文章摘要

结肠癌患者中医证型分布与营养标志物的关系

作者: 1王蕾, 2谢智惠, 3吴平
1 江南大学附属医院中医科,江苏 无锡 214062
2 江南大学附属医院胃肠肿瘤外科,江苏 无锡 214062
3 江南大学附属医院营养科,江苏 无锡 214062
通讯: 王蕾 Email: xzhihui@yeah.net
DOI: 10.3978/j.issn.2095-6959.2022.08.007
基金: 国家中医临床研究基地(江苏省中医药研究院)开放课题(JD2019SZXYB11)。

摘要

目的:探讨结肠癌患者术前中医证型分布与营养标志物之间的相关性,为结肠癌患者进行全面的中医辨证治疗提供新思路。方法:收集2012年6月至2015年12月江南大学附属医院胃肠肿瘤外科首次入院的结肠癌患者150例,收集其临床资料,进行中医证型判定及其分布情况统计,收集的患者均定期随访,分析术前中医证型与白蛋白(albumin,ALB)、预后营养指数(prognostic nutritional index,PNI)、控制营养状况(controlling nutritional status,CONUT)评分间的相关性。结果:结肠癌患者中医证型分布占比由高到低依次为湿热郁毒证(31.33%)、瘀毒内结证(22.00%)、肝肾阴虚证(18.67%)、气血两亏证(14.67%)、脾肾阳虚证(6.67%)、无证型(6.67%);在5年存活率方面,气血两亏证(63.63%)、瘀毒内结证(66.67%)的存活率最低;中医证型与营养标志物的相关性统计中,瘀毒内结证的ALB水平低于脾肾阳虚证(P<0.05)、显著低于湿热郁毒证、肝肾阴虚证、无证型(P<0.01);气血两亏证的ALB水平低于脾肾阳虚证、无证型(P<0.05),显著低于湿热郁毒证、肝肾阴虚证(P<0.01)。瘀毒内结证与气血两亏证两组的PNI低于脾肾阳虚证(P<0.05),显著低于湿热郁毒证、肝肾阴虚证、无证型(P<0.01)。结论:瘀毒内结证及气血亏虚证的患者更易于出现较低水平的ALB、PNI,低ALB值及低PNI值合并瘀毒内结证及气血亏虚证的患者生存率有下降的趋势。
关键词: 结肠癌;营养标志物;中医证型

Relationship of the distribution of traditional Chinese medicine syndrome type and nutritional markers of colon cancer patients

Authors: 1WANG Lei, 2XIE Zhihui, 3WU Ping
1 Department of Traditional Chinese Medicine, Affiliated Hospital of Jiangnan University, Wuxi Jiangsu 214062, China
2 Department of Gastrointestinal Tumor Surgery, Affiliated Hospital of Jiangnan University, Wuxi Jiangsu 214062, China
3 Department of Nutrition, Affiliated Hospital of Jiangnan University, Wuxi Jiangsu 214062, China

CorrespondingAuthor: WANG Lei Email: xzhihui@yeah.net

DOI: 10.3978/j.issn.2095-6959.2022.08.007

Foundation: This work was supported by the National Clinical Research Base of Traditional Chinese Medicine (Jiangsu Academy of Traditional Chinese Medicine) Open Topic, China (JD2019SZXYB11).

Abstract

Objective: To investigate the correlation between the distribution of preoperative traditional Chinese medicine (TCM) syndrome type and nutritional markers of colon cancer patients, and to provide a new way for comprehensive TCM syndrome differentiation and treatment in colon cancer patients. Methods: A total of 150 colon cancer patients were selected, who were first admitted to the Gastrointestinal Tumor Surgery Department of the Affiliated Hospital of Jiangnan University from June 2012 to December 2015. The clinical data were collected, and the TCM syndrome types were determined and their distribution statistics were made. The collected patients were followed up regularly, and the correlation between preoperative TCM syndrome type and albumin (ALB), prognostic nutritional index (PNI), controlling nutritional status (CONUT) scores was analyzed. Results: The distribution proportion of TCM syndrome types of colon cancer patients from high to low was the syndrome of damp heat stagnation toxin (31.33%), the syndrome of internal stagnation of blood stasis and toxin (22.00%), the syndrome of liver and kidney yin deficiency (18.67%), the syndrome of qi and blood deficiency (14.67%), the syndrome of spleen and kidney yang deficiency (6.67%), and undocumented discernible type (6.67%). According to the statistics of 5-year survival rate, the survival rates of the syndrome of qi and blood deficiency (63.63%), and the syndrome of internal stagnation of blood stasis and toxin (66.67%) were the lowest. In the correlation statistics between TCM syndrome types and nutritional markers, the level of ALB in the syndrome of internal stagnation of blood stasis and toxin was lower than that in the syndrome of spleen and kidney yang deficiency (P<0.05), which was significantly lower than that in the syndrome of damp heat stagnation toxin, the syndrome of liver and kidney yin deficiency, and undocumented discernible type (P<0.01). The level of ALB in the syndrome of qi and blood deficiency was lower than that in the syndrome of spleen and kidney yang deficiency and undocumented discernible type (P<0.05), which was significantly lower than that in the syndrome of damp heat stagnation toxin and the syndrome of liver and kidney yin deficiency (P<0.01). The value of PNI in the 2 groups of the syndrome of internal stagnation of blood stasis and toxin and the syndrome of qi and blood deficiency were lower than that in the syndrome of spleen and kidney yang deficiency (P<0.05), which was significantly lower than that in the syndrome of damp heat stagnation toxin, the syndrome of liver and kidney yin deficiency, and undocumented discernible type (P<0.01). Conclusion: Patients with the syndrome of internal stagnation of blood stasis and toxin and the syndrome of qi and blood deficiency are more likely to have lower levels of ALB and PNI, and the survival rate of patients with low ALB value and low PNI value combined with the syndrome of internal stagnation of blood stasis and toxin and the syndrome of qi and blood deficiency demonstrates a downward trend.

Keywords: colon cancer; nutritional markers; traditional Chinese medicine syndrome type

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