大肠癌中医证候的回顾性研究

摘要

目的：研究大肠癌中医证型的分布规律，以临床常见证型为研究对象，进一步探讨大肠癌中医证候的演变及疗效规律。方法对383例大肠癌患者进行资料整理及统计学分析。结果大肠癌中医证型分布规律为：按虚实辨证，实证＞虚证＞虚实夹杂证；按脏腑辨证，脾＞肾＞肝＞心＞肺；按临床证型辨证，湿热下迫型＞脾肾亏虚型＞大肠瘀毒型。大肠癌演变规律为：由实证或虚实夹杂证演变为虚证，表现为湿热下迫→脾肾亏虚，大肠瘀毒→脾肾亏虚。大肠癌疗效规律为：湿热下迫型与大肠瘀毒型患者均能显著提高体质量。同一证型治疗后与治疗前对比KPS评分差异有统计学意义。湿热下迫型与大肠瘀毒型CEA差异有统计学意义，大肠瘀毒型CEA最高，阳性率各型差异无统计学意义。湿热下迫型患者能耐受更多疗程的化疗。结论大肠癌中医证型分布具有一定规律性，其中以实证、归于脾肾、湿热下迫型最为常见；其证候均有从实转虚的变化；不同中医证型均可以提高大肠癌患者体质量、改善生活质量、降低CEA、耐受不同程度的化疗数量，实证疗效更好。%Objective ToobservetheTCMSyndromedistributionregularityofcolorectalcancerandfurtherdiscuss theevolvementandefficacyregularitywithclinicaltypeforexample.Methods Aretrospectiveanalysisof383patients withcolorectalcancerwasmade.Results TCMsyndromedistributionregularitywasempirical>deficiency>both deficiency and empirical by syndrome differentiation of excess and deficiency;spleen> kidney> liver> heart> lung by syndrome differentiation of zang-fu viscera;damp-heat type> spleen and kidney deficiency type> colon blood sta-sis type by clinical type. TCM Syndrome evolvement regularity was changing from damp-heat type to spleen and kidney deficiency type and colon blood stasis type to spleen and kidney deficiency type. The efficacy regularity was that the weight,CEA marker and quality of life on damp-heat type and colon blood stasis type could improve statistically signifi-cantwithmorechemotherapytreatmentcourseondamp-heattype.Conclusion Thereisacertainregularityonthe TCM syndrome distribution,evolvement and efficacy of colorectal cancer.