159例多发性骨髓瘤化疗相关周围神经病变中医证型研究  

Study on the Traditional Chinese Medicine Syndrome Types ofChemotherapy-Induced Peripheral Neuropathy in MultipleMyeloma Patients:An Investigation of 159 Cases

作　　者：刘焕君 欧海涛 黎耀和[3] 胡莉文[3] LIU Huan-Jun;OU Hai-Tao;LI Yao-He;HU Li-Wen(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Gaozhou Hospital of Traditional Chinese Medicine,Maoming 525200 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510405 [2]高州市中医院,广东茂名525200 [3]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2023年第5期1060-1064,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20202050)。

摘　　要：【目的】基于聚类分析探索多发性骨髓瘤化疗相关周围神经病变(MM-CIPN)的中医证型分布规律。【方法】纳入159例MM-CIPN患者的中医四诊信息,运用系统聚类分析和K-均值聚类分析方法,归纳总结该病的高频证候及其中医证型。【结果】(1)共筛选出27个高频证候,其中,频率超过50%的证候有5个,分别是肢体麻木151例(占95.0%)、肢体刺痛115例(占72.3%)、畏寒肢凉93例(占58.5%)、疲倦乏力89例(占56.0%)和屈伸不利82例(占51.6%)。(2)根据两种聚类分析方法,可将MM-CIPN的中医证型分为气虚血瘀证、痰瘀痹阻证、肾虚血瘀证、阴虚血瘀证4型,其中,以气虚血瘀证及肾虚血瘀证居多,阴虚血瘀证、痰瘀痹阻证次之。(3)中医证候分型与患者性别无显著相关性(P>0.05)。年龄方面,在34~40岁和41~50岁年龄段,均以痰瘀痹阻证所占比例最高,分别为75.0%(3/4)和44.5%(4/9);在51~60岁和61~70岁年龄段,均以气虚血瘀证所占比例最高,分别为56.9%(29/51)和43.6%(30/69);在71~80岁年龄段,以肾虚血瘀证所占比例最高,为46.2%(12/26),其次为阴虚血瘀证,占26.9%(7/26)。【结论】肢体麻木、肢体刺痛为MM-CIPN的主要证候;MMCIPN的中医证型以气虚血瘀证及肾虚血瘀证居多,阴虚血瘀证、痰瘀痹阻证次之;不同年龄段患者的中医证型有所差异,中年患者以痰瘀痹阻证居多,中老年患者以气虚血瘀证多见,老年患者以肾虚血瘀证及阴虚血瘀证所占比例较高。Objective To investigate the distribution of traditional Chinese medicine(TCM)syndrome types in patients suffering from multiple myeloma with chemotherapy-induced peripheral neuropathy(MM-CIPN)by using cluster analysis.Methods Information collected by the four TCM diagnostic methods in 159 MM-CIPN patients was analyzed,and hierarchical cluster analysis and K-means cluster analysis were used to investigate the highfrequency symptoms of MM-CIPN and its TCM syndrome types.Results(1)A total of 27 high-frequency symptoms were screened out,among which 5 symptoms with a frequency of over 50%were presented in 151 cases(95.0%)of numbness in the limbs,115 cases(72.3%)of stabbing pain in the limbs,93 cases(58.5%)of aversion to cold and coldness in the limbs,89 cases(56.0%)of fatigue and weakness,and 82 cases(51.6%)of dysfunction of flexion and extension.(2)The results of hierarchical cluster analysis and K-means cluster analysis showed that the TCM syndromes of MM-CIPN could be classified into 4 types,i.e.qi deficiency and blood stasis syndrome,phlegm and stasis obstruction syndrome,kidney deficiency and blood stasis syndrome,yin deficiency and blood stasis syndrome.And qi deficiency and blood stasis syndrome and kidney deficiency and blood stasis syndrome were most frequently seen,followed by yin deficiency and blood stasis syndrome and phlegm and stasis obstruction syndrome.(3)There was no significant correlation between the TCM syndrome types and the gender of the patients(P>0.05).In terms of age,patients with the age groups of 34-40 and 41-50 years old were predominated by phlegm and stasis obstruction syndrome,with the proportion being 75.0%(3/4)and 44.5%(4/9)respectively;patients with the age groups of 51-60 and 61-70 years old were predominated by qi deficiency and blood stasis syndrome,with the proportion being 56.9%(29/51)and 43.6%(30/69)respectively;patients with the age group of 71-80 years old were predominated by kidney deficiency and blood stasis syndrome[46.2%(12/26)]and yin deficiency and blood stasis syndro

关 键 词：多发性骨髓瘤 化疗相关周围神经病变 中医证型 气虚血瘀证 肾虚血瘀证 阴虚血瘀证 痰瘀痹阻证 聚类分析 

分 类 号：R273.942[医药卫生—中西医结合]