晚期非小细胞肺癌中医证型分布规律及预后探讨

Exploration on TCM syndromes distribution and prognosis of NSCLC

目的:探讨晚期非小细胞肺癌中医证型分析分布规律,以期有利于中医治疗指导。方法:选取我院肿瘤科2012年1月-2016年8月晚期非小细胞肺癌(包括Ⅲb、Ⅳ期)患者共85例,男性56人,女性29人。其中腺癌45例,鳞癌40例。采用回顾性研究与入院后按照中医证候分布表填表,进行跟踪随访。观察症状、舌象、脉象进行中医证候分型,比较各证型分布规律,患者总生存期,无疾病进展时间等。结果:非小细胞肺癌晚期患者临床以痰热者居多,占35.29%,其次为气阴两虚,占27.0%,痰湿型占22.36%。痰湿组与痰热组相比较,脑转移率及总转移率的差异有统计学意义(P<0.05)。晚期非小细胞肺癌痰热者治疗无疾病进展期为(8.20±3.25)个月,而痰湿型为(3.6±3.37)个月。两组差异有显著性,P<0.05。两组在总生存期比较无显著差异,其他组间比较无显著差异,P>0.05。结论:肺癌晚期虽然有痰热、痰湿、血瘀等标实表现,其实不同程度存在气虚、阴虚等虚象,而且虚实夹杂。在治疗过程中我们应该把握痰热毒邪,给予清热解毒、化痰散结,及早益气养阴。

Objective To investigate the distribution of TCM syndromes in patients with advanced non-small cell lung cancer, and to facilitate the guidance of treatment in TCM. Methods： A total of 85 patients with advanced non-small cell lung cancer （including stage Ⅲb, Ⅳ） were enrolled in our hospital from January 2012 to August 2016, 56 males and 29 females. There were 45 cases of adenocarcinoma, and 40 cases of squamous cell carcinoma. Symptoms, tongue, pulse were observed; the TCM syndromes were classifed and the distribution rules of the syndromes and so on were compared. Results： The majority TCM syndrome was the Tanre type, accounting for 35.29%, followed by the Qiyin Liangxu type and the Tanshi type, accounting for 27.0% and 22.36% respectively. The diferences of the brain metastasis rate and total metastasis rate in the Tanshi group and the Tanre group were statistically signifcant, P〈0.05. No disease progression of the Tanre type were （8.20±3.25） months, and （3.6±3.37） months of the Tanshi type. The diference between the groups was signifcant （P〈0.05）. Conclusion： Although lung cancer has phlegm-heat, phlegm-dampness, blood stasis and other standard performance, in fact, there are defciency syndromes such as diferent degrees of Qixu, Yinxu and other virtual images. In the course of treatment we should applied the therapy of Qingre Jiedu Huayu and Sanjie, in order to play the role of Yiqi Yangyin.