晚期非小细胞肺癌中医证候分布及动态演变临床研究

Clinical Study of the Distribution and Dynamic Evolution of Traditional Chinese Medicine Syndromes for Advanced Non-Small-Cell Lung Cancer

目的:观察晚期非小细胞肺癌中医证候的分布及动态演变。方法:采用前瞻性流行病研究方法,对初次治疗的晚期非小细胞肺癌在病情发展的7个不同时点(治疗前,治疗后42 d、84 d、150 d、270 d、390 d及510 d)进行动态的证候观察。结果:各时点共出现20种不同的的中医辨证分型。证候要素研究方面,气虚证素治疗后42 d、84 d、390 d、510 d与治疗前比较,具有显著差异(P<0.05);阴虚证素、痰湿证素、血瘀证素治疗后510 d与治疗前比较,具有显著差异(P<0.05);在虚实证候研究方面,实证、虚实夹杂证治疗后42 d、84 d、390 d、510 d与治疗前比较,差异具有统计学意义(P<0.05)。结论:晚期非小细胞肺癌中医证候随着病程的推移,单证逐渐减少,复证逐渐增加。虚证、实证呈减少的趋势,而虚实夹杂证则逐渐增多。证侯要素中气虚、阴虚、痰湿及血瘀等均呈现增加的趋势。

Objective：To observe the distribution and dynamic evolution of traditional Chinese medicine（TCM） syndromes for advanced non-small-cell lung cancer（NSCLC）. Methods：Prospective epidemiological methodology was adopted to observe the dynamic syndromes of the initial NSCLC treatment at seven different time points（before the treatment,and at 42,84,150,270,390 and 510 days after treat- ment）. Results：There were a total of 20 different TCM syndroms at different time points. In terms of syndrome elements, in the patients with Qi deficiency syndrome, compare the curative effect with before and after the treatment （42 d, 84 d, 390 d,510 d）, there was a sig- nificant difference（P 〈0.05）. in the patients with Yin deficency syndrom, phlegm-damp syndrom and syndrome of blood stasis, com- pare the curative effect with before and after the treatment （510 d）, there was a significant difference （P 〈 0.05 ）. In terms of excess and deficiency, in the patients with syndrome of intermingled deficiency and excess, compare the curative effect with before and after the treatment（42 d,84 d,390 d,510 d） ,The difference is statistically significant. Conclusion：With the development of advanced NSCLC, single syndrome gradually declined and multiple syndromes increased. Deficiency syndromes and excess syndromes showed adecreasing, while the syndrome of intermingled deficiency and excess increased. Qi deficiency, Yin deficiency, phlegm-damp syndrom and syndrome of blood stasis were also on the increase as disease progressed.