大肠癌合并腹腔积液的中医证型分析及用药规律

TCM syndrome analysis and medication rule of colorectal cancer complicated with ascites

目的分析大肠癌合并腹腔积液中医证型与相关因素的关系,探讨其对预后的影响及用药规律,为临床针对性干预治疗提供依据。方法回顾性分析2017年1月~2022年6月在辽宁中医药大学附属医院住院治疗的74例患者,收集患者的性别、年龄、四诊、化疗及手术史、处方用药等,并分析不同证型的发病特点、生存时间及用药规律。结果研究共纳入74例患者,以肝郁脾虚型为主,中医证型在年龄、化疗史、有无淋巴结转移等方面的差异有统计学意义(P<0.05),水饮内停型患者的生存时间较肝郁脾虚型短(P=0.043)。临床用药以六君子汤合五苓散、龙牡汤为核心。结论大肠癌合并腹腔积液的中医证型多为肝郁脾虚型,年龄、化疗史以及有无淋巴结转移与中医证型相关。其中,水饮内停型预后差,生存时间显著较短。治疗上应重视健脾益气、利水祛湿、解毒散结。

Objective To analyze the relationship between TCM syndrome types and related factors in patients with colorectal cancer complicated with ascites,and to explore the influence on prognosis and the rule of medication,so as to provide the basis for the targeted intervention therapy in clinic.Methods A retrospective analysis of 74 patients admitted to a Liaoning University of Traditional Chinese Medicine Hospital between January 2017 and June 2022 was performed,the patients’sex,age,chemotherapy and Operation History,survival period and prescription were collected,and analyze the characteristics of different syndrome types,survival period and medication rules.Results A total of 74 patients were included in the study.Liver depression and spleen deficiency were the main causes.There were significant differences in the distribution of TCM syndrome types in age,chemotherapy history and lymph node metastasis(P<0.05).The survival time of Fluid Retention was shorter than that of Liver depression and spleen deficiency(P=0.043).The clinical prescription was based on Liujunzi Decoction,Wuling Powder and Longmu Decoction.Conclusion The TCM syndrome types of colorectal cancer complicated with ascites were mostly liver depression and spleen deficiency.Fluid Retention has a poor prognosis.The TCM syndrome types were related to age,chemotherapy history and lymph node metastasis.In the treatment,we should pay attention to strengthening spleen and qi,diuresis and dispelling dampness,detoxification and dispelling knots.