食管癌放疗患者舌脉象及证型的客观化研究  

Objective Study of Tongue and Pulse Parameters and TCM Syndrome Types of Radiotherapy Patients with Esophageal Cancer

作　　者：周之毅[1] 张淑娟 阿提坎.卡吾力 热孜亚.库来西 许玲[1] 李和根[1] 田建辉[1] 刘慧[3] 尤圣富[4] 

机构地区：[1]上海中医药大学附属龙华医院肿瘤科,上海200032 [2]新疆喀什地区第二人民医院中西医肿瘤科,新疆喀什844000 [3]上海中医药大学附属曙光医院肿瘤科,上海200021 [4]上海中医药大学附属龙华医院临床评价中心,上海200032

出　　处：《辽宁中医杂志》2015年第10期1844-1847,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：上海市卫生局青年科研项目(20114Y010);上海市科委中医引导类项目(12401905700)

摘　　要：目的:观察新疆喀什地区食管癌维吾尔族患者放疗前后舌脉象及证型的变化。方法:对食管癌患者在放疗前及放疗后,分别运用中医数字化四诊仪进行舌脉象及问诊数据的采集录入,并通过计算机分析辨证得到相应结果。结果:49例患者放疗前后舌质均以黯红为最多,所占比例为77.6%、79.6%;舌苔见厚苔、腻苔或两者兼而有之者放疗前占85.7%,放疗后占79.6%;脉象参数h1、h3、t1、t4、t5、w1、w2、Ass、h3/h1在放疗后下降明显,与放疗前比较,差异有统计学意义(P<0.05);放疗后见弦脉者较放疗前减少,促、数脉者增加,其脉象分布,差异有统计学意义(P=0.023);患者放疗后,症状频数咽喉异物感明显减少,肩痛、善怒、腰膝无力、失眠频数略减少,体型瘦弱、口干、易疲劳、干性皮肤、痰多、善太息频数略增多。食管癌患者证型以脾肾两虚为主证,放疗后兼见肝胃火炽、肝肾阴虚证型增加,经精确卡方检验,差异具统计学差异(P=0.006)。结论:喀什地区食管癌患者以暗红舌、厚或腻苔为多,其病机虚实夹杂,以脾肾两虚为主要矛盾,同时存在痰湿内蕴、肝郁气滞、肝肾阴虚等兼证;放疗后兼见肝胃火炽、肝肾阴虚证型者比例有所上升;放疗后患者脉象参数h1、Ass明显下降,提示可能出现早期心脏功能损害。Objective： To investigate the changes of tongue and pulse parameters and the syndrome types of patients with esophageal cancer before and after radiotherapy. Methods： Electropulsograms and tongue pictures of 49 esophageal cancer patients were examined by digital electropulsography before and after radiotherapy. All the results including the inquiry questions would be input the computer through which the syndrome types could be gained. Results： The proportion of the patients with dark- red tongue and thick or greasy tongue coating before radiotherapy was 77. 6% and 85. 7% and both of the proportions after radiotherapy were 79.6%. The pulse parameters such as h1,h3,t1,t4,t5,w1,w2,Ass and h3/h1 were significantly decreased after radiotherapy（ P〈0. 05）. Compared with those before radiotherapy,the percentage of the taut pulse decreased and the percentage of the rapid pulse and rapid but intermittent pulse increased after radiotherapy. The deficiency of spleen and kidney was the most common syndrome type of esophageal cancer patients and the concurrent syndrome of excuberance of liver or stomach fire and Yin deficiency of liver or kidney increased after radiotherapy. Conclusion： Dark- red tongue and thick or greasy tongue coating are very common in the patients with esophageal cancer in Kashgar region and the deficiency of spleen and kidney is the most common syndrome type. The concurrent syndromes are phlegm- damp retention,stagnation of liver- Qi and Yin deficiency of liver and kidney. The decline of h1 and Ass may hint early damage of cardiac function in the esophageal cancer patients after radiotherapy.

关 键 词：食管癌 放疗 舌脉象 证型 

分 类 号：R735.1[医药卫生—肿瘤]