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结直肠癌术后中医证型与临床因素的相关性分析

Correlations between TCM syndromes and clinical factors after colorectal cancer surgery

    摘要
  • 摘要:
    目的 探讨结直肠癌术后患者中医证型与性别、分化程度、分期、年龄等因素的相关性。
    方法 将天津市人民医院肛肠中心的结直肠癌术后患者351例纳入本研究，收集患者的临床资料、症状、体征等信息，分析结直肠癌患者术后中医证型与性别、分化程度、分期、年龄等因素的相关性。
    结果 结直肠癌患者术后中医证型包括脾肾两虚、肝肾阴虚、脾虚气滞、肝脾不调、气血两虚; 年龄、性别、分期与中医证型分布有相关性(P < 0.05); 分化程度与中医证型无相关性(P>0.05)。多因素Logistic回归分析显示，年龄、性别是脾肾两虚证的独立影响因素; 临床分期与年龄为肝肾阴虚证患者的独立影响因素; 临床分期为脾虚气滞证患者的独立影响因素。
    结论 结直肠癌患者术后中医证型以脾肾两虚、肝肾阴虚、脾虚气滞为主，中医证型与年龄、性别、临床分期相关。根据患者术后不同证型选择合适的中医药辅助治疗不仅能够提高患者免疫功能，还能减轻放化疗导致的不良反应。

     

    Abstract:
    Objective To explore the correlations of TCM syndromes with age, gender, differentiation degree and stage of colon cancer patients after surgery.
    Methods A total of 351 patients with colorectal cancer after surgery in the Anorectal Center of Tianjin People′s Hospital were recruited in the study.The clinical data, symptoms and signs of the patients were collected to analyze the correlations of TCM syndromes after surgery with age, gender, degree of differentiation, stage and other factors.
    Results The postoperative TCM syndromes of colorectal cancer included spleen-kidney deficiency, liver-kidney Yin deficiency, spleen deficiency and qi stagnation, liver-spleen dysregulation, and qi and blood deficiency.Age, gender, stage were correlated with the distribution of TCM syndromes (P < 0.05).There was no correlation between differentiation degree and TCM syndromes (P>0.05). Multivariate Logistic regression analysis showed that age and gender were two independent factors affecting dual deficiency of spleen and kidney, clinical stage and patient′s age can be regarded as independent factors in patients with liver and kidney Yin deficiency syndrome, and clinical stage can be regarded as an independent factor in patients with spleen deficiency and Qi stagnation syndrome.
    Conclusion After colorectal cancer surgery, the main clinical TCM syndromes are spleen-kidney deficiency, liver-kidney yin deficiency, spleen deficiency and qi stagnation. TCM syndrome is correlated with age, gender and clinical stage. Selecting appropriate TCM adjuvant therapy according to different postoperative syndromes can not only improve the immune function of patients, but also relieve the adverse reactions caused by radiotherapy and chemotherapy.

     

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