结直肠癌术后患者气虚证的兼夹特点及其影响因素的研究(1)
摘要 目的：观察结直肠癌术后患者气虚证的兼夹特点及影响因素。方法：选取福建省肿瘤医院消化外科收治的结直肠癌术后气虚证患者78例，观察证素的兼夹特点，并分析性别、化疗情况、肿瘤部位、病理分期和GSTP1基因多态性对证素兼夹频率的影响情况。结果：所有患者都兼夹其他证素，兼夹频率大于10%的主要证素共有14种，频率最高的依次为阳虚、气滞和血虚。女性兼夹血虚、脾和肾的频率要高于男性；而男性兼夹热的频率要高于女性；化疗中的患者肝证素多于未化疗患者；肿瘤分期越高大肠证素兼夹比例越高，差异均有统计学意义(P<0.05)。对GSTP1遗传多态性型的分析显示兼夹脾证素的频率在A/A，A/G和G/G 3种基因型患者中依次下降，差异有统计学意义(P<0.05)。结论：结直肠癌术后气虚证患者普遍兼夹其他证素，虚实夹杂，虚多于实。性别、化疗、肿瘤分期和基因多态性对证素的兼夹都有一定影响。
关键词 结直肠癌；气虚证；证素兼夹；基因多态性
Abstract Objective：To investigate the characteristics and influence factors of the pattern elements accompanied with qi deficiency in the postoperative colorectal patients.Methods：A total of 78 postoperative colorectal patients with qi deficiency who were identified by using the method of differentiation of pattern elements.The characteristics of complicated pattern elements were studied and the effects of gender，chemotherapy，tumor site，TNM staging and GSTP1 genetic polymorphism were analyzed by comparing the frequency of pattern elements in different groups.Results：All the qi deficiency patients were accompanied with at least 1 other pattern element.Among 14 common pattern elements with frequency higher than 10%，yang deficiency，qi stagnation and blood deficiency ranked the first to third highest frequency pattern elements.The frequency of blood deficiency，spleen and kidney were higher in the female than in the male while the frequency of heat pattern was higher in the male than in the female.And the frequency of liver pattern increased significantly in the patients undergoing chemotherapy compared with that in the non-chemotherapy patients.The colon pattern frequency was significantly higher in the TNM IV stage patients than in the II and III stage patients.Furthermore the analysis on GSTP1 genetic polymorphisms showed the frequency of spleen reduced in turn in the patients carrying A/A，A/G and G/G genotypes.The difference was statistically significant (P<0.05).Conclusion：The postoperative colorectal cancer patients with qi deficiency were accompanied with other pattern commonly，and simultaneous occurrence of deficiency and excess patterns coexisted in body.Gender，chemotherapy，tumor staging and GSTP1 genetic polymorphisms can affect the frequency of pattern elements accompanying with qi deficiency.
Key Words Colorectal cancer； Qi deficiency； Accompanied pattern element； Genetic polymorphism
中圖分类号：R241.4文献标识码：Adoi：10.3969/j.issn.1673-7202.2017.10.058
结直肠癌，也称大肠癌，其发病率在我国逐年上升，目前已成为我国常见的恶性肿瘤之一。2015年，结直肠癌的发病率分别是我国男性最高肿瘤发病率第4位，女性最高肿瘤发病率的第3位[1]。中医药对结直肠癌的治疗效果已被临床实践所验证，尤其是结直肠癌术后，中医药配合放化疗具有显著的减轻不良反应、改善生命质量，提高生存率的效用[2-3]。本课题组前期研究中发现气虚证是结直肠癌患者根治术后出现频率最高的证素[4]，本研究针对结直肠癌术后未化疗和正在化疗的患者，探讨该人群气虚证的兼夹特点，分析化疗、肿瘤部位、性别和遗传多态性等因素对中医病理兼夹的影响，丰富中医理论的生理内涵，促进中医药的临床应用。, 百拇医药(廖凌虹 魏丞 崔欢 王俊杰 吴同玉)
关键词 结直肠癌；气虚证；证素兼夹；基因多态性
Abstract Objective：To investigate the characteristics and influence factors of the pattern elements accompanied with qi deficiency in the postoperative colorectal patients.Methods：A total of 78 postoperative colorectal patients with qi deficiency who were identified by using the method of differentiation of pattern elements.The characteristics of complicated pattern elements were studied and the effects of gender，chemotherapy，tumor site，TNM staging and GSTP1 genetic polymorphism were analyzed by comparing the frequency of pattern elements in different groups.Results：All the qi deficiency patients were accompanied with at least 1 other pattern element.Among 14 common pattern elements with frequency higher than 10%，yang deficiency，qi stagnation and blood deficiency ranked the first to third highest frequency pattern elements.The frequency of blood deficiency，spleen and kidney were higher in the female than in the male while the frequency of heat pattern was higher in the male than in the female.And the frequency of liver pattern increased significantly in the patients undergoing chemotherapy compared with that in the non-chemotherapy patients.The colon pattern frequency was significantly higher in the TNM IV stage patients than in the II and III stage patients.Furthermore the analysis on GSTP1 genetic polymorphisms showed the frequency of spleen reduced in turn in the patients carrying A/A，A/G and G/G genotypes.The difference was statistically significant (P<0.05).Conclusion：The postoperative colorectal cancer patients with qi deficiency were accompanied with other pattern commonly，and simultaneous occurrence of deficiency and excess patterns coexisted in body.Gender，chemotherapy，tumor staging and GSTP1 genetic polymorphisms can affect the frequency of pattern elements accompanying with qi deficiency.
Key Words Colorectal cancer； Qi deficiency； Accompanied pattern element； Genetic polymorphism
中圖分类号：R241.4文献标识码：Adoi：10.3969/j.issn.1673-7202.2017.10.058
结直肠癌，也称大肠癌，其发病率在我国逐年上升，目前已成为我国常见的恶性肿瘤之一。2015年，结直肠癌的发病率分别是我国男性最高肿瘤发病率第4位，女性最高肿瘤发病率的第3位[1]。中医药对结直肠癌的治疗效果已被临床实践所验证，尤其是结直肠癌术后，中医药配合放化疗具有显著的减轻不良反应、改善生命质量，提高生存率的效用[2-3]。本课题组前期研究中发现气虚证是结直肠癌患者根治术后出现频率最高的证素[4]，本研究针对结直肠癌术后未化疗和正在化疗的患者，探讨该人群气虚证的兼夹特点，分析化疗、肿瘤部位、性别和遗传多态性等因素对中医病理兼夹的影响，丰富中医理论的生理内涵，促进中医药的临床应用。, 百拇医药(廖凌虹 魏丞 崔欢 王俊杰 吴同玉)
参见：首页 > 医疗版 > 疾病专题 > 消化内科 > 肠道疾病 > 类癌及类癌综合征 > 结、直肠癌