271例结直肠癌患者术前中医证候分布规律及其影响因素研究  

Analysis of the Distribution Pattern and Influencing Factors of Preoperative Traditional Chinese Medicine Syndromes in 271 Colorectal Cancer Patients

作　　者：姚源 赵硕琪 李晨[1] 杨明泽 李维忠 程海波[1,3] YAO Yuan;ZHAO Shuoqi;LI Chen;YANG Mingze;LI Weizhong;CHENG Haibo(The First School of Clinical Medicine,Nanjing University of Chinese Medicine,Nanjing 210023 Jiangsu,China;Department of Oncology,the Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029 Jiangsu,China;Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine Prevention and Treatment of Tumor,Nanjing 210023 Jiangsu,China)

机构地区：[1]南京中医药大学第一临床医学院,江苏南京210023 [2]南京中医药大学附属医院肿瘤科,江苏南京210029 [3]江苏省中医药防治肿瘤协同创新中心,江苏南京210023

出　　处：《中医肿瘤学杂志》2025年第1期32-39,46,共9页Journal of Oncology in Chinese Medicine

基　　金：国家中医药管理局中医药创新团队及人才支持计划项目(编号:ZYYCXTD-C-202208);国家中医药管理局高水平中医药重点学科建设项目资助(编号:国中医药人教函[2023]85号)。

摘　　要：目的探讨结直肠癌术前中医证候、症状的分布情况,分析术前中医证候的影响因素。方法采用横断面研究,对271例就诊于江苏省中医院的结直肠癌患者进行调查,采集患者基本信息、临床诊疗和中医证候等信息,根据临床实际,以5种常见证候(大肠湿热证、瘀毒内阻证、湿热瘀毒证、脾气亏虚证和肝肾亏虚证)作为标准,对辨证结果进行分类。对结直肠癌术前主、次要症状进行描述性统计,通过单因素分析及logistics回归分析,探究不同证候与性别、年龄、病理分期、大体形态、组织学分级、是否存在淋巴转移组间的分布差异及其相关性。结果结直肠癌的术前主要症状为腹痛、便血、矢气频作、便溏和腹部肿块;次要症状为口干口苦、乏力、汗出异常和腰膝酸软。中医证候分布频次从高到低分别为湿热瘀毒证、脾气亏虚证、瘀毒内阻证、大肠湿热证、肝肾亏虚证。不同中医证型在性别,病理分期,肿瘤大体形态差异有统计学意义(P<0.05)。结论结直肠癌患者术前中医证候总体实证多于虚证,以湿热瘀毒证为主要证候。性别、病理分期和大体形态是中医证候的影响因素。Objective To explore the distribution of traditional Chinese medicine(TCM)syndromes and symptoms in preoperative colorectal cancer,and to analyze the influencing factors of TCM syndromes.Methods A crosssectional study was conducted to investigate 271 patients with colorectal cancer who were treated in Jiangsu Provincial Hospital of Chinese Medicine and to collect information on basic information,clinical diagnosis and treatment,and TCM syndromes of patients.Based on clinical practice,the results of differentiation were classified using 5 common syndromes(damp-heat in large intestine,internal obstruction of stasis and toxin,damp-heat stasis toxin,spleen qi deficiency,and deficiency of liver and kidney)as criteria.Descriptive statistics of primary and secondary symptoms of preoperative colorectal cancer was conducted,and univariate analysis and logistics regression analysis were used to explore the distribution difference and correlation between different syndromes and gender,age,pathological stage,gross morphology,histological grade,and whether lymph metastases existed,respectively.Results The principal preoperative syndromes of colorectal cancer were abdominal pain,hematochezia,frequent breaking wind,loose stool,and abdominal mass.Secondary syndromes included dry mouth and bitterness, fatigue, abnormal sweating, and soreness and weakness of waist and knees. Thedistribution frequency of TCM syndromes from high to low was as follows: damp-heat stasis toxin, spleen qideficiency, internal obstruction of stasis and toxin, damp-heat in large intestine, and deficiency of liver andkidney. There were statistically significant differences between different TCM syndromes and gender,pathologicalstage, and tumor gross classification(P<0.05). Conclusion TCM syndromes of preoperative colorectal cancerpatients are generally more prevalent in excess syndrome than deficiency syndrome, as damp-heat stasis toxinbeing the main syndrome. Gender, pathological stage, and gross morphology of the patients are identified asfactors influenc

关 键 词：结直肠癌 中医 证候 症状 影响因素 

分 类 号：R735.3[医药卫生—肿瘤] R273[医药卫生—临床医学]