淋巴瘤患者症状特征及证候特点研究

Study on the characteristics of symptoms and syndromes of patients with lymphoma

目的探索淋巴瘤单纯中医药治疗阶段患者的症状特征及中医证候特点。方法采用肿瘤常见症状及中医症状调查量表(MDASI-TCM),对40例处于单纯中医药治疗阶段的淋巴瘤患者进行横断面调查。采用Spearman相关分析分析患者症状间的相关性,采用主成分分析提取患者的症状群。结果 40例淋巴瘤患者普遍存在多种症状,其中发生率最高的3个症状分别为口干(65.00%)、疲劳(62.50%)、睡眠不安(62.50%),症状得分最高的3个症状分别为疲劳(3.10±2.99)、出汗(2.80±2.98)、口干(2.30±2.58)。Spearman相关分析结果显示,大多数症状之间存在正相关关系。主成分分析提取出6个症状群,其中症状群1(苦恼、悲伤、口苦、手足心热、口腔溃疡)可辨证为阴虚内热、心肝火旺;症状群2(气短、出汗、怕冷)可辨证为气阴两虚、阴损及阳。结论淋巴瘤患者存在不同的多发症状及症状群,认识患者的症状、症状群有助于医者准确辨证并及时采取干预措施。

Objective To explore the characteristics of symptoms and TCM syndromes of lymphoma patients. Methods MD Anderson Symptom Inventory-Traditional Chinese Medicine （MDASI-TCM） was applied in this questionnaire survey to 40 lymphoma patients who were under pure traditional Chinese medicine （ TCM ） treatment for a cross-sectional study. Spearman correlation analysis was used to explore symptom relativity and principal component analysis （PCA） to extract symptom clusters. Results Lymphoma patients had several common symptoms, among which the three most frequently occurred symptoms were dry mouth （65.00%）, fatigue （62.50%） and restless sleep（62. 50% ）, and the ones with highest scores were fatigue （3.10 ~ 2. 99 ）, sweating （2. 80 ~ 2. 98 ） and dry mouth （2. 30 ~ 2. 58 ）. Spearman correlation analysis showed that these symptoms were positively correlated with each other. Six tree symptoms clusters were extracted by PCA, which were： 1. （worry, sadness, bitter taste in the mouth, hot sensation in the hands, feet and chest, ulcer in the mouth ） belonging to internal heat due to y/n deficiency and hyperactivity of heart-liver fire; 2. （ shortness of breath, sweating, fear of cold） belonging to deficiency of both qi and yin and yin deficiency affecting yang. Conclusion Lymphoma patients have different common symptoms and symptom clusters. Knowing these symptoms and symptoms clusters will help doctors precisely conduct syndrome differentiation and timely make intervention measures as a reference.