原发性支气管肺癌中医证型分布特点的研究  

Distribution Characteristics of TCM Syndrome Differentiation in Patients with Primary Lung Cancer

作　　者：杨丹[1] 田国庆[1] 王景[1] 孙青[1] 马青山[1] 张力[2] 王孟昭[2] 李龙芸[2] 李单青[3] 韩少梅[4] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院中医科,北京市100730 [2]中国医学科学院北京协和医学院北京协和医院呼吸科,北京市100730 [3]中国医学科学院北京协和医学院北京协和医院胸外科,北京市100730 [4]中国协和医科大学

出　　处：《中国全科医学》2010年第32期3607-3611,共5页Chinese General Practice

摘　　要：目的探讨原发性支气管肺癌的中医辨证分型特点。方法参照"中药新药临床研究指导原则"、"中华人民共和国国家标准——中医临床诊疗术语证候部分",结合北京协和医院名老中医郭赛珊教授的临床经验拟定肺癌辨证分型标准,采用问卷及计算机统一辨证的方法对152例患者进行调查。结果 (1)单一证:血瘀证、阴虚证、气滞证、湿热证、气虚证、痰热证、痰湿证、阳虚证、火旺证的分布差异有统计学意义(P<0.01)。在单一证脏病中,肺脏受累占32.1%,其次为肝、心,各占22.6%和22.0%。(2)证型的出现率:单一证型为31.6%(48/152)、两证相兼型33.6%(51/152),三证及三证以上相兼型为32.9%(50/152),无证可辨型2.0%(3/152)。(3)临床分期分别与9个单一证出现的例次之间呈正相关(P<0.05)。血瘀证在临床各期患者中的出现率:Ⅰ期61.5%(16/26)、Ⅱ期60.0%(6/10)、Ⅲ期74.5%(38/51)、Ⅳ期80.0%(52/65)。(4)原发性肺癌吸烟与不吸烟患者中医证的分布比较,差异有统计学意义(P<0.05)。结论单一证中以血瘀证最为多见,单一证脏病受累最多者为肺。临床分期与中医证之间有正相关,血瘀证在原发性支气管肺癌各期均最为多见,在肺癌的发病过程中占有重要地位,对于临床辨证论治有一定的指导意义。吸烟的肺癌患者以痰热证、湿热证多见。Objective To investigate the characteristics of traditional Chinese medicine（TCM）syndrome differentiation in 152 hospitalized patients with primary lung cancer in Peking Union Medical College Hospital（PUMCH）.Methods One hundred fifty-two patients were investigated by questionnaire survey and computer identifying syndromes.Criterions of symdrome differentiation of lung cancer were put out based on ＂The Guidelines of Clinical Research on New Chinese Medicine＂ and ＂The People＇s Republic of China＇s National Standard-Clinic Terminology of TCM Diagnosis and Treatment-Syndromes＂ and combined with the clinical experience of distinguished TCM Professor Guo Saishan.Results（1）Distributions of the 9 basic syndromes（blood stasis syndrome,deficiency of yin syndrome,stagnation of qi syndrome,damp-heat syndrome,deficiency of qi syndrome,phlegm-heat syndrome,phlegm-dampness syndrome,deficiency of yang syndrome,fire syndrome）was different（P〈0.01）.In 5 zang-organs,lung was involved in the first place（32.1%）,liver and heart followed（22.6%,22.0%,respectively）.（2）Frequency of differentiation types：31.6%（48/152）patients were divided into 2-syndrome differentiation group,33.6%（51/152）patients into 2-syndrome group;32.9%（50/152）patients into 3-syndrome group or above;3 patients could not be divided into any group.（3）Clinical staging was positively correlated with TCM syndromes（P〈0.05）.The frequency of patients with blood stasis syndromes in each staging was as follows：staging Ⅰ 61.5%（16/26）,staging Ⅱ 60.0%（6/10）,staging ⅢI 74.5%（38/51）,staging Ⅳ 80.0%（52/65）.（4）There was significant difference in distribution of TCM syndromes between smoking and non-smoking patients with lung cancer（P〈0.05）.Conclusion Blood stasis syndrome is the most common in basic syndromes.In 5 zang-organs,lung was involved in the first place.Clinical staging was positively correlated with TCM syndromes.Blood stasis syndrome was the most frequent syndrome in each

关 键 词：肺肿瘤 证候 血瘀 肿瘤分期 吸烟 

分 类 号：R734.2[医药卫生—肿瘤]