结直肠癌的证型分布特点及证型判别分析

The distribution characteristics and recognition of TCM syndrome types of colorectal cancer

目的:探讨结直肠癌的中医证型分布特点并对其建立判别函数。方法:收集辽宁中医药大学附属医院肿瘤科诊断为结直肠癌的患者107例,根据中医辨证分型分为湿热瘀滞证、肝郁脾虚证、气阴两虚证、脾肾阳虚证、气血亏虚证,通过统计学探索中医证型的分布特点,并根据该证型的患者的症状、体征及部分临床特征进行逐步判别分析,有序变量分为“有”和“无”两级,分别记为“1”和“0”,然后根据入选因素建立判别函数,并对函数式的正确率进行检验。结果:统计学分析表明结直肠癌的中医证型分布由高到低分别是气阴两虚证、肝郁脾虚证、湿热瘀滞证、脾肾阳虚证、气血亏虚者;苔黄腻、情志不畅、舌淡、下肢浮肿、畏寒、少苔、血便、大便溏结不调和肝区不适,以上9个因素对区分5类中医证型有意义,被用来建立判别函数,回代Fisher判别函数结果,正确率达到85%。结论:结直肠癌患者以气阴两虚证居多,其次为肝郁脾虚证,根据主要证候因素建立的判别函数判别正确率较高,有一定的参考意义。

Objective:To explore the distribution characteristics of TCM syndrome types of colorectal cancer and establish a discriminant function for it.Methods:A total of 107 cases were collected.According to TCM syndrome types,they were divided into five types:the damp-heat stagnation type,the liver stagnation and spleen deficiency type,the deficiency of both Qi(气)and Yin(阴)type,the Yang(阳)deficiency of spleen and kidney type,and the deficiency of Qi and blood type.The distribution characteristics of TCM syndrome types were explored by statistics,and a stepwise discriminant analysis was carried out based on the symptoms,signs and some clinical characteristics of the patients with that syndrome type.The ordinal variables were divided into two levels,“Yes”and“No”,which were recorded as“1”and“0”respectively.And then a discriminant function was established according to the selected factors,and the correctness of the function formula was tested.Results:The statistical analysis showed that the distribution of TCM syndrome types of colorectal cancer from high to low were the deficiency of both Qi and Yin type,the liver stagnation and spleen deficiency type,the damp-heat stagnation type,the Yang deficiency of spleen and kidney type,the deficiency of Qi and blood type.9 factors such as yellow and greasy fur,bad mood,pale tongue,edema of lower limbs,chills,little fur,bloody stools,irregular stools,and liver discomfort were meaningful for distinguishing the 5 TCM syndrome types,and were used to establish the discriminant function.The results of the Fisher discriminant function showed that the correct rate reached 85%.Conclusion:Patients with colorectal cancer show the deficiency of both Qi and Yin type most,followed by the liver depression and spleen deficiency type.The discriminant function established based on the main syndrome factors shows a higher accuracy,and has a certain reference significance.