肿瘤心脏病中医证候分布及临床特征研究  

Research of the Traditional Chinese Medicine Syndrome Distribution and Clinical Characteristics of Cardio-Oncology

作　　者：林宏远 卫晓红 彭梦琪 邓湘琴 张晓维 孔一帆 商洪才[2,5] LIN Hongyuan;WEI Xiaohong;PENG Mengqi;DENG Xiangqin;ZHANG Xiaowei;KONG Yifan;SHANG Hongcai(The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410005,China;Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Shandong Second Medical University,Weifang 261053,China;Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Changsha 410006,China;School of Integrated Chinese and Western Medicine,Hunan University of Chinese Medicine,Changsha 410208,China)

机构地区：[1]湖南中医药大学第二附属医院,长沙410005 [2]北京中医药大学东直门医院中医内科学教育部和北京市重点实验室,北京100700 [3]山东第二医科大学,山东潍坊261053 [4]湖南省中西医结合医院,长沙410006 [5]湖南中医药大学中西医结合学院,长沙410208

出　　处：《中国中医基础医学杂志》2025年第4期608-614,共7页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：国家科技重大专项(2023ZD0502700,2023ZD0502705);北京市通州区2023年度医药健康产业发展项目(JX2023YJ024);首都医学科技创新成果转化优促计划项目(YC202401YW0617)。

摘　　要：目的探究肿瘤心脏病患者的临床特征及中医证候分布规律,以期为肿瘤心脏病的防治提供依据。方法本研究以肿瘤心脏病中肿瘤治疗相关心功能不全(cancer therapy-related cardiac dysfunction,CTRCD)患者为研究对象,回顾性采集北京中医药大学东直门医院117例CTRCD患者资料,描述性分析人口学特征、临床症状、舌脉特征及证素特征,分析患者临床资料及中医证候分布规律。结果117例患者中有症状CTRCD患者共有51例(43.59%),无症状CTRCD患者共有66例(56.41%),且皆以轻中度为主。相较于无症状CTRCD组,有症状CTRCD组B型利钠肽(BNP)等7个心肌损伤标志物有明显升高(P<0.01)。对CTRCD患者四诊信息进行规范化处理后,共纳入32种症状信息、9种舌象信息、6种脉象信息。将证素整体分为单一证素、双证素及多证素3类,其中双证素有92例(78.63%),占比最高;根据不同证素的组合规律,共得到5个主要中医证候,分别为气阴两虚证、气血亏虚证、气阳两虚证、气虚血瘀证、痰瘀互结证,其中气阴两虚证占比最高(26.5%);与无症状CTRCD组比较,有症状CTRCD组气阴两虚证分布差异无统计学意义,气阳两虚证在有症状CTRCD组分布居多(P<0.05)。结论肿瘤心脏病患者中分级为轻、中度的患者占绝大多数,临床防治可能应将关注点前移。中医证候以气阴两虚证最多见,气阴两虚证贯穿肿瘤心脏病从轻到重的演变过程。Objective To explore the clinical characteristics and distribution of traditional Chinese medicine (TCM) syndromes in patients with cardio-oncology,in order to provide basis for the prevention and treatment of cardio-oncology.Methods In this study,117 cases of cancer therapy-related cardiac dysfunction (CTRCD) in Dongzhimen Hospital,Beijing University of Chinese Medicine were retrospectively collected.This study involved the descriptive analysis of demographic characteristics,clinical symptoms,tongue and pulse features,and syndrome elements.The clinical data of patients who met the measurements and the distribution of TCM syndrome elements.Results There were 51 cases of symptomatic CTRCD (43.59%) and 66 cases of asymptomatic CTRCD (56.41%) among the 117 patients,and all of them were predominantly mild to moderate.Seven markers of myocardial injury,including b-type natriuretic peptide (BNP),were significantly elevated in the symptomatic CTRCD group compared with the asymptomatic CTRCD group (P<0.01).After normalising the information of the four diagnostic examinations of CTRCD patients,a total of 32 kinds of symptom information,9 kinds of tongue information and 6 kinds of pulse information were included.The syndrome elements as a whole were classified into three categories,namely,single syndrome elements,double syndrome elements and multiple syndrome elements,of which 92 cases (78.63%) of double syndrome elements accounted for the highest percentage.Based on the combination pattern of the different syndrome elements,a total of five major TCM syndrome elements were obtained.They were Qi-Yin deficiency syndrome,Qi-blood deficiency syndrome,Qi-Yang deficiency syndrome,Qi deficiency and blood stasis syndrome,and phlegm and stasis syndrome,among which Qi-Yin deficiency syndrome accounted for the highest proportion (26.5%).Compared with patients in the asymptomatic CTRCD group,the difference in the distribution of Qi and Yin deficiency syndrome in the symptomatic CTRCD group was not statistically significant,and Qi-Yang

关 键 词：肿瘤心脏病 证候 临床特征 回顾性研究 

分 类 号：R259[医药卫生—中西医结合]