宫颈上皮内瘤变及宫颈癌中医证型演变规律研究  

Study of the evolution law of Chinese medicine syndrome types in cervical intraepithelial neoplasia and cervical cancer

作　　者：郑怡真[1] 吴冬梅[1] 刘倩[1] 余江[1] 徐萍[1] 汪敏华[1] 

机构地区：[1]福建中医药大学附属福建省第二人民医院妇产科,福州350003

出　　处：《中国医药》2011年第12期1543-1545,共3页China Medicine

基　　金：陈可冀中西医结合发展基金资助项目（CKJ2009010）

摘　　要：目的探讨宫颈上皮内瘤变（CIN）与宫颈癌中医证型分布及演变规律。方法对149例CIN及宫颈癌患者进行中医辨证分型，探讨证型与年龄分布关系及不同病理阶段证型演变规律。结果149例CIN患者主要证型依次为湿热蕴毒型[57例（38．3％）]、外染毒邪型[43例（28．9％）]、肝经湿热型[29例（19．5％）]、阴虚夹湿型[17例（11．4％）]、脾肾阳虚型[3例（2．0％）]。不同证型组间的年龄分布差异无统计学意义（P=0．184）。CINⅠ多见外染毒邪型[20／29（69．0％）]，其次为湿热蕴毒型[9／29（31．0％）]；CINⅡ、CINⅢ以湿热蕴毒型为主[CINⅡ15／29（51．7％；CINⅢ：16／30（53．3％）]；宫颈癌以湿热蕴毒型、阴虚夹湿型为主[均17／61（27．9％）]。证型在不同病理阶段的分布差异有统计学意义（P〈0．01）。外染毒邪型与湿热蕴毒型病理程度差异无统计学意义（P〉0．05），阴虚夹湿型与肝经湿热型差异无统计学意义（P〉0．05），阴虚夹湿型、肝经湿热型分别与湿热蕴毒型、外染毒邪型比较，差异有统计学意义（P〈0．01）。结论CIN及宫颈癌的中医证型以湿热蕴毒型为多，随着病变的进展，由外染毒邪、湿热蕴毒．肝经湿热、阴虚夹湿．脾肾阳虚发生演变。Objective To investigate the Chinese medicine syndrome type distribution and evolution law in patients with cervical intraepithelial neoplasia （CIN） and cervical cancer. Methods Chinese medicine syndrome types of 149 CIN or cervical cancer patients were sorted, and the relationship with age distribution was analyzed, as well as the evolution law of syndrome types in different pathologic stage. Results Chinese medicine syndrome of 149 women were differentiated into five types ： 43 patients （28.9 % ） of out-evil infection type, 57 （38.3 % ） of damphot poison-aggregation type, 29 （ 19.5 % ） of liver-meridian damp-hot type, 17 （ 11.4% ） of yin-deficiency with damp type and 3 （2.0%）of spleen-and-kidney yang-deficiency type. Among 5 syndrome types, damp-hot poison-aggregation type was most commonly seen. There were no significant differences of the age distribution between patients with different syndromes types（P = 0. 184）. Syndromes types changed following cervical lesion evolving.＇ Out-evil infection type were commonly seen in CIN Ⅰ , accounting for 20 patients （69.0%）. Patients with CIN Ⅱ were mostly damp-hot poison-aggregation type, which were 15 patients（51.7% ）. Patients with CIN Ⅲ were mostly damp-hot poison-aggregation type （ 16 patients,53.3% ）. Retention of damp-hot poison-aggregation（ 17 patients,27.9% ） and yin-deficiency with damp type（ 17patients ,27.9% ）were the dominance in patients with cervical cancer. There was a significant difference of syndrome type distribution in varying pathologic degrees （ P 〈 0. 001 ）. Compared with different syndromes, there was a significant difference in pathologic degrees （χ^2 = 45. 7769, P 〈 0. 0001 ）. There were no differences between out-evil infection type and damp-hot poison-aggregation type （P 〉 0.05 ）, yin-deficiency with damp and liver-meridian damp-hot type （P 〉 0.05）. Conclusion Damp-hot poison-aggregation type accounts for most of Chinese medicine syndrome type in patients with

关 键 词：宫颈上皮内瘤变 宫颈癌 证型演变 

分 类 号：R737.33[医药卫生—肿瘤]