晚期卵巢癌中医证型与血栓前状态的关系  

Study on the relations of TCM syndrome types of advanced ovarian cancer with the prethrombotic state

作　　者：王冬梅[1] 庞瑞[1] 茹明芳[2] 黄艳春[3] 王莹[4] 杨格娟[1] 谢丹[1] 

机构地区：[1]新疆医科大学附属肿瘤医院中西医结合科 [2]新疆医科大学附属肿瘤医院妇外一科,乌鲁木齐830000 [3]新疆医科大学附属肿瘤医院检验科,乌鲁木齐830000 [4]新疆医科大学附属肿瘤医院医务部,乌鲁木齐830000

出　　处：《环球中医药》2015年第8期921-925,共5页Global Traditional Chinese Medicine

基　　金：新疆医科大学附属肿瘤医院科研启动基金(肿2014-14)

摘　　要：目的研究晚期卵巢癌各中医证型的血栓前状态(PTS)指标的变化,探讨各项指标与中医分型关系。方法对84例晚期卵巢癌患者进行中医辨证分为气滞血瘀证组、气血亏虚证组、痰湿凝聚证组,分别对其采用鞘流阻抗法、免疫比浊法、ELISA法检测血小板(platelet,PLT)、D-二聚体(D-dimer,DDI)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、血浆凝血酶原时间(prothrombin time,PT)、纤维蛋白原量(fibrinogen,FIB)、血小板α颗粒膜蛋白(granule membrane protein 140,GMP-140),并与正常组进行对比。结果 (1)与正常对照组相比,晚期卵巢癌各中医证型组PLT增多(P<0.05)、PT缩短(P<0.01)、FIB升高(P<0.01)、GMP-140升高(P<0.01)及DDI升高(P<0.01),而APTT表达上无统计学差异(P>0.05)。(2)与气滞血瘀证组相比,痰湿凝聚证组PT延长(P<0.05),FIB下降(P<0.05),GMP-140下降(P<0.05),DDI下降(P<0.05),而在PLT、APTT表达上无差异(P>0.05)。与气滞血瘀证组相比,气血亏虚证组FIB下降(P<0.05),GMP-140下降(P<0.05),DDI下降(P<0.05),而在PLT、PT、APTT表达上无差异(P>0.05)。而痰湿凝聚证组与气血亏虚证组在PLT、APTT、PT、FIB、GMP-140及DDI表达上无统计学差异(P>0.05)。(3)采用Binary Logistic回归模型分析气滞血瘀证与FIB、DDI及GMP-140有明显相关性(P<0.05)。结论晚期卵巢癌气滞血瘀证、痰湿凝聚证、气血亏虚证均存在一定程度的血栓前状态,以气滞血瘀证最为明显,DDI、FIB及GMP-140可以作为提示存在血栓前状态的晚期卵巢癌气滞血瘀证的生物学指标。检测PLT、PT、APTT、FIB、GMP-140、DDI有助于指导中医药改善晚期卵巢癌患者血栓前状态。Objective To explore the relations of Prethrombotic State with TCM syndrome types of advanced ovarian cancer. Methods 84 patients with advanced ovarian cancer were divided into 3 groups according to syndrome differentiation： qi stagnation and blood stasis syndrome group, phlegm and damp condensation syndrome group and deficiency of qi and blood syndrome group. The expression of Platelet （ PLA） was tested by impedance （ PLT-I ）; Activated partial thromboplastin time （ APTT ） , Fibrinogen （FIB）, Prothrombin time（PT）, and D-dimer（DDI）were tested by immunoturbidimetory; GMP-140 was tested by ELASA method and auto coagulometer. The results were compared to that of in the control group. Results （1）Compared to the control group, there was no significant difference on the expression of APTT in all syndrome types of advanced ovarian cancer. However, the expression of PLT（P〈0. 05）, FIB（P〈0. 01）, GMP-140（P〈0. 01） and DDI （P〈0. 01） were significantly higher;PT was significantly shortened （P〈0. 01）. （2） Compared to the qi stagnation and blood stasis syndrome group, PT was significantly longer and the level of FIB, GMP-140, DDI were significantly lower in the stagnation of phlegm and damp syndrome group（P〈0. 05）, while the expression of PLT and the level of APTT were no significant difference （P〉0. 05）. The expressions of FIB, GMP-140, DDI were significantly lower in the deficiency of qi and blood syndrome group（P〈0. 05）, while the expression of PLT, the level of PT and APTT were no significant difference compared to the qi stagnation and blood stasis syndrome group. （P〉0. 05）; There were no significant differences in the levels of PLT, PT, APTT, FIB, DDI and GMP-140 between the stagnation of phlegm and damp syndrome group and the deficiency of qi and blood syndrome（P〉0. 05）. （3） The qi stagnation and blood stasis syndrome group has evident correlation with the expression levels of FIB, DDI and GMP-140 （ P〈0. 05 ） by Binary

关 键 词：卵巢癌 血栓前状态 中医证型 

分 类 号：R2-03[医药卫生—中医学]