胃癌术后中医证型演变的临床观察

目的：观察胃癌术后患者不同阶段中医证型的演变,为中医治疗胃癌术后辨证论治提供依据。方法：对48例胃癌术后患者按时间分为术后早期、化疗期间、化疗间期以及术后1年进行临床观察,归纳各期主要中医证型。结果：①术后早期以脾气不足为主,兼有气滞、湿阻;②化疗期间以气血亏虚为主,兼有气逆、湿阻;③化疗间期以脾肾两虚为主,兼有阴虚;④术后1年以肝胃不和为主,兼有气血不足、血瘀。结论：胃癌术后以虚证为主,不同阶段的证型各有侧重,宜分期论治。

Clinic observation on TCM syndrome evolvement of postoperative gastric carcinoma

Objective：To investigate syndrome evolvement of patients with postoperative gastric carcinoma in different stage,so as to afford foundation for syndrome differentiation and treatment. Methods： 48 patients with postoperative gastric carcinoma were followed up at four stage,early postoperative stage,chemotherapy period,chemotherapy interphase and one-year-after-surgery stage. Main TCM syndromes were concluded in these different stages.Results：①Early postoperative stage gave priority to spleen qi deficiency,accompanied with qi stagnation and dampness obstruction;②Chemotherapy period gave priority to both deficiency of qi and blood,accompanied with qi countercurrent and dampness obstruction;③Chemotherapy interphase gave priority to both deficiency of spleen and kidney,accompanied with yin deficiency;④One-year-after-surgery stage gave priority to disharmony of liver and stomach,accompanied with deficiency of qi and blood,and blood stasis. Conclusion： deficiency syndrome was dominant for patients with with postoperative gastric carcinoma,however,different stage had own focus. Treatment methods according to stage ought to be applied.