老年中晚期肺癌患者舌苔脱落细胞形态学变化与中医辨证分型相关性分析  

Correlation between morphological changes of tongue exfoliated cells and TCM syndrome types in elderly patients with middle and advanced lung cancer

作　　者：马子坤[1] 韩冉[1] Ma Zikun;Han Ran(Oriental Hospital of Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学东方医院,北京100078

出　　处：《现代肿瘤医学》2020年第14期2422-2426,共5页Journal of Modern Oncology

基　　金：北京中医药大学青年教师项目(编号:2019-JYB-JS-120)。

摘　　要：目的:探讨老年中晚期肺癌患者舌苔脱落细胞形态学变化规律和证型的相关性,为患者的诊治提供指导依据。方法:选取我院自2018年2月-2019年2月间收治的老年肺癌患者110例作为实验对象,依据TNM分期标准进行分组,比较各个分期患者证型分布情况;选取同期行健康体检的患者35例作为对照组,对比两组受检者舌苔脱落细胞形态学指标差异。结果:老年中晚期肺癌不同证型舌象存在较大差异;TNM-Ⅱ期患者气虚痰湿证占比最高,Ⅲ期患者以阴虚热毒证占比最高;Ⅳ期以气阴两虚证为主,不同分期患者证型分布差异有统计学意义(P<0.05);老年中晚期肺癌舌苔脱落细胞形态学和中医证型密切相关,中层细胞、表层细胞MI改变最明显的均为气血淤滞证;MV改变最为显著的为气血淤滞证。紫暗色表层细胞MI、MV均显著低于其他舌质类型(P<0.05),绛红舌组表层MI水平低于淡胖舌和淡红舌组(P<0.05)。结论:老年中晚期肺癌患者舌苔脱落细胞形态学指标与中医证型有密切相关性,能为舌诊提供指导。Objective:To investigate the morphological changes and the correlation of tongue-type exfoliated cells in elderly patients with middle and advanced lung cancer,and to provide guidance for the diagnosis and treatment of patients.Methods:A total of 110 elderly lung cancer patients admitted to our hospital from February 2018 to February 2019 were selected as subjects.The TNM staging criteria were used to compare the distribution of symptoms in each staged patients.Patients who underwent healthy physical examination at the same time were selected.35 cases were used as the control group,and the morphological indexes of the exfoliated cells of the tongue coating were compared between the two groups.Results:There was a big difference in the tongue image of different types of lung cancer in the elderly.The TNM-II stage patients had the highest proportion of Qi deficiency and dampness syndrome.The III stage patients had the highest proportion of syndromes of Yin deficiency and heat toxicity.The IV stage was mainly the Qi and Yin deficiency syndrome.There were significant differences in the distribution of disease types between different stages(P<0.05).The morphology of exfoliated cells in the middle and advanced stage of lung cancer was closely related to the symptoms of TCM.The most obvious changes in MI in the middle layer and superficial cells were Qi and blood stasis syndrome.The most significant change in MV was the syndrome of Qi and blood stasis.The MI and MV of purple dark surface cells were significantly lower than those of other tongue types(P<0.05).The surface MI level of the red tongue group was lower than that of the pale fat tongue and pale red tongue group(P<0.05).Conclusion:The morphological indexes of exfoliated cells in elderly patients with middle and advanced lung cancer are closely related to the symptoms of TCM,which provides guidance for patients with tongue diagnosis.

关 键 词：肺癌 舌苔脱落细胞 细胞理化指标 中医辨证分型 

分 类 号：R734.2[医药卫生—肿瘤]