原发性胃癌中医证候病性分布特点研究

Study on the Distribution Characteristics of TCM Syndromes in Primary Gastric Cancer

目的探析原发性胃癌中医常见证候及病性分布特点,为中医临床准确辨证论治提供理论参考。方法通过回顾性分析,收集符合纳入标准的70例原发性胃癌患者病历资料,建立数据库。运用描述性分析及多因素分析方法从总体上把握四诊信息的内在规律,初步探讨原发性胃癌中医病性类证候分布特点。结果 (1)原发性胃癌患者最常出现乏力,纳差症状;其次为上腹部疼痛,面色无华,寐差,舌红,脘腹胀满,消瘦,恶心,苔薄白,舌淡红,脉弦,便秘,腹痛等。(2)病性类证候根据频数由大到小分布依次为气虚证,气滞证,血虚证,痰湿证,阴虚证,湿热证,血瘀证,热毒证。(3)单一证候中最常见的有气虚证,气滞证,复合证候中最常见的有气虚证+血虚证,气虚证+气滞证;单一证候较复合证候多见,整体以虚性证候最为常见。结论 (1)原发性胃癌中医证候正虚以气虚、血虚为主,邪实以气滞为主,"气虚"是贯穿胃癌发病过程的病性类证候。(2)分析原发性胃癌常见中医证候及病性分布特点可为临床中医证型规范化分类及方药施治提供参考。

Objective： To analyze the common syndromes and pathological distribution characteristics of traditional Chinese medicine for primary gastric cancer and to provide a theoretical reference for the clinical diagnosis and treatment of TCM. Methods： Through retrospective analysis, the medical records of 70 patients with primary gastric cancer who met the inclusion criteria were collected and a database was established. Descriptive analysis and multi-factor analysis methods were used to grasp the internal law of the four diagnostic information in general, and to explore the distribution characteristics of TCM syndromes in primary gastric cancer. Results： A. Patients with primary gastric cancer often had fatigue and anorexia , followed by upper abdominal pain, lusterless complexion, poor sleep, red tongue, abdominal distension, weight loss, nausea, thin white fur, pale red tongue, pulse string, constipation, abdominal pain and etc. B. According to the frequency of syndromes, the syndromes of nature of the diseases was qi deficiency, qi stagnation, blood deficiency, phlegm-dampness, yin deficiency, damp-heat, blood stasis and heat-toxin. C. The most common single syndrome is qi deficiency, qi stagnation, and the most common recombination syndrome is qi deficiency ＋ blood deficiency, qi deficiency ＋ qi stagnation. The single syndrome is more common than composite syndrome, and the qi deficiency syndromes were the most common in general. Conclusion： A.The syndrome of TCM syndrome of primary gastric cancer is mainly due to qi deficiency and blood deficiency. The evil spirit is mainly due to qi stagnation. “Qi deficiency” is a pathological syndrome that runs through the pathogenesis of gastric cancer. B. The analysis of common TCM syndromes and disease distribution characteristics of primary gastric cancer can provide reference for the standardization of TCM clinical syndrome types and prescription treatment.