胃癌脾虚证的前瞻性队列研究及相关因素的logistic回归分析  

Prospective Cohort Study on Stomach Cancer with Spleen Deficiency Syndrome and Logistic Regression Analysis of Related Factors

作　　者：王克穷[1] 马娟[1] 于明洋[1] 毛照海 马永录 

机构地区：[1]陕西中医学院,陕西西安712000 [2]甘肃省武威市中医医院,甘肃武威733000 [3]甘肃省酒泉地区医院,甘肃酒泉735000

出　　处：《中华中医药学刊》2012年第8期1725-1727,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(30873471)

摘　　要：目的:探索胃癌在手术、化疗前后脾虚证与临床因素的相互关系,以期指导临床。方法:通过对466人1097次胃癌手术、化疗前后患者的前瞻性队列调查,以胃癌脾虚证为因变量,以临床因素为自变量进行logistic回归分析。结果:脾虚证发病率为36.65%,其中,术前、术后化疗前/化疗前、术后化疗后/化疗后分别为34.09%、34.77%和39.66%;从logistic回归分析来看,术前呈正相关的是卡氏评分;术后化疗前呈正相关者分别为:术后化疗前或化疗间歇期服用中药、化疗次数、组织学分级。呈负相关:外科切缘;术后化疗后呈正相关的依次是:淋巴结转移、卡氏评分;呈负相关:化疗方案、病理类型。结论:治疗手段不同、时间不同,胃癌脾虚证的发病率不同,临床影响因素也不同。Objective ： To study the relationship of the clinical factors and the spleen deficiency on gastric carcinoma of pre- and post- surgry and chemotherapy, and guide the clinical practice. Method： A prospective cohort study of pre - and post results of 1097 gastric carcinoma operations and chemotherapies of 466 cases was carried out, taking the spleen deficiency on gastric carcinoma as the dependent variables and clinical factors as the independent variables for Logistic re- gression analysis. Result：The incidence of spleen deficiency on gastric carcinoma was 36.65%. The incidence rate of preoperative,postoperative and before chemotherapy were 34.09% ,34.77% and 39.66%. With the Logistic regression analysis, the positive correlations of postoperative gastric carcinoma were Karnofsky Score of performance status, the posi- tive correlation of post operative and before chemotherapy were ： taking traditional Chinese medicine postoperative hut be- fore or during chemotherapy, chemotherapy times, histological grade. The negative correlations was surgical cutting edge. The positive correlation of post operative and after chemotherapy were Lymph node metastasis , Karnofsky Score of per- formance status and the negative correlations were pathological type and chemotherapy regimen. Conclusion ： Effect of dif- ferent therapeutic approaches and time could play an important role in different incidence of spleen deficiency on gastric carcinoma and clinical factors.

关 键 词：胃癌 脾虚证 临床因素 队列研究 回归分析 

分 类 号：R735.2[医药卫生—肿瘤]