Ⅰ型和Ⅱ型子宫内膜癌患者中医证候差异性初探

Preliminary study of difference in TCM pattern types between patients with Type Ⅰ and those with Type Ⅱ endometrial cancer

目的探讨Ⅰ型和Ⅱ型子宫内膜癌(EC)患者中医证候分布规律及其在年龄、子宫内膜厚度、体重指数(BMI)等方面的差异,以期为中医药防治EC提供理论依据。方法回顾性分析87例EC患者的临床病例资料,归纳并比较Ⅰ型和Ⅱ型EC患者中医证候分布、年龄、子宫内膜厚度、BMI等方面的分布差异。结果Ⅰ型EC患者67例,以脾肾阳虚证为主,Ⅱ型EC患者20例,以肝肾阴虚证为主,组间比较差异有统计学意义(P<0.05)。Ⅰ型EC患者平均年龄小于Ⅱ型EC患者,可见于育龄期及非育龄期,Ⅱ型EC患者均为非育龄期,组间比较差异有统计学意义(P<0.05);Ⅰ型EC患者术前内膜厚度大于Ⅱ型EC患者,组间比较差异有统计学意义(P<0.05);Ⅰ型EC患者超重比例高于Ⅱ型EC患者,组间比较差异有统计学意义(P<0.05);Ⅰ型EC患者合并高血压、糖尿病、血脂异常人数多于Ⅱ型EC患者,但组间比较差异无统计学意义(P>0.05)。结论Ⅰ型EC患者以脾肾阳虚证为主,Ⅱ型EC以肝肾阴虚证为主,二者在年龄、子宫内膜厚度、BMI等方面分布具有差异性。临床应根据EC患者具体情况辨证施治,以更好地发挥中医药在防治EC方面的优势。

Objective To explore the distribution of TCM patterns in patients with typeⅠendometrial cancer(EC)and those with type II EC and patients’differences in age,endometrial thickness and body mass index(BMI),in order to provide a theoretical basis for the prevention and treatment of endometrial cancer with traditional Chinese medicine.Methods Clinical data of 87 EC patients were retrospectively analyzed,and differences in TCM pattern,age,endometrial thickness and BMI between typeⅠand typeⅡEC patients were identified.Results The 67 patients with typeⅠEC were mainly diagnosed as having the pattern of spleen-kidney yang deficiency,and the 20 patients with typeⅡEC liver-kidney yin deficiency.There was statistically significant difference between the two groups(P<0.05).The average age of type I EC patients who were of or after childbearing age was younger than that of typeⅡEC patients who were all after childbearing age.There was statistically significant difference between the groups(P<0.05).Average preoperative endometrial thickness of patients with typeⅠEC was greater than that of patients with typeⅡEC with statistically significant difference(P<0.05).The percentage of overweight patients with type Ⅰ EC is higher than that of overweight patients with typeⅡEC and there was statistically significant difference between the two(P<0.05).The percentage of type Ⅰ EC patients with hypertension,diabetes and dyslipidemia was higher than that of typeⅡEC patients but there was no statistically significant difference between them(P>0.05).Conclusion Type Ⅰ EC patients mainly suffered from spleen-kidney yang deficiency,while Type Ⅱ EC patients liver-kidney yin deficiency.There were differences in age,endometrial thickness and BMI between the two groups.Treatment should be tailored to the specific conditions of patients based on pattern differentiation to give full play to the advantages of TCM in the prevention and treatment of EC.