肺癌患者舌苔脱落细胞形态变化与证型的相关性  

Correlation between morphological changes of exfoliative cells of tongue fur and syndrome types in patients with lung cancer

作　　者：周俊琴[1] 鲁琴[1] 

机构地区：[1]河北医科大学中医学院中医诊断教研室,河北050091

出　　处：《北京中医药大学学报》2013年第3期200-202,206,共4页Journal of Beijing University of Traditional Chinese Medicine

基　　金：河北省自然科学基金资助项目(No.C2010000503)

摘　　要：目的探讨不同证型中晚期原发性支气管肺癌患者舌苔脱落细胞形态变化规律,为中医辨证提供客观依据。方法选择TNM分期为Ⅱ～Ⅳ期的肺癌患者140例,分为气虚痰湿、气血瘀滞、阴虚热毒、气阴两虚4个证型,探讨不同TNM分期患者的中医证型分布特点。检测各证型患者舌苔脱落细胞的成熟指数(MI)、成熟价值(MV),将结果进行比较,并与30例正常人相对照。结果中晚期原发性肺癌不同TNM分期的中医证型分布有显著性差异(P<0.01),ⅡB期患者多见气虚痰湿型,占72.42%,ⅢA期则以气血瘀滞证为主,占52.17%,ⅢB期多表现为阴虚热毒证型,占66.67%,IV期多集中在气阴两虚证,占90.00%。中晚期肺癌各证型中层细胞数所占比例高于正常人,表层细胞数所占比例低于正常人,各组舌苔脱落细胞的MV均小于正常组(P<0.01)。各证型的MI、MV改变以气血瘀滞组最为明显(P<0.01),以阴虚毒热组改变最轻(P<0.01)。MV的趋势是:气血瘀滞<气阴两虚<气虚痰湿<阴虚毒热<正常组,气阴两虚组与气虚痰湿组之间无显著差异性,其他各组间均有差异(P<0.05或P<0.01)。结论不同TNM期的肺癌患者中医证型分布有差别,舌苔脱落细胞MI、MV的改变与肺癌所表现的中医证型有关。Objective To discuss the laws of morphological changes of exfoliative cells of tongue fur in the patients with different TCM syndrome types of middle-advanced primary bronchogenic lung cancer, and provide objective evidence for TCM syndrome differentiation. Methods The patients （n = 140） at from stage [[ to stage IV of TNM staging were divided into 4 syndrome types including qi deficiency and phlegm-dampness syndrome （group 1 ）, syndrome of qi stagnation and blood stasis （group 2）, yin deficiency and heat-toxin syndrome （group 3 ） , and syndrome of dual deficiency of qi and yin （group 4）. The distribution characteristics of TCM syndrome types were investigated in the patients at different TNM stages of middle-advanced primary, hmg cancer. The maturity index （MI） and maturity value （MV） of exfoliative ceils of tongue fur were detected and compared in the patients of different syndrome types, and other 30 normal people were taken as the control （ normal group）. Results The distribution of TCM syndrome types was significantly different （P 〈 0. 0l ） at different TNM stages. Qi deficiency and phlegm- dampness syndrome was mainly occurred in I] B stage （72.42%）, syndrome of qi stagnation and blood stasis, in mA stage （52. 17% ）, yin deficiency and heat-toxin syndrome, in mB stage （66.67%）, andsyndrome of dual deficiency of qi and yin, in 1V stage （90.00%）. The proportion of middle layer cells was higher and that of superficial cells was lower in all syndrome groups than those in normal group. MV was lower in all syndrome groups than that in normal group （P 〈0.01 ）. The changes of MI and MV were the most significant in group 2 （P 〈0.01 ） and the most mild in group 3 （P 〈0.01 ）. The trend of MV showed a descending order in group 2, group 4, group 1, group 3 and normal group. There was no significant difference between group 4 and group 1, and there was difference among other groups （P 〈0.05 or P 〈0.01）. Conclusion The contribution of TCM synd

关 键 词：肺癌 舌苔脱落细胞 中医辨证 

分 类 号：R241.25[医药卫生—中医诊断学]