肝癌放疗期间中医证候演变规律  

Primary Exploration of the Evolvement Rule of TCM Symptoms During Radiotherapy of Liver Cancer

作　　者：斯韬[1] 宁雪坚[1] 冯献斌[1] 石彧[1] 冯驭臣[1] 李蓉[1] 

机构地区：[1]柳州市中医院,广西柳州545001

出　　处：《河南中医》2016年第7期1169-1171,共3页Henan Traditional Chinese Medicine

基　　金：柳州市应用技术研究与开发计划课题(编号:2011J0302010);广西壮族自治区中医管理局中医药民族医药课题(编号:GZZC1152)

摘　　要：目的:观察肝癌放疗期间中医证候变化的规律,探寻放疗引起不良反应的中医病因病机。方法:采用流行病学调查方法,回顾性调查289例接受放疗的肝癌患者放疗前、放疗30 GY、放疗后共3次的中医四诊资料,应用SPSS 19.0软件,采用聚类分析法及因子分析法,将患者分类并确定每类的证候要素,归纳出每类的中医证候,比较放疗期间中医证候变化特点。结果:放疗期间,肝癌的中医分型以5型为主,分别为:肝郁气滞证、血瘀证、湿热蕴结证、脾虚证、阴虚证。放疗不同阶段常见基本证候整体分布差异具有统计学意义(P<0.01);湿热蕴结证在放疗30GY、放疗后较放疗前均显著增多(P<0.05),脾虚证在放疗30 GY较放疗前显著减少(P<0.05),放疗后较放疗30 GY显著增多(P<0.05),而放疗后较放疗前无统计学差异(P>0.05),而肝郁气滞、血瘀证、阴虚证三类证候在放疗过程中的变化差异无统计学意义(P>0.05)。结论:在放疗前,肝癌患者以脾虚和肝郁气滞两型最为多见;放疗30 GY时以湿热蕴结证和肝郁气滞证为主;放疗后以脾虚和湿热蕴结两型为主。Objective：To observe the evolvement rule of TCM symptoms during radiotherapy of liver cancer, and to explore the TCM etiology and pathogenesis of the adverse reactions induced by radiotherapy. Methods： The method of epidemiological investigation was applied to conduct retrospective investigation of 289 cases undergone radiotherapy in order to collect the TCM four diagnostic materials before radiotherapy, 30GY of radiotherapy and after radiotherapy. The software of SPSS19.0, clustering methodology and factor analysis were applied to classify the patients and determine the symptom elements of each category, generalize the TCM symptoms of each category, and compare the characteristics of the tchanges of the TCM symptoms during radiotherapy. Results： During radiotherapy, the TCM patterns of liver cancer can be classified into 5 categories：syndrome of liver depression and qi stag- nation, blood stasis syndrome, damp heat accumulation syndrome, spleen deficiency syndrome, yin deficiency syndrome. The gener- al distribution difference among the commonly seen basic symptoms during different phases of radiotherapy had statistical signifi- cance （ P 〈 0.01 ）. The damp heat accumulation syndrome greatly increased during 30GY and after the radiotherapy（ P 〈 0.05）. The spleen deficiency syndrome during 30GY of the radiotherapy declined markedly compared with before radiotherapy （ P 〈 0. 05 ）, and this syndrome significantly increased after radiotherapy compared with 30GY of the radiotherapy（ P 〈 0.05 ）, but there was no statistical difference between before and after the radiotherapy （ P 〉 0.05）. The differences of the changes among syn- drome of liver depression and qi stagnation, blood stasis syndrome and yin deficiency syndrome had no statistical significance（ P 〉 0.05 ）. Conclusion ： Before the radiotherapy,the syndrome of spleen deficiency and syndrome of liver depression and qi stagnation are most commonly seen before the radiotherapy ;damp heat accumulation syndrome and syn

关 键 词：肝癌 放疗 肝郁气滞证 血瘀证 湿热蕴结证 脾虚证 阴虚证 

分 类 号：R273.357[医药卫生—中西医结合]