老年晚期非小细胞肺癌氩氦刀冷冻治疗前后证型变化规律探讨

TCM syndrome elements and the distribution law of elderly patients with non-small cell lung cancer before and after argon-helium cryoablation

目的:研究老年晚期非小细胞肺癌患者氩氦刀冷冻治疗前后的证候类型分布及变化规律,探讨主要证候要素及其影响因素。方法:共收集104例患者,分别于术前1天、术后1周、术后1个月、术后3个月进行辨证,总结证候类型变化规律。结果:(1)104例患者在4个时点共出现27个中医证型,主要以气虚痰湿、气虚痰湿+其他要素、气虚+其他要素3种形式为主。(2)获取病性类证候要素共8个,出现频次排前4位的有气虚(84例)、痰湿(61例)、阴虚(63例)、血瘀(23例)。各时点气虚证素证素频次在疾病发展过程中始终保持较高水平。(3)在证型虚实方面,各时点均以虚实夹杂证最多,虚实夹杂证术后3月例数(74例)比术前(59例)增多,差异具有统计学意义(P<0.05)。(4)气虚为最主要的证候要素,其影响因素为年龄和PS评分,随着年龄增长和PS评分升高,气虚发生风险越高。结论:气虚合并其他要素是老年晚期非小细胞肺癌患者贯穿氩氦刀冷冻治疗前后最主要的证型;年龄>75岁和PS评分升高,气虚发生风险更高。

Objective:To study TCM syndrome patterns,their distribution and transformation law,syndrome factors and the influence factors of elderly patients with non-small cell lung cancer(NSCLC) before and after argon-helium cryoablation.Methods:A total of 104 NSCLC patients were included in this study.TCM syndromes were observed and analyzed at 1 day before operation,postoperative 1 week,postoperative 1 month and postoperative 3 months respectively.Results:(1)Twenty-seven types of TCM syndromes were found in total and mainly manifested with qi deficiency,qi deficiency and phlegm-damp intermingled with other factors,qi deficiency intermingled with other factors.(2)The syndrome elements could be mainly summed as 8 patterns,the first 4 patterns with high frequency were qi deficiency(84 cases),yin deficiency(63 cases),phlegm-damp(61 cases) and blood stasis(23 cases).There were no statistical differences on the frequency of these 4 patterns at different time points respectively and also are at relatively high levels.(3)Syndrome of intermingled deficiency and excess was the main deficiency-excess syndromes.The number of deficiency-excess syndromes 3 months after surgery(74 cases) increased with the progression of the disease compared with that before surgery(59 cases)(P<0.05).(4)Qi deficiency was the chief syndrome elements.The occurrence risk of qi deficiency increased with age and PS scores.Conclusion:Syndrome of qi deficiency intermingled with other factors was the main syndrome for elderly patients with non-small cell lung cancer before and after argon-helium cryoablation.The occurrence risk increases when age>75 years old and PS scores increase.