不同分期乳腺癌证候分布规律研究  

Study on the syndrome distribution of different stages of breast cancer

作　　者：岳振松[1] 姜战胜[1] 李燕巍[1] 欧阳华强[1] 谢广茹[1] 潘战宇[1] 刘东颖[1] 

机构地区：[1]天津医科大学肿瘤医院,乳腺癌防治教育部重点实验室,国家肿瘤临床医学研究中心,天津市“肿瘤防治”重点实验室,天津300060

出　　处：《中华中医药杂志》2016年第11期4790-4793,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：中国中西医结合学会-金港榄香烯中医药肿瘤研究基金项目(No.2010-F4);中国抗癌协会临床肿瘤协作专业委员会-丽珠中医药肿瘤研究基金(No.Y-L2013-003)~~

摘　　要：目的:研究不同分期乳腺癌的证候分布规律,为中医治疗乳腺癌奠定基础。方法:通过临床问卷调查收集709例乳腺癌患者的四诊信息,由2名中医肿瘤专业主任医师根据事先制定的证候诊断标准,采用传统辨证方法进行辨证。然后对不同分期乳腺癌的证候进行频次分析及χ2分析,阐明不同分期乳腺癌的证候分布规律。结果:乳腺癌的总体证候分布规律如下(从高频到低频):肝气郁滞、肾阴虚、肝热、肝阴虚、湿邪困脾、脾气虚、痰证、瘀血内停、阳虚、心阴虚、气虚、肾阳虚、胃热、湿热困脾。其中随临床分期变化的证候有肝阴虚、脾气虚、湿邪困脾、心阴虚、痰证;不随临床分期变化的证候有肝气郁滞、肝热、瘀血停滞、肾阴虚、肾阳虚、阳虚、气虚、胃热、湿热困脾。具体分析不同分期的证候变化规律:Ⅳ期及复发患者中,肝阴虚证、脾气虚证、痰证、湿邪困脾证频率最高,心阴虚证出现频率最低,并且与其他期别比较有统计学意义。结论:不同分期对中医辨证有一定程度的影响,但有一定的限度。而且即使受分期影响的证候也只是出现频率的不同,而没有有和无的差异。也就是说上述证候贯穿乳腺癌发病的始终,是乳腺癌病因病机的体现。Objective： To lay the foundation for the treatment of breast cancer with traditional Chinese medicine（TCM） by studying the distribution regularity of the syndromes of breast cancer of different stages. Methods： Informations of the four methods of diagnosis in 709 breast cancer patients were collected through clinical questionnaire. Two chief physicians of TCM oncology conducted syndrome differentiation with traditional differentiating method based on the pre-established criteria. Then frequency analysis and chi-square analysis were conducted on the syndromes of breast cancer of different stages to clarify the distribution regularity of the syndromes of breast cancer of different stages. Results： The overall distribution regularity of breast cancer syndromes is as follows（from high frequency to low frequency）： stasis of liver qi, deficiency of kidney yin, liver heat, deficiency of liver yin, pathogenic dampness retaining in spleen, deficiency of spleen qi, phlegm syndrome, internal blockade of static blood, yang deficiency, deficiency of heart yin, qi deficiency, deficiency of kidney yang, stomach heat, dampnessheat stagnating in spleen. The syndromes changing with clinical stages included deficiency of liver yin, deficiency of spleen qi, pathogenic dampness retaining in spleen and deficiency of heart yin and phlegm syndrome; the syndromes not changing with clinical stages included stasis of liver qi, liver heat, internal blockade of static blood, deficiency of kidney yin, deficiency of kidney yang, yang deficiency, qi deficiency, stomach heat and dampness-heat stagnating in spleen. The result of analyzing the change rule of the syndromes of different stages was as follows： in stage Ⅳ and the relapsing patients, syndrome of deficiency of liver yin, syndrome of deficiency of spleen qi, phlegm syndrome and pathogenic dampness retaining in spleen presented the highest frequency while the syndrome of deficiency of heart yin presented the lowest frequency. The differences from stages indicated stati

关 键 词：乳腺癌 证候 证候要素 单证 

分 类 号：R273[医药卫生—中西医结合]