放疗期间急性放射性肠炎中医证型分布、转化临床观察

Clinical observation on TCM syndrome type distribution and transformation of acute radiation enteritis during radiotherapy

目的:观察急性放射性肠炎中医证候分布情况及转化规律。方法:收集102例放疗期间急性放射性肠炎患者中医四诊资料,进行中医辨证,确定中医证候,并研究其在不同放疗阶段的分布情况。结果:急性放射性肠炎出现的时期主要集中在放疗中期(放疗第10~20天)。急性放射性肠炎初次出现时放疗各阶段中医证型皆以湿热蕴肠证最为多见,其次是脾虚湿盛证、气血两虚证,中后期脾虚湿盛证、气血两虚证的比例较初期明显增加。急性放射性肠炎初次出现时中医证型以实证为主,实证中以湿热蕴肠证为主。随着放疗剂量的增加、放射性肠炎的发展,后期急性放射性肠炎中虚证比例明显升高,虚证以脾虚湿盛证和气血两虚证为主。结论:湿热蕴肠证为急性放射性肠炎主要的中医证型,其次是脾虚湿盛证、气血两虚证。急性放射性肠炎初次出现时中医证型以实证为主,后期急性放射性肠炎中虚证比例明显升高。随着放疗剂量的增加、放射性肠炎的迁延,急性放射性肠炎中医证型有自实转虚的趋势。

Objectiveto study and analyze the distribution and transformation of TCM syndromes of ARE(acute radiation enteritis).Methods data of 102 patients with ARE during radiotherapy were collected,TCM syndrome differentiation was carried out,TCM syndromes were determined,and their distribution in different radiotherapy stages was studied.Results ARE appeared mainly in the middle stage of radiotherapy(10-20 days after radiotherapy).When ARE first appeared,damp-heat entrapment syndrome was the most common TCM syndromes in all stages of radiotherapy,followed by damp-heat entrapment syndrome of spleen deficiency and deficiency of qi and blood,and the proportion of damp-heat entrapment syndrome of spleen deficiency and deficiency of qi and blood was significantly increased in the middle and later stages compared with the initial stage.When ARE first appeared,TCM syndrome type was dominated by empirical evidence,in which damp-heat entrails syndrome was the dominant one.With the increase of radiotherapy dose and the development of radioactive enteritis,the proportion of deficiency syndromes in ARE increases obviously in the later stage,and the deficiency syndromes ARE mainly the deficiency of spleen and qi and blood.Conclusion damp-heat entrapment syndrome is the main TCM syndrome type of ARE,followed by spleen-deficiency damp-heat entrapment syndrome and qi-blood deficiency syndrome.When ARE first appeared,TCM syndromes were dominated by empirical evidence,and the proportion of deficiency syndromes in ARE increased significantly in the later stage.With the increase of radiotherapy dose and the delay of radiation enteritis,ARE syndrome of traditional Chinese medicine has the tendency of self-consolidation to deficiency.