胃癌患者化疗前后中医证候临床观察

目的:观察化疗对于胃癌病人的中医证候的影响,为中医治疗胃癌化疗病人的辨证论治提供依据。方法:选取上海交通大学医学院附属仁济医院肿瘤科的胃癌化疗住院病人70例,观察经过2个疗程奥沙利铂联合希罗达化疗前后的中医证候特点,并按照中医证候诊断标准加以评分及分类为单一证候,运用统计学分析化疗前后中医证候的差异。结果:①化疗前胃癌病人以血虚、气虚、气滞和血瘀为主要表现,舌苔以舌淡苔薄及舌淡紫苔厚为主。②化疗后阴虚、脾虚和痰湿表现明显增加(P0.05),舌象转变为红舌厚腻苔为主(P0.05)。脉象在化疗前后以细脉为多见,化疗前后无统计学差异(P0.05)。结论:胃癌病人经过化疗后血瘀和气滞表现减少,但阴虚、脾虚和痰湿表现明显增加,根据临床观察的结果提示对于胃癌化疗后患者中医治疗上应该将养阴及健脾化湿作为重点。

Observation about Traditional Chinese Medicine Syndromes in Gastric Cancer Patients with Pro and Post-treatment of Chemotherapy

Objectives: By approaching or observing Traditional Chinese medicine(TCM) syndrome of gastric cancer patients before and after chemotherapy,to provide theory evidence for TCM treatment of chemotherapy patients.Methods: Select 70 patients of gastric cancer in oncology department of Renji Hospital affiliated to Shanghai Jiaotong University,observing TCM syndrome of gastric cancer before and after two courses of combine chemotherapy(Oxaliplatin + Capecitabine).According to TCM diagnostic criteria score,classify the patients as a single syndrome,and analyzed the syndrome variation before and after chemotherapy.Results: 1.Before chemotherapy TCM syndrome were blood deficiency,qi deficiency,qi stagnation and blood stasis.And the types of tongue were pale tongue thin coat and purple tongue thick coat.2.After chemotherapy,the expressions of yin deficiency,spleen deficiency and phlegm significantly increased(P <0.05).Red tongue thick and greasy coat increased(P <0.05).The string pulse was more common before chemotherapy,but there was no significant difference before and after chemotherapy(P> 0.05).Conclusion: The expressions of qi stagnation and blood stasis reduced after chemotherapy,and the expressions of yin deficiency,spleen deficiency and phlegm increased.It’s necessary to strength the treatment of nourishing qi to invigorate spleen and nourishing yin during the chemotherapy.