145例肾细胞癌术后患者中医证候分布规律及其与危险因素的相关性研究

Study on Distribution of Traditional Chinese Medicine Syndromes and Correlation with Risk Factors in Postoperative Periods of 145 Patients with Renal Cell Carcinoma

目的:分析肾细胞癌患者术后中医证候分布特点,探讨其危险因素与证型分布的相关性。方法:采用回顾性调查,制定肾细胞癌术后患者症状评估量表,采集患者中医四诊信息,统计分析145例肾细胞癌术后患者中医证型分布规律;利用频数方法观察危险因素在不同证型中的分布特点;利用多因素Logistic回归分析方法分析不同中医证型与危险因素的相关性。结果:肾细胞癌术后患者临床症状主要有双腿沉重(87.59%),情志不佳(82.07%),腰痛(33.79%),头晕(27.59%)等。中医证型以脾肾气虚、肝肾阴虚、脾肾阳虚、湿热下注为主。描述性统计分析显示,影响证型分布的因素有性别、年龄、饮酒、吸烟、高血压、体质量指数(BMI)≥24 kg/m2。回归分析显示,饮酒史、BMI≥24 kg/m2是脾肾气虚证的危险因素;高血压病史是肾癌术后出现肝肾阴虚证的保护性因素;年龄是肾癌术后出现脾肾阳虚证的保护性因素;男性是肾细胞癌患者出现湿热下注证保护性因素,吸烟史、饮酒史是湿热下注证的危险因素。结论:肾细胞癌术后患者脾肾气虚、肝肾阴虚、脾肾阳虚、湿热下注为常见中医证型;临床症状表现主要为双腿沉重、腰酸腰困腰痛、情志不佳等;肾细胞癌术后的中医证候类型与危险因素存在一定的相关性。饮酒史、超重与脾肾气虚证相关;吸烟史、饮酒史与湿热下注证相关。

Objective:To analyze distribution of traditional Chinese medicine(TCM)syndromes in postoperative periods of patients with renal cell carcinoma,and to explore correlation between risk factors and distribution of TCM syndromes.Methods:A retrospective survey was conducted to establish a postoperative symptom assessment scale for patients with renal cell carcinoma.The data of patients in postoperative periods were collected.The distribution of TCM syndromes in 145 patients with renal cell carcinoma was analyzed statistically.The frequency distribution method was used to observe the distribution characteristics of risk factors in different syndrome types.Multi-factor logistic regression method was used to analyze the relevance between different TCM syndromes and risk factors.Results:The major clinical symptoms of patients with renal cell carcinoma in postoperative periods were heavy sensation in legs(87.59%),depression(82.07%),low back pain(33.79%)and dizziness(27.59%).The TCM syndrome types were mainly spleen and kidney qi deficiency,liver and kidney yin deficiency,spleen and kidney yang deficiency,damp heat pouring down.Descriptive statistical analysis showed that the factors affecting the distribution of syndrome types were gender,age,alcohol consumption,smoking,hypertension,and body mass index(BMI)≥24 kg/m2.Regression analysis showed that alcohol consumption history and BMI≥24 kg/m2 were risk factors for spleen and kidney qi deficiency syndrome;hypertension was a protective factor for liver and kidney yin deficiency syndrome after renal cancer surgery;age was the protective factors for spleen and kidney yang deficiency syndrome after renal cancer surgery;male was the protective factors for damp heat pouring down syndrome in patients with renal cell carcinoma,while smoking history and alcohol consumption history were the risk factors for damp heat pouring down syndrome.Conclusions:Spleen and kidney qi deficiency,liver and kidney yin deficiency,spleen and kidney yang deficiency,and damp heat pouring down were common TCM syndromes in patients with renal cell carcinoma in postoperative period.The clinical symptoms were mainly heavy sensation in legs,soreness and weakness of loins,depression,low back pain and dizziness.There was a certain correlation between the types of TCM syndromes and risk factors in postoperative periods.Alcohol consumption history,overweight are related to spleen and kidney qi deficiency syndrome;smoking history,alcohol history are related to damp heat pouring down syndrome.