胃癌术后患者的中医证候分布及阳虚证相关因素分析——一项多中心横断面研究  

Analysis of Traditional Chinese Medicine Syndrome Characteristics and Related Factors of Yang Deficiency Syndrome in Postoperative Gastric Cancer Patients:A Multicenter Cross-Sectional Study

作　　者：葛媛莎 高瑞珂 李杰[1] 许博文 吴静远 曹璐畅 匡子禹 GE Yuansha;GAO Ruike;LI Jie;XU Bowen;WU Jingyuan;CAO Luchang;KUANG Ziyu(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing,100053;Beijing University of Chinese Medicine)

机构地区：[1]中国中医科学院广安门医院,北京市100053 [2]北京中医药大学

出　　处：《中医杂志》2024年第24期2565-2571,共7页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82074402);中国中医科学院科技创新工程(CI2021A01802);北京市重大疑难疾病中西医协同攻关项目(2023BJSZDYNJBXTGG-013);北京市科技计划课题(Z221100003522021);中央高水平中医医院临床研究和成果转化能力提升项目-临床科研一体化人才专项(创新团队培育项目)(HLCMHPP2023001)。

摘　　要：目的探索胃癌术后患者中医证候分布特征,并分析胃癌术后患者阳虚证及其程度的相关因素。方法纳入2022年2月22日至2023年3月21日就诊于全国4个中心的173例胃癌术后患者,采集一般资料、中医证型,填写“胃恶性肿瘤阳虚证诊断量表”,分析胃癌术后中医证型分布情况,并对阳虚证与非阳虚证以及阳虚证不同程度的相关影响因素的进行单因素分析和多因素Logistic回归分析。结果胃癌术后患者气虚证最多,为95例(54.91%),其次为阳虚证87例(50.29%)。阳虚证患者常兼有气虚证、气滞证、痰湿证。单因素分析显示,阳虚证与非阳虚证比较,在饮酒史、病理分期、分化程度、Lauren分级、印戒细胞癌、脉管癌栓、神经侵犯方面差异具有统计学意义(P<0.05);Logistic回归多因素分析显示饮酒史、印戒细胞癌、病理分期Ⅲ期和Ⅳ期、脉管癌栓(P<0.05)可能是胃癌术后阳虚证患者的相关因素。单因素分析显示,阳虚轻证与阳虚重证比较,在年龄、病理分期、癌前病变、体质量指数分级方面差异有统计学意义(P<0.05);Logistic回归多因素分析显示,年龄、低体重、病理分期Ⅲ期和Ⅳ期(P<0.05)可能是胃癌术后阳虚重证患者的相关因素。结论气虚证、阳虚证是胃癌术后患者常见中医证型,饮酒、病理分期Ⅲ期和Ⅳ期、印戒细胞癌、存在脉管癌栓可能是阳虚证的相关因素,高年龄、低体重、病理分期Ⅲ期和Ⅳ期可能为阳虚重证的相关因素。Objective To explore the distribution characteristics of traditional Chinese medicine(TCM)syn⁃dromes in postoperative gastric cancer patients,and to analyse the factors associated with yang deficiency syndrome and its severity.Methods Totally,173 patients who underwent postoperative gastric cancer surgery and were treated in four centers nationwide from February 22,2022 to March 21,2023,were enrolled.General information and TCM syndromes were collected,and Diagnostic Scale for Yang Deficiency Syndrome in Gastric Malignancies was filled in.The frequency of TCM syndromes after gastric cancer surgery was analyzed,and univariate analysis and multivariate logistic regression analysis were performed on the related factors of yang deficiency syndrome versus non-yang defi⁃ciency syndrome and between different severity of yang deficiency syndrome.Results The most common syndrome after gastric cancer surgery was qi deficiency(95 cases,54.91%),followed by yang deficiency(87 cases,50.29%).Patients with yang deficiency syndrome were often suffered from qi deficiency,qi stagnation,and phlegm dampness syndrome.Comparing yang deficiency syndrome with non-yang deficiency syndrome,univariate analysis showed that history of alcohol consumption,pathological stage,degree of differentiation,Lauren grade,signet ring cell carcinoma,vascular cancer thrombus,and nerve invasion were statistically significant(P<0.05);and multivariate logistic re⁃gression analysis showed that history of alcohol consumption,signet ring cell carcinoma,pathological stageⅢ,Ⅳ,and vascular cancer thrombus may be correlated with yang deficiency syndrome in postoperative gastric cancer patients(P<0.05).The univariate analysis showed that age,pathological stage,precancerous lesions,and body mass index grade were significantly different when compared between mild and severe yang deficiency syndrome(P<0.05);multivariate logistic regression analysis showed that age,low body weight,and pathological stageⅢandⅣmight be correlated with severe yang deficiency s

关 键 词：胃癌术后 中医证候 阳虚证 相关因素 

分 类 号：R273[医药卫生—中西医结合]