胰腺癌患者化疗前后中医舌象及证型变化研究

目的：探索胰腺癌患者化疗前后舌象及中医证型的变化规律。方法采用前瞻性研究的方法，对60例初次接受含吉西他滨（GEM）方案化疗的胰腺癌患者化疗前和化疗结束后的 d 4，d 8清晨的舌象和证型的变化进行对照研究。结果首次化疗后的 d 4，d 8与化疗前的舌象构成比差异均具有统计学意义（P ﹤0.05），红舌和紫黯舌明显减少，淡红舌、淡白舌及齿痕舌明显增加；黄苔和灰黑苔均明显减少，薄白苔和花剥苔或无苔明显增加。通过证型分析，发现化疗后比化疗前正虚类证候增多（P ﹤0.05），邪实类证候减少（P ﹤0.05）。结论胰腺癌化疗前后证候会发生变化，主要是化疗药物损伤脾肾两脏，引起脾虚湿滞和气阴两虚。

Change of TCM tongue coating and syndromes of patients with pancreatic cancer before and after chemotherapy

Objective To explore the change of TCM tongue coating and syndromes of pancreatic cancer patients before and after chemotherapy. Methods A prospective study method,the first controlled study of pancreatic cancer patients receiving chemotherapy containing GEM before and after chemotherapy of d4,d8 morning tongue and syn-dromes change for 60 cases. Results For the first time after chemotherapy d4,d8 and tongue characteristics before chemotherapy than have significant difference(P ﹤ 0. 05),red tongue and dark purple tongue decreased,pink tongue, pale tongue and tongue with teeth marks significantly increased;Yellow tongue coating and grey black tongue coating were significantly decreased,thin white tongue coating and incomplete loss of the coating of the tongue or with no tongue coating were significantly increased. Whatsmore,the incidence of deficiency syndromes in TCM was higher (P ﹤ 0. 05),but the incidence of excess syndromes in TCM was lower( P ﹤ 0. 05)after chemotherapy than before chemotherapy. Conclusion The TCM syndrome had changed before and after chemotherapy,the spleen and kidney injured by chemotherapeutics is main reason,it can cause spleen deficiency and stagnation of dampness and deficiency of both qi and yin.