1739例消化道恶性肿瘤“异病同证”核心证候分布规律研究

Study on the“Different Diseases with Same Syndrome”of Core Syndromes of 1739 Cases of Digestive Tract Malignant Tumors

目的分析消化道恶性肿瘤的证素基本特征及核心证候分布规律。方法遵循临床流行病学调查原则,选取大样本回顾性研究设计。收集2012年1月-2021年12月湖南中医药大学第一附属医院1739例消化道恶性肿瘤患者的病历资料,自拟《消化道恶性肿瘤中医证候学临床调查表》进行调查,提取病性、病位等证素信息,建立Excel数据库,采用SPSS26.0统计软件进行因子分析和聚类分析,分析消化道恶性肿瘤的核心证候分布规律。结果共纳入73项有效四诊信息条目,常见病位证素包括脾、胃、肝,常见病性证素包括气虚、气滞、气郁、血瘀、水湿。聚类分析结果显示,证候可依次归纳为脾气亏虚证(31.24%)、瘀血内阻证(28.37%)、胃气亏虚证(17.43%)、脾虚湿盛证(11.97%)、气机阻滞证(10.99%)。结论消化道恶性肿瘤病机繁复庞杂,总的病机为本虚标实,其核心证候可归纳为“中虚血积”。

Objective To analyse the basic characteristics and core syndrome distribution patterns of digestive tract malignant tumors.Methods Following the guidelines and steps of clinical epidemiology and selecting large samples for retrospective study,medical information of 1739 cases of digestive tract malignant tumors from the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2012 to December 2021 was collected.Self-designed“Clinical Survey Questionnaire of TCM Syndromes of Digestive Tract Malignant Tumors”was used for investigation,and the syndrome information of disease property and location was extracted to establish Excel database.SPSS 26.0 statistical software was selected for factor analysis and clustering analysis to analyze the core syndrome distribution patterns of digestive tract malignant tumors.Results A total of 73 meaningful items of the four-diagnosis method were included.The main locations of disease included spleen,stomach,and liver;the main property of disease included qi deficiency,qi stagnation,qi depression,blood stasis,and water-dampness.Clustering analysis results showed that syndromes could be summarized in order as spleen qi deficiency syndrome(31.24%),syndrome of blood stasis(28.37%),stomach qi deficiency syndrome(17.43%),syndrome of spleen deficiency with dampness encumbrance(11.97%)and stagnant qi movement patter(10.99%).Conclusion The mechanism of disease of digestive tract malignant tumors is complex and complicated,the major pathogenesis is deficiency in nature and excess in superficiality,and its core syndrome can be summarized as“deficiency of middle qi and blood stasis”.