食管癌患者放化疗后中医证型的相关影响因素

Influencing Factors for Traditional Chinese Medicine Syndrome Types in Patients with Esophageal Cancer after Chemoradiotherapy

目的探讨食管癌患者放化疗前后中医证型的相关影响因素。方法在放化疗前后,分别对120例食管癌患者进行中医辨证分型,采用多项多类Logistic回归分析考察中医证型的相关影响因素。结果放化疗后,食管癌患者痰气互阻型由34.2%减少至10.0%,血瘀痰滞型由37.5%减少至30.0%,阴虚热毒型由25.8%增加至40.0%,气虚阳微型由2.5%增加至20.0%,放化疗前后中医证型的差异具有统计学意义(P<0.05)。放化疗前食管癌患者中医证型与KPS评分、骨髓抑制分级和原发部位有明显相关性(P<0.05),放化疗后食管癌患者中医证型与KPS评分和原发部位有明显相关性(P<0.05)。结论食管癌患者放化疗前后中医证型具有明显差异,KPS评分、骨髓抑制分级和原发部位与中医证型具有相关性。

Objective To investigate the influencing factors for traditional Chinese medicine （TCM） syndrome types in patients with esophageal cancer before and after chemoradiotherapy. Methods The TCM syndrome differentiation was performed in 120 patients with esophageal cancer before and after chemoradiotherapy. The influencing factors for TCM syndromes were evaluated using multivariate logistic regression analysis. Results In all the patients with esophageal cancer, the incidence rates of syndrome of intermingled phlegm and qi and syndrome of blood stasis and phlegm stagnation were significantly reduced after chemoradiotherapy （34.2% vs 10. 0%, P〈 0.05; 37.5% vs 30.0%, P〈0.05）, while the incidence rates of syndrome of yin deficiency and heat toxicity and syndrome of qi deficiency causing weak yang were significantly elevated after chemoradiotherapy （25. 8% vs 40.0%, P〈0.05; 2.5% vs 20.0% P〈0.05）. Before chemoradiotherapy, the TCM syndrome types in patients were significantly correlated with Karnofsky Performance Status （KPS） score, marrow suppression grade, and primary site （P〈0.05）. After chemoradiotherapy, the TCM syndrome types in patients were significantly correlated with KPS score and primary site （P〈0.05）. Conclusion Patients with esophageal cancer showed significant changes in TCM syndrome types after chemoradiotherapy. The TCM syndrome types are correlated with KPS score, marrow suppression grade, and primary site.