初诊鼻咽癌中医证型与临床分期及EBV-DNA相关性研究  

A Study on Relationship among Syndrome Type of Traditional Chinese Medicine,Clinical Stage and EpsteinBarr Virus DNA of newlydiagnosed Nasopharyngeal Carcinoma

作　　者：张蓓[1] 汪桃利[2] 黄圆圆[1] 丘惠娟[1] 胡丕丽[1] 王艳玲[1] 

机构地区：[1]中山大学肿瘤防治中心,广州510060 [2]深圳市中医院

出　　处：《中国中西医结合耳鼻咽喉科杂志》2011年第6期404-407,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：2007年广东省中医药局项目(2007101)

摘　　要：目的中医治疗是鼻咽癌综合治疗中的一个重要组成部分,辨证论治是中医治病的精髓。本研究拟观察初诊鼻咽癌患者中医证型与临床分期及EBV-DNA浓度的相关性,为鼻咽癌各中医证型的预后判断及治疗提供依据。方法自2007年7月～2008年8月,共收集94例初诊未治且无远处转移的鼻咽癌患者,采集中医分型、TNM分期以及血浆EBV-DNA浓度等信息,分析三者相关性。结果肺热型的T分期、N分期及TNM分期均较低,EBV-DNA浓度在四型中最低(P=0.001);痰凝型N_2+N_3期占60%;血瘀型T_3+T_4期占93%;血瘀痰凝型均为Ⅲ、Ⅳ期,N_2+N_3期占55%,T_3+T_4期占91%,该型EBV-DNA浓度在四型中最高(P=0.001)。结论随着初诊鼻咽癌患者临床分期的升高,其EBV-DNA浓度逐渐增高,中医证型则呈现"肺热型→痰凝型或血瘀型→血瘀痰凝型"的变化趋势;三者之间存在一定的相关性。Objective Traditional Chinese Medicine （TCM） is an important component of Comprehensive Treatment of Nasopharyngeal Carcinoma （NPC）, which essentiality is Treatment with syndrome differentiation in. In this study, we analyzed the association of TCM Syndrome type with clinical stage or Epstein-Barr virus DNA （EBV-DNA） copies of newly-diagnosed NPC to provide the basis for therapies and prognosis of NPC from TCM Syndrome type. Methods From July 2007 to August 2008, 94 cases of newlydiagnosed NPC were collected without distant metastasis, gathered information of TCM syndrome type, TNM stage as well as EBV-DNA copies then analyzed the correlation among the three. Resuts Lung-heat type of NPC had low T-stage, N-stage as well as TNM stage, and its level of EBV-DNA copy was the lowest of the four TCM syndrome types （p=0.001 ）; the ratio of N2＋N3 in Sputum-coagulation type was 60% ; the ratio of T3＋T4 was 93% with blood-stagnation type; all cases of the sputum-coagulation combining blood-stagnation type were stage Ⅲ or Ⅳ, N2＋N3 accounted for 55%,T3＋T4 accounted for 91%, and its level of EBV-DNA copy was the highest of the four types （P=0.01）. Conclusions In newly-diagnosed NPC, the higher of the clinical stage had the higher of the EBV-DNA copies. TCM syndrome type of them showed the trend as ＇Lung-heat→Sputum-coagulation or blood-stagnation→sputum-coagulation combining blood-stagnation＇, all of them had certain correlation.

关 键 词：鼻咽癌 中医辨证分型 EB病毒DNA 临床分期 

分 类 号：R273[医药卫生—中西医结合]