Ⅲ期胃癌患者术后中医证型分布特点及与全身炎症反应标志物的相关性研究  

Study on the distribution characteristics of Traditional Chinese Medicine syndrome types and their correlation with systemic inflammatory reaction markers in patients with stageⅢgastric cancer after operation

作　　者：陈晶 姜伟华 王蕾[3] 谢智惠[4] CHEN Jing;JIANG Weihua;WANG Lei;XIE Zhihui(Department of Digestive Endoscopy Center,Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Jiangsu Province Hospital of Chinese Medicine,Nanjing,210029,China;Department of Vascular Surgery,Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Jiangsu Province Hospital of Chinese Medicine;Department of Traditional Chinese Medicine,Affiliated Hospital of Jiangnan University;Department of Oncology of Integrated Traditional Chinese and Western Medicine,Affiliated Hospital of Jiangnan University)

机构地区：[1]南京中医药大学附属医院江苏省中医院消化内镜中心,南京210029 [2]南京中医药大学附属医院江苏省中医院血管外科,南京210029 [3]江南大学附属医院中医科 [4]江南大学附属医院中西医结合肿瘤科

出　　处：《中国中西医结合消化杂志》2023年第2期126-131,共6页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：国家中医临床研究基地(江苏省中医药研究院)开放课题(No:JD2019SZXYB11)。

摘　　要：目的:探讨Ⅲ期胃癌患者术后中医证型分布特点及其与全身炎症反应标志物的相关性,为临床更全面的治疗提供依据。方法:随机选择2015年1月—2017年12月初治的182例术后Ⅲ期胃癌患者为研究对象,分析中医证型分布特点及其与临床特征的关系,患者均定期随访,采用受试者工作特征曲线(ROC)确定中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、淋巴细胞与单核细胞比值(LMR)的最佳截断值,分为高值组和低值组,分析中医证型与C-反应蛋白(CRP)、NLR、PLR、LMR的相关性。结果:(1)182例胃癌患者中医证型占比由高到低依次为胃阴亏虚证(27.5%)、脾肾阳虚证(20.8%)、肝气犯胃证(15.4%)、气血两亏证(14.3%)、痰瘀互结证(11.0%)、湿热内蕴证(11.0%);(2)不同中医证型间年龄分布差异有统计学意义(P<0.05),胃阴亏虚证和脾肾阳虚证患者>63岁(中位年龄)的占比高于其他4个证型;不同中医证型间性别差异有统计学意义(P<0.05),湿热内蕴证以男性居多,肝气犯胃证以女性为主;不同中医证型间T分期差异有统计学意义(P<0.05),T_(1-2)期患者的证型分布占比均较少,实证患者在T_(3)期占比居多,虚证患者以T_(4)期占比为主;不同中医证型间N分期差异有统计学意义(P<0.05),各证型在N_(1-2)期分布差异不大,虚证患者在N3期分布占比高于实证患者;不同中医证型间临床分期差异有统计学意义(P<0.05),虚证患者在ⅢC期的占比明显高于实证患者;不同中医证型间血红蛋白(Hb)值差异有统计学意义(P<0.05),气血亏虚证患者的Hb均值显著低于与其他5个证型患者的Hb均值;(3)不同中医证型间PLR、LMR比较差异有统计学意义,虚证患者中PLR高值所占的比例显著高于实证患者(P<0.05),虚证患者中LMR低值的比例高于实证患者(P<0.05)。结论:Ⅲ期胃癌患者术后中医证型以虚证多见;随着局部肿瘤侵犯深度扩大、淋巴结受累程度和范Objective:To investigate the distribution characteristics of postoperative Traditional Chinese Medicine(TCM)syndrome type in patients with stageⅢgastric cancer and its correlation with markers of systemic inflammatory response,so as to provide a basis for more comprehensive clinical treatment.Methods:From January 2015 to December 2017,a total of 182 patients with postoperative stageⅢgastric cancer who were initially treated were randomly selected,their clinical data were collected,the characteristics of TCM certificate type distribution and their relationship with clinical features were analyzed,and the patients were followed up regularly,and the best cut-off values of NLR,PLR and LMR were determined by using the receiver operating characteristic curve ROC.It was divided into high-value group and low-value group,and the correlation between TCM syndrome type and CRP,NLR,PLR and LMR was analyzed.Results:(1)The proportion of TCM syndrome type in 182 patients with gastric cancer from high to low was the syndrome of stomach yin deficiency(27.5%),the syndrome of spleen and kidney yang deficiency(20.8%),the syndrome of liver qi invading stomach(15.4%),the syndrome of qi and blood deficiency(14.3%),the syndrome of phlegm and blood stasis(11.0%),and the syndrome of damp heat connotation(11.0%).(2)There was a statistical difference between the TCM syndrome type and the age distribution(P<0.05),the proportion of the age distribution between the syndrome of stomach yin deficiency and the syndrome of spleen and kidney yang deficiency above 63 years old(median age)was higher than that of the other four types;there was a significant statistical difference between the TCM syndrome type and the sex(P<0.05),the syndrome of damp heat connotation was mostly male,and the syndrome of liver qi invading stomach was mainly female;there was a significant statistical difference between the TCM syndrome type and the T stage(P<0.05),the proportion of the T_(1-2)patients was relatively small,the proportion of the excessive patients in the

关 键 词：胃癌 中医证型 全身炎症反应标志物 

分 类 号：R735.7[医药卫生—肿瘤]