中晚期肺癌舌苔脱落细胞形态学指标与中医证型、病理学分期相关性研究  

Correlation between Morphological Indexes of Exfoliated Cells of Tongue Coating and TCM Syndromes and Pathological Stages in Advanced Lung Cancer

作　　者：董文军[1] 鲁琴[1] 金辉 邢志峰[1] 葛美娜[1] DONG Wen-jun;LU Qin;JIN Hui;XING Zhi-feng;GE Mei-na(Hebei University of Chinese Medicine,Shijiazhuang 05020)

机构地区：[1]河北中医学院,石家庄050200 [2]河北省第四医院肿瘤科,石家庄050011

出　　处：《河北中医药学报》2018年第4期14-16,共3页Journal of Hebei Traditional Chinese Medicine and Pharmacology

基　　金：河北省教育厅青年基金资助项目:No.QN2015066;河北中医学院青年科研基金项目:No.QNZ2014022

摘　　要：目的:研究中晚期原发性肺癌舌苔脱落细胞形态学指标与中医证型及病理分期间的关系,为中医辨证提供客观的舌诊方法。方法:按病例选择标准收集了152例中晚期肺癌患者,按国际肺癌TNM分类标准,将其分为:ⅡB期,ⅢA期,ⅢB期,Ⅳ期,并按照中医辨证诊断标准,分为气血瘀滞、气虚痰湿、气阴两虚、阴虚热毒4证型。检测入组人员舌苔脱落细胞的成熟指数(MI)、成熟价值(MV),将结果进行比较。结果:中晚期肺癌TNM分期的中医证型分布不同,ⅢA期患者多见气血瘀滞型,ⅢB期多集中在阴虚热毒型;中晚期肺癌中医证型与舌苔脱落细胞形态学指标有一定的相关性,气血瘀滞型的MI、MV改变最明显(P<0.01),阴虚热毒型的改变最小(P<0.01);TNM分期与舌苔脱落细胞形态学指标也有相关性,MV的变化趋势是:ⅢA期<Ⅳ期<ⅡB期<ⅢB期<正常组。结论:舌苔脱落细胞形态学指标与肺癌中医证型、病理学分期均有一定的相关性,舌苔脱落细胞形态学指标可作为中医证型、病理分期的客观参考指标,也为舌诊客观化研究提供了方法。Objective：To study the relationship between morphological indexes of exfoliated cells of tongue coating in middle and advanced primary lung cancer and TCM syndromes and the pathological stages,so as to provide an objective method of tongue diagnosis for TCM syndrome differentiation.Methods：152 patients with middle and advanced lung cancer were collected according to the standard of case selection.According to the international standard of TNM classification of lung cancer,they were divided into stage Ⅱ B,stageⅢA,stageⅢB and stage IV,and divided into 4 syndrome types：qi and blood stagnation,qi deficiency and phlegm dampness,qi-yin deficiency,and yin deficiency and heat toxicity according to the diagnostic criteria of TCM syndrome differentiation.The mature index（MI） and mature value（MV） of the exfoliated cells of tongue coating were detected,and the results were compared.Results：the distribution of TCM Syndrome Types in the TNM staging of middle and late stage lung cancer was different.The patients in stageⅢA were mostly with qi and blood stagnation type,and the stageⅢB was mostly concentrated on the yin deficiency type.The TCM syndrome type of middle and late stage lung cancer had some correlation with the morphological indexes of exfoliated cells of tongue coating,the change of MI and MV in qi and blood stagnation type were the most obvious（P〈0.01）,the change of yin deficiency and heat toxicity type was minimum（P〈0.01）;TNM staging was also related to morphological indexes of exfoliated cells of tongue coating,and the trend of MV was：stageⅢAⅣⅡBⅢBnormal group.Conclusion：The morphological indexes of exfoliated cells of tongue coating have a certain correlation with the TCM syndromes and pathological stage of lung cancer.The morphological indexes of the exfoliated cells of tongue coating can be used as the objective reference index of TCM syndromes and pathological stages,and also provide a method for the objective study of tongue diagnosis.

关 键 词：肺癌 中医证型 病理分期 舌苔脱落细胞 形态学指标 

分 类 号：R241.25[医药卫生—中医诊断学]