肿瘤标志物筛查阳性受检者中医体质及生活方式调查

Investigation of TCM Constitutions and Lifestyles of Subjects with Positive Tumor Marker Screening

目的探讨肿瘤标志物筛查阳性受检者与筛查正常者的中医体质及生活方式的差异性。方法选取2014年9月-2017年12月威海地区肿瘤标志物筛查阳性受检者245例为观察组,肿瘤标志物筛查正常受检者300例为对照组,采用现场问卷方式进行中医体质和生活方式调查。结果观察组中,平和质比例显著低于对照组,差异有统计学意义(χ~2=207.483,P<0.001),痰湿质、血瘀质、气虚质、气郁质比例明显高于对照组,差异有统计学意义(P<0.05)。2组作息不规律、大量饮酒、经常吸烟、缺乏运动、饮食不规律和存在偏食的人群比较,差异有统计学意义(P<0.05)。观察组肿瘤标志物阳性指标癌胚抗原常见于痰湿质(40.43%)和气虚质(22.70%),糖类抗原199常见于气郁质(38.71%)和气虚质(24.19%),甲胎蛋白常见于血瘀质(38.46%)和气虚质(23.08%),糖类抗原125常见于血瘀质(33.33%)和气郁质(19.05%),细胞角蛋白19的可溶性片段常见于痰湿质(54.55%)和气虚质(22.73%),前列腺特异性抗原常见于痰湿质(61.52%)和湿热质(23.08%)。结论本研究可有效掌握威海地区肿瘤标志物筛查阳性受检者的中医体质分布情况,了解生活习惯对肿瘤标志物的影响,对临床改善患者偏颇体质、降低肿瘤标志物的阳性指标起到指导作用。

Objective To explore the differences of TCM constitutions and lifestyles among the subjects with positive tumor marker screening and those with normal tumor marker screening. Methods Totally 245 subjects with positive tumor marker screening from September 2014 to December 2017 in Weihai area were selected as the observation group and 300 subjects with normal tumor marker screening were selected as the control group. Field questionnaire was used to investigate TCM constitutions and lifestyles. Results In the observation group, the ratio of constitution of yin-yang harmony was significantly lower than the control group, with statistical significance（χ~2=207.483, P0.001）. The ratios of constitution of phlegm-dampness, constitution of blood stasis, constitution of qi deficiency and constitution of qi stagnation were significantly higher than the control group, with statistical significance（P0.05）. There was statistical significance between the 2 groups in irregular rest, heavy drinking, regular smoking, lack of exercise, irregular diet and partial eclipse（P0.05）. CEA, a positive indicator of tumor markers in the observation group, was commonly found in constitution of phlegm-dampness（40.43%） and constitution of qi deficiency（22.70%）; CA199 was commonly found in constitution of qi stagnation（38.71%） and constitution of qi deficiency（24.19%）; AFP was commonly found in constitution of blood stasis（38.46%） and constitution of qi deficiency（23.08%）; CA125 was commonly found in constitution of blood stasis（33.33%） and constitution of qi stagnation（19.05%）; CYFRA21-1 was commonly found in constitution of phlegm-dampness（54.55%） and constitution of qi deficiency（22.73%）; PSA was commonly found in constitution of phlegm-dampness（61.52%） and constitution of damp-heat（23.08%）. Conclusion Effectively controling the distribution of TCM constitutions of subjects with positive tumor marker screening in Weihai area and understanding the influence of lifestyles on tumor markers can provide guidance for clinical improvement of patients＇ biased constitutions and reduction of positive indicators of tumor markers.