3384例晚期结直肠癌患者中医舌象特征研究  

Characteristics of Tongue Images in 3384 Patients with Advanced Colorectal Cancer

作　　者：徐钰莹 杨宇飞[1] 张雪雪 隗睿 张继伟[1] 李芮 宋婷婷 李秋艳[1] XU Yu-ying;YANG Yu-fei;ZHANG Xue-xue;WEI Rui;ZHANG Ji-wei;LI Rui;SONG Ting-ting;LI Qiu-yan(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091;Graduate School of Beijing University of Chinese Medicine,Beijing 100029;Institute of Microelectronics of Chinese Academy of Sciences,Beijing 100029)

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]北京中医药大学研究生院,北京100029 [3]中国科学院微电子研究所,北京100029

出　　处：《世界中西医结合杂志》2024年第3期433-440,共8页World Journal of Integrated Traditional and Western Medicine

基　　金：中国中医科学院科技创新工程(CI2021A05012)。

摘　　要：目的探讨晚期结直肠癌(Advanced colorectal cancer,ACRC)患者舌象在不同临床因素中的分布规律以及对辨证的重要意义,为中医临床诊治ACRC提供参考。方法选取2017年1月1日—2022年9月30日期间在中国中医科学院西苑医院肿瘤科杨宇飞教授门诊治疗的3384例ACRC患者作为研究对象,收集整理3384例患者的一般人口学信息、舌象信息以及诊疗信息。探讨ACRC患者舌象特点,分析在不同临床因素中ACRC患者的舌象分布差异。使用SPSS 26.0统计学软件对数据进行描述性统计分析,主要采用χ^(2)检验或Fisher精确检验对计数资料进行差异性比较。结果纳入3384份ACRC病例进行分析,其中男性1891例,女性1493例,男女构成比为1.27∶1,平均年龄(60.90±25.66)岁,其中男性年龄分布较女性前移;异常舌色以暗红舌、红舌、淡暗舌居多,异常舌形以齿痕舌、裂纹舌以及舌有瘀斑为主,异常舌苔以腻苔与厚苔为主。相关性分析结果显示,发病部位与舌色(暗红,淡暗)、舌形(齿痕)、苔色(黄、白)、苔质(厚、腻、水滑)存在显著统计学差异;初次确诊状态(初发晚期,非初发晚期)与舌色(淡红、淡暗)、舌形(嫩、胖大、齿痕)、苔色(黄、白)、苔质(腻、润、水滑、无)存在显著统计学差异;转移部位(肝转移/肺转移)在舌色(暗红)、舌形(嫩舌、瘦薄舌)、苔色(黄苔、白苔)、苔质(薄苔、厚苔、腻苔)方面存在显著统计学差异;基因突变状态(RAS、BRAF基因突变/野生)与舌色(绛、淡暗舌)、舌形(裂纹、瘀斑、嫩、齿痕)、苔质(腻、厚)存在显著统计学差异;微卫星状态与舌色(红)、舌形(裂纹、齿痕、瘀斑),苔色(黄、白)存在显著统计学差异。结论ACRC患者以虚实夹杂的舌象最为多见,可见不同程度的脾虚、痰湿、阴虚、血瘀、热邪等舌象表现,不同临床因素影响下的ACRC舌象特征具有一定规律性,能够为中医临床诊治ACRC提供参考。Objective To explore the distribution pattern of tongue images in patients with advanced colorectal cancer(ACRC)under different clinical factors and their significant implications for syndrome differentiation,providing references for the clinical diagnosis and treatment of ACRC in traditional Chinese medicine(TCM).Methods A total of 3384 ACRC patients treated at the Oncology Department of Xiyuan Hospital,China Academy of Chinese Medical Sciences,by Professor Yang Yufei from January 1,2017,to September 30,2022,were selected as the research participants.General demographic information,tongue image data,and diagnosis and treatment information of the 3384 patients were collected and organized.The characteristics of tongue images in ACRC patients were explored,and the differences in tongue images among ACRC patients under different clinical factors were analyzed.Descriptive statistical analysis was conducted on the data using SPSS 26.0 statistical software,and differences in count data were mainly compared using the Chi-square test or Fisher′s exact test.Results A total of 3384 cases of ACRC were analyzed,including 1891 males and 1493 females,with a male-to-female ratio of 1.27∶1.The average age was 60.90±25.66 years,with a tendency for males to be younger than females.Tongue manifestations primarily included dark red tongue,red tongue,and pale-dark tongue.Tongue abnormalities mainly consisted of teeth marks,cracked tongue,and tongue ecchymosis,while tongue coating abnormalities were predominantly greasy coating and thick coating.The correlation analysis results showed significant statistical differences in tongue color(dark red,pale-dark),tongue shape(teeth marks),tongue coating color(yellow,white),and tongue coating texture(thick,greasy,slippery)with the site of onset;significant statistical differences in tongue color(pale red,pale-dark),tongue shape(tender,swollen,teeth marks),tongue coating color(yellow,white),and tongue coating texture(greasy,moist,slippery,none)with the initial diagnosis status(initial adv

关 键 词：晚期结直肠癌 舌象特征 临床特征 中医病机 

分 类 号：R735.37[医药卫生—肿瘤] R241.25[医药卫生—临床医学]