原发性支气管肺癌中医证候研究现状评述

Review on TCM syndromes of primary bronchial lung cancer

证候是中医辨证论治的主要依据。从肺癌的证候与客观指标相关性研究、证候规范化研究、证候研究的常用方法三方面着手,对近年来肺癌证候研究现状加以梳理和分析。多数研究认为肺癌证型分布与TNM分期、舌象、影像学表现、卡氏评分、系统生物学、各理化指标等存在相关性,而在与不同病理分型之间有无相关性方面,仍存在争议;证候规范化研究是肺癌证候研究长期以来的重点和难点,证候诊断标准规范化、证候量表规范化和术语规范化是证候规范化研究的重要环节,研究者在这些方面进行的探索性研究取得了一些成果,但尚未成熟,其推广应用亦显不足;肺癌证候研究的常用方法有聚类分析、主成分分析、关联分析、Logistic回归分析、因子分析、隐结构模型、贝叶斯网络等,各研究方法有其自身特点,适应不同的研究需求。针对研究中的问题,提出综合多学科知识和成果,结合多种研究方法,参考专家经验,在证候规范化基础上开展肺癌的多中心、大样本、前瞻性研究会更有价值。

Syndrome is the main basis of traditional Chinese medicine syndrome differentiation.This paper reviews and analyzes the research status of lung cancer syndrome in recent years from three aspects:the correlation between the syndromes and objective indicators of lung cancer,the standardization of syndromes and the common methods of syndrome research.Most studies show that there is a correlation between the distribution of lung cancer syndrome type and TNM stage,tongue image,imaging manifestations,Cartesian scores,system biology,physical and chemical indicators,etc.However,there is still controversial that whether there is a correlation on the distribution of lung cancer syndrome type with the different pathological types.For a long time,the research of syndrome standardization is the key and difficult point for lung cancer syndrome research,to standardize the standard syndromes and syndrome scale standardization and terminology standardization is an important part of syndrome standardization study,the researchers conducted in these areas have made some exploratory studies,but those are not mature yet,its promotion and application also shows insufficient;The commonly used methods of lung cancer syndrome research include cluster analysis,principal component analysis,association analysis,logistic regression analysis,factor analysis,hidden structure model,bayesian network and so on.Each method has its own characteristics and to adapt to different research.In view of this study,it is more valuable to carry out multi-center,large sample and prospective study of lung cancer on the basis of syndrome standardization by integrating multidisciplinary knowledge and results,combining multiple research methods and referring to expert experience.