phase of chemotherapy.