局部进展期直肠癌中医证型与新辅助放化疗骨髓抑制相关性研究  

Correlation Between TCM Syndromes and Myelosuppression with Neoadjuvant Radiotherapy and Chemotherapy in Locally Progressive Rectal Cancer

作　　者：梁毛毛 吴勉华[2] 王万霞 王逸君[2] 张碧云[2] LIANG Maomao;WU Mianhua;WANG Wanxia;WANG Yijun;ZHANG Biyun(The First Clinical Medical College,Nanjing University of Chinese Medicine,Nanjing Jiangsu China 210023;The Affiliated Hospital to Nanjing University of Chinese Medicine,Nanjing Jiangsu China 210029)

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,江苏南京210029

出　　处：《中医学报》2025年第5期1116-1120,共5页Acta Chinese Medicine

基　　金：江苏省中医药管理局科技项目(JD201801)。

摘　　要：目的:分析局部进展期直肠癌患者的不同中医证型与新辅助放化疗骨髓抑制的相关性。方法:选取接受新辅助放化疗的局部进展期直肠癌患者180例,根据中医四诊资料辨证分型为脾肾亏虚证、气虚血瘀证、气阴两虚证,统计分析局部进展期直肠癌中医证型与新辅助放化疗骨髓抑制的相关性。结果:(1)新辅助放化疗期间脾肾亏虚证出现中重度骨髓抑制率为75.8%,气虚血瘀证为46.7%,气阴两虚证为53.4%;脾肾亏虚证的中重度骨髓抑制率显著高于其他两种证型(P<0.05)。(2)各证型的血红蛋白水平、血小板数量、淋巴细胞数量比较,差异有统计学意义(P<0.05);气虚血瘀证患者血红蛋白水平显著低于其他两种证型(P<0.05);脾肾亏虚证患者淋巴细胞数量显著低于其他两种证型(P<0.05)。结论:局部进展期直肠癌患者新辅助放化疗后,脾肾亏虚证患者易发生中重度骨髓抑制,淋巴细胞数量显著降低;气虚血瘀证患者血红蛋白水平显著降低。Objective:To analyze the correlation between different Chinese medicine syndromes and myelosuppression of neoadjuvant radiotherapy and chemotherapy in patients with locally advanced rectal cancer.Methods:180 patients with locally advanced rectal cancer who received neoadjuvant radiotherapy and chemotherapy were selected and classified as Spleen and Kidney deficiency syndrome,Qi and blood stasis syndrome as well as Qi and Yin deficiency syndrome according to the data of the four diagnostic examinations of traditional Chinese medicine,and statistically analyzed the correlation between Chinese medicine syndromes and myelosuppression during neoadjuvant radiotherapy and chemotherapy for locally advanced rectal cancer.Results:(1)During neoadjuvant radiotherapy and chemotherapy,the rate of moderate-to-severe myelosuppression was 75.8%in Spleen and Kidney deficiency syndrome,46.7%in Qi deficiency and blood stasis syndrome,and 53.4%in Qi and Yin deficiency syndrome;the rate of moderate-to-severe myelosuppression was significantly higher in Spleen and Kidney deficiency syndrome than that in the other two syndromes(P<0.05).(2)Comparison of hemoglobin levels,platelet counts and lymphocyte counts of each evidence type showed statistically significant differences(P<0.05);hemoglobin levels of patients with Qi deficiency and blood stasis syndrome were significantly lower than those of the other two syndromes(P<0.05);platelet counts and lymphocyte counts of patients with Spleen and Kidney deficiency syndrome were significantly higher than those of the other two syndromes(P<0.05).Conclusion:After neoadjuvant radiotherapy and chemotherapy in patients with locally advanced rectal cancer,patients with Spleen and Kidney deficiency syndrome were prone to moderate-to-severe myelosuppression,and platelet and lymphocyte counts were significantly higher;hemoglobin was significantly lower in patients with Qi deficiency and blood stasis syndrome.

关 键 词：局部进展期直肠癌 中医证型 骨髓抑制 新辅助放化疗 

分 类 号：R273.353[医药卫生—中西医结合]