蒽环类药物心脏毒性患者的临床特征与中医证候分布特点  

Characteristics of clinical characteristics and traditional Chinese medicine syndrome distribution of patients with cardiotoxicity induced by anthracycline

作　　者：张晓囡 节阳华[3] 刘龙涛[2] 王丽蓉 李艳阳[4] 朱亚萍[1] 吕仕超[1] 张军平[1] ZHANG Xiao-nan;JIE Yang-hua;LIU Long-tao;WANG Li-rong;LI Yan-yang;ZHU Ya-ping;LYU Shi-chao;ZHANG Jun-ping(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300112,China;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University,Xinjiang 830000,China;Tianjin Medical University Cancer Institute and Hospital,Tianjin 300060,China)

机构地区：[1]天津中医药大学第一附属医院,天津300112 [2]中国中医科学院西苑医院,北京100091 [3]新疆医科大学附属中医医院,新疆830000 [4]天津医科大学肿瘤医院,天津300060

出　　处：《中华中医药杂志》2022年第3期1685-1689,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金青年科学基金项目(No.81904118);天津市卫生计生行业高层次人才选拔培养工程(No.津人才[2017]18号)。

摘　　要：目的:分析蒽环类药物心脏毒性患者的临床特征及中医证候分布。方法:纳入2017年9月至2019年12月于天津中医药大学第一附属医院及新疆医科大学附属中医医院住院的蒽环类药物心脏毒性患者104例,采集并分析患者的相关信息,运用系统聚类分析患者的临床特征和证候特点。结果:共纳入蒽环类药物心脏毒性患者104例,其症状见心悸(96.15%)、乏力(76.92%)、面色淡白(74.04%)、气短(45.19%)等;舌脉以舌淡(61.54%)或舌淡胖(36.54%),苔白(44.23%)或苔少(41.35%),脉弦(27.88%)或脉弱(25.00%)为主;常见中医症状可聚为6类,辨证为阴虚火旺证、心阳不振证、气阴两虚证、心血亏虚证、脾虚湿困证、胆郁痰扰证。结论:蒽环类药物心脏毒性患者以心悸、乏力、面色淡白、气短为核心症状,证候分型以阴虚火旺证、心阳不振证、气阴两虚证、心血亏虚证、脾虚湿困证、胆郁痰扰证为主。Objective: To analyze the clinical characteristics and traditional Chinese Medicine(TCM) syndrome distribution of the patients with cardiotoxicity induced by anthracyclines. Methods: A total of 104 patients with cardiotoxicity induced by anthracyclines who were hospitalized in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and the Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University from September 2017 to December 2019 were included. The relevant information of patients were collected. Then, the frequency and cluster analysis were used to analyze the clinical and syndrome characteristics. Results: A total of 104 patients with cardiotoxicity of anthracyclines were enrolled. The symptoms included palpitations(96.15%), fatigue(76.92%), pale white complexion(74.04%), shortness of breath(45.19%), etc.. The tongue and pulse manifestation were mainly pale tongue(61.54%) or plump and pale tongue(36.54%),white fur(44.23%) or less fur(41.35%), string pulse(27.88%) or weak pulse(25.00%). The common symptoms of TCM can be grouped into 6 categories, hyperactivity of fire due to yin deficiency, syndrome of deficiency of heart yang, syndrome of deficiency of both qi and yin, syndrome of deficiency of heart blood, syndrome of dampness stagnancy due to spleen deficiency,syndrome of stagnated gallbladder qi with disturbing phlegm. Conclusion: The core symptoms of patients with cardiotoxicity of anthracyclines are palpitations, fatigue, pale white complexion, and shortness of breath. The syndrome types are mainly syndrome of hyperactivity of fire due to yin deficiency, syndrome of deficiency of heart yang, syndrome of deficiency of both qi and yin, syndrome of deficiency of heart blood, syndrome of dampness stagnancy due to spleen deficiency, syndrome of stagnated gallbladder qi with disturbing phlegm.

关 键 词：蒽环类药物 心脏毒性 临床特征 证候分布 恶性肿瘤 

分 类 号：R737.9[医药卫生—肿瘤]