肺癌骨转移相关因素与中医证型研究

A study on the related factors of lung cancer with bone metastasis and TCM syndromes

目的:探究肺癌骨转移相关的影响因素,分析中医证型,为肺癌患者的中医药治疗提供一定的参考依据。方法:采用回顾性研究方法,搜集2018年1月-2021年4月于辽宁中医药大学附属医院肿瘤科住院且第一诊断为肺癌的临床病例资料。运用Microsoft Excel软件对肺癌骨转移患者的性别、年龄、吸烟史、手术史、化疗史、病理类型、症状表现、舌脉象等进行收集录入。辨证后统计中医证型。运用SPSS 26.0软件对数据行χ^(2)检验或Fisher确切概率法等分析组间差异。结果:(1)根据纳排标准,共有143例肺癌患者纳入研究,未发生骨转移的有76例,发生骨转移的有67例。(2)肺癌骨转移与中医证型差异具有统计学意义(P<0.05)。(3)肺癌骨转移与病理类型差异具有统计学意义(P<0.05)。(4)性别、年龄、吸烟史、手术史、化疗史与肺癌骨转移不具有统计学意义(P>0.05)。(5)肺癌患者的证型分布情况:气阴两虚证(42.66%,61/143)>肺脾气虚证(25.17%,36/143)>痰湿蕴肺证(17.48%,25/143)>瘀阻肺络证(10.49%,15/143)>热毒壅肺证(4.20%,6/143)。结论:肺癌患者中医证型中气阴两虚证患者更易发生肺癌骨转移,肺脾气虚证次之。在病理类型中,腺癌易发生骨转移。肺腺癌且中医证型为气阴两虚证或肺脾气虚证的患者应及时诊断治疗,注意随访,观察患者的病情变化。

Objective:To explore the influencing factors related to bone metastasis of lung cancer and analyze TCM syndrome types,so as to provide some reference for TCM treatment of lung cancer patients.Methods:A retrospective study was conducted to collect clinical data of patients with lung cancer who were hospitalized in the Department of Oncology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 2018 to April 2021.The gender,age,smoking history,surgical history,chemotherapy history,pathological type,symptom and pulse condition of lung cancer patients with bone metastasis were collected and recorded by Microsoft Excel software.TCM syndrome types were counted after syndrome differentiation.SPSS 26.0 software was used to analyze the differences between groups byχ^(2) test or Fisher’s exact probability method.Results:(1)A total of 143 patients with lung cancer were included in the study according to the inclusion criteria,with 76 patients without bone metastasis and 67 patients with bone metastasis.(2)There was a statistical difference between bone metastasis of lung cancer and TCM syndrome type(P<0.05).(3)There was a statistical difference between bone metastasis and pathological type of lung cancer(P<0.05).(4)Gender,age,smoking history,surgery history,chemotherapy history and bone metastasis of lung cancer were not statistically significant(P>0.05).(5)The distribution of syndrome types of lung cancer patients:Qi(气)and Yin(阴)both deficiency syndrome(42.66%,61/143)>Qi deficiency of lung and spleen syndrome(25.17%,36/143)>phlegm-dampness accumulation in lung syndrome(17.48%,25/143)>stasis in lung collaterals syndrome(10.49%,15/143)>heat and toxin obstruction in lung syndrome(4.20%,6/143).Conclusion:Lung cancer patients with Qi and Yin both deficiency syndrome are more likely to have lung cancer with bone metastasis,Qi deficiency of lung and spleen syndrome is the second.Among pathological types,adenocarcinoma is prone to be bone metastasis.Patients with lung adenocarcinoma and TCM syndrome type of Qi and Yin both deficiency syndrome or Qi deficiency of lung and spleen syndrome should be diagnosed and treated in time,pay attention to follow-up,and observe the changes of patients’condition.