非小细胞肺癌不同证型患者舌象特征及与实验室指标相关性研究  

Study on Tongue Manifestations of Patients with Different Syndromes in Non-Small Cell Lung Cancer and Their Correlation with Laboratory Indicators

作　　者：刘嘉懿 屠立平[1] 石玉琳 王瑜 许玲[3] 杨蕴 焦文 周昌乐[1,5] 许家佗[1] LIU Jiayi;TU Liping;SHI Yulin;WANG Yu;XU Ling;YANG Yun;JIAO Wen;ZHOU Changle;XU Jiatuo(School of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Office of Academic Affairs,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Department of Intelligent Science and Technology,Xiamen University,Xiamen 361005,China)

机构地区：[1]上海中医药大学中医学院,上海201203 [2]上海中医药大学教务处,上海201203 [3]上海中医药大学附属岳阳中西医结合医院,上海200437 [4]上海中医药大学附属上海市中医医院,上海200071 [5]厦门大学信息科学与技术学院,福建厦门361005

出　　处：《中国中医药信息杂志》2025年第3期136-143,共8页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家自然科学基金青年科学基金(82305090);国家中医药管理局高水平中医药重点学科建设项目中医诊断学(ZYYZDXK-2023069);上海市“科技创新行动计划”启明星培育(扬帆专项)(22YF1448900);上海市卫健委临床研究专项(20234Y0168);上海中医药大学科技发展项目(23KFL005);上海市中医医院中医药科技发展项目(WL-ZDJS-2021001K)。

摘　　要：目的探究不同证型非小细胞肺癌(NSCLC)患者的舌象特征及不同证型舌象与肿瘤标志物、凝血指标的相关性。方法对497例NSCLC患者进行辨证分组,对比不同证型的舌象特征差异,运用双变量相关性分析,研究不同证型NSCLC患者的舌象特征与血清肿瘤标志物、凝血指标之间的相关性。结果不同证型与健康人比较,TB-a方面,阴虚痰热证>健康组>气阴两虚证>脾虚痰湿证>肺郁痰瘀证(P<0.001)。TB-L方面,健康组>脾虚痰湿证>气阴两虚证>肺郁痰瘀证>阴虚痰热证(P<0.001)。TB-b方面,阴虚痰热证>气阴两虚证>脾虚痰湿证>健康组>肺郁痰瘀证(P<0.001)。阴虚痰热证TB-a最高,Per-all最低。脾虚痰湿证TB-L、Per-all最高。肺郁痰瘀证TB-b、TC-b低于其他各组,TB-a低于健康组,Per-all指数偏高(P<0.05)。肿瘤标志物方面,脾虚痰湿证Per-all与糖类抗原19-9、糖类抗原50、糖类抗原242呈正相关(P<0.05),凝血指标方面,肺郁痰瘀证舌象纹理指标与纤维蛋白原相关性较高(P<0.01)。结论NSCLC不同中医证型具有各自的典型舌象特征。不同证型舌象分别与肿瘤标志物、凝血指标具有相关性,可反映临床状态的变化。Objective To study the tongue manifestation of patients with different syndromes in non-small cell lung cancer(NSCLC)and the correlation between tongue characteristics of different syndromes and tumor markers and coagulation indicators.Methods Totally 497 patients with NSCLC were grouped according to syndrome differentiation,and the differences in tongue characteristics of different syndromes were compared.Bivariate correlation analysis was used to study the correlation between tongue characteristics and serum tumor markers and coagulation indicators in patients with NSCLC of different syndromes.Results Compared with healthy people of different syndromes,in TB-a,yin deficiency and phlegm-heat syndrome>healthy group>qi-yin deficiency syndrome>spleen deficiency and phlegm-dampness syndrome>lung stagnation and phlegm-stasis syndrome(P<0.001).In TB-L,healthy group>spleen deficiency and phlegm-dampness syndrome>qi-yin deficiency syndrome>lung stagnation and phlegm-stasis syndrome>yin deficiency and phlegm-heat syndrome(P<0.001).In TB-b,yin deficiency and phlegm-heat syndrome>qi-yin deficiency syndrome>spleen deficiency and phlegm-dampness syndrome>healthy group>lung stagnation and phlegm-stasis syndrome(P<0.001).Yin deficiency and phlegm-heat syndrome had the highest TB-a and the lowest Per-all.Spleen deficiency and phlegm-dampness syndrome had the highest TB-L and Per-all.Lung stagnation and phlegm-stasis syndrome had lower TB-b and TC-b than other groups,lower TB-a than the healthy group,and a high Per-all index(P<0.05).In terms of tumor markers,Per-all in spleen deficiency and phlegm-dampness syndrome was positively correlated with Ca199,Ca50 and Ca242(P<0.05).In terms of coagulation indicators,the tongue texture index of lung stagnation and phlegm-stasis syndrome had a high correlation with the coagulation indicator Fg(P<0.01).Conclusion Different TCM syndromes of NSCLC have their own typical tongue characteristics.Tongue manifestations of different syndromes are correlated with tumor markers and coagulation indic

关 键 词：非小细胞肺癌 舌象 中医证候 肿瘤标志物 凝血指标 

分 类 号：R2-03[医药卫生—中医学] R273.4