摘要
目的 探讨胆管癌(CCA)中医证候及其在疾病亚型、TNM分期分布特点。方法 收集399例CCA患者中医证候信息,使用多元数理统计方法进行数据分析。结果 CCA患者中医证型以脾虚痰湿证[92例(23.1%)]、脾阳虚衰证[91例(22.8%)]、痰毒瘀结证[73例(18.3%)]为主。肝内胆管癌(ICC)胆汁瘀滞证占比低于肝外胆管癌(ECC),脾阳虚衰证占比高于ECC(P<0.01)。TNM分期Ⅲ、Ⅳ期脾虚痰湿证占比低于Ⅰ和Ⅱ期(P<0.01),脾阳虚衰证占比高于Ⅱ期(P<0.01),Ⅳ期胆郁痰扰证占比高于Ⅰ期(P<0.01),胆汁瘀滞证占比低于Ⅰ期(P<0.01)。男性、吸烟、饮酒患者脾虚痰湿证占比较高,女性及既往肝胆病病史患者脾阳虚衰证占比较高,差异无统计学意义(P>0.05)。结论 CCA中医证候以脾虚痰湿证最常见。ECC多见胆汁瘀滞证,ICC多见脾阳虚衰证。Ⅰ、Ⅱ期多见脾虚痰湿证,Ⅲ、Ⅳ期多见脾阳虚衰证;Ⅰ期多见胆汁瘀滞证,Ⅳ期多见胆郁痰扰证。
Objective To explore the characteristics of Chinese medicine(CM)syndromes distributions in disease subtypes and TNM stages with cholangiocarcinoma(CCA).Methods CM syndrome information of 399 CCA patients was collected.The multivariate mathematical statistics method was used for data analysis.Results Pi-deficiency phlegm-dampness syndrome[92(23.1%)],Pi-yang depletion syndrome[91(22.8%)],phlegm-toxin blood-stasis syndrome[73(18.3%)]were main CM syndrome types in CCA patients.Compared with extrahepatic cholangiocarcinoma(ECC),the proportion of pattern of bile stasis in intrahepatic cholangiocarcinoma(ICC)was lower,and the proportion of pattern of Pi-yang depletion was higher(P<0.01).For TNM stage,the proportion of pattern of Pi-deficiency phlegm-dampness in stages III and IV were lower than that of stages I and II(P<0.01),the proportion of pattern of Pi-yang depletion was higher than that of stage II(P<0.01),the proportion of pattern of depressed gallbladder with harassing phlegm in stage IV was higher than that of stage I(P<0.01),and the proportion of pattern of bile stasis was lower than that of stage I(P<0.01).The proportion of Pi-deficiency phlegm-dampness syndrome in men,smokers,and drinkers was relatively high,and the proportion of pattern of Pi-yang depletion in women and patients with a previous history of the hepatobiliary disease was relatively high,there was no difference in statistics(P>0.05).Conclusions Pi-deficiency phlegm-dampness syndrome was the most common CM syndrome of CCA.The pattern of bile stasis was a common syndrome type of ECC,and Pi-yang depletion syndrome was a common syndrome type of ICC.Pi-deficiency phlegm-dampness syndrome was a common syndrome type of stages I and II,Pi-yang depletion syndrome was a common syndrome type of stages III and IV;bile stasis syndrome was a common syndrome type of stage I,and depressed gallbladder with harassing phlegm syndrome was a common syndrome type of stage IV.
作者
余宋
郭玉玉
胡佳佳
郭晨旭
郁沙莎
吴孝雄
翟笑枫
YU Song;GUO Yu-yu;HU Jia-jia;GUO Chen-xu;YU Sha-sha;WU Xiao-xiong;ZHAI Xiao-feng(Department of Traditional Chinese Medicine Oncology,The First Affiliated Hospital of Naval Medical University,Shanghai,200433;Department of Teaching and Training,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai,200437;Department of Integrative Medicine,Eastern Hepatobiliary Surgery Hospital,Naval Medical University,Shanghai,201805;Department of Oncology,Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,200137)
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2023年第5期549-555,共7页
Chinese Journal of Integrated Traditional and Western Medicine
基金
上海市科委科技创新行动计划项目(No.22Y11921200)
长海医院“234学科攀登计划”(No.2019YXK029)。
关键词
胆管癌
中医
证候
分布
疾病亚型
TNM分期
cholangiocarcinoma
Chinese medicine
syndrome
distribution
disease subtype
TNM stage
