EGFR-TKI治疗后非小细胞肺癌中医证候研究

发布时间：2018-11-22 20:23

【摘要】：目的观察靶向药物治疗后非小细胞肺癌(NSCLC)患者的中医证候分布。方法采用临床流行病学调查方法观察506例表皮生长因子受体酪氨酸激酶阻滞剂(EGFR-TKI)治疗后的NSCLC患者症状、体征、舌脉四诊资料,运用聚类分析方法观察靶向药物治疗后NSCLC患者的中医证候特征规律,进行因子分析,观察各个证型辨证的主次症。结果患者中医证型主要为肺阴亏虚证(281例,55.53%)、气阴两虚证(145例,28.66%)、肺脾气虚证(80例,15.81%)。肺阴亏虚证主要证素为咳嗽、痰少、痰黏、皮疹瘙痒、皮肤干燥、口干渴、舌红、裂纹舌、脉细;次症为苔薄或苔白(P=0.001)。气阴两虚证主要证素为头晕、口干不欲饮、脉弱、少寐;次症为气促、干咳无痰、咽干、心烦(P=0.001)。肺脾气虚证主要证素为神疲乏力、恶心、纳差、大便不成形、舌淡红、苔腻、胖大齿痕舌、脉滑;次症为面萎黄或胸闷(P=0.001)。结论靶向药物治疗后NSCLC患者的证型主要为肺阴亏虚证、气阴两虚证和肺脾气虚证,其核心证型是肺阴亏虚证。
[Abstract]:Objective to observe the distribution of TCM syndromes in (NSCLC) patients with non-small cell lung cancer (NSCLC) after targeted drug therapy. Methods the clinical epidemiologic investigation was used to observe the symptoms, signs and tongue pulse data of 506 NSCLC patients treated with epidermal growth factor receptor tyrosine kinase blocker (EGFR-TKI). Cluster analysis was used to observe the characteristics of TCM syndromes in patients with NSCLC after targeted drug therapy, and factor analysis was carried out to observe the main and secondary syndromes of different syndrome types. Results the main types of TCM syndromes were deficiency of lung yin (281 cases, 55.53%), deficiency of qi and yin (145 cases, 28.66%) and deficiency of lung and spleen (80 cases, 15.81%). The main syndromes of deficiency of lung yin were cough, phlegm less, sputum viscosity, pruritus, dry skin, thirst, tongue red, crack tongue, thin pulse, and the second symptom was thin fur or white fur (P0. 001). The main syndromes of qi and yin deficiency syndrome were dizziness, dry mouth, weak pulse and low sleep, second symptom was shortness of breath, dry cough without phlegm, dry pharynx, and upset (P0. 001). The main syndromes were fatigue, nausea, anorexia, defecation, pale red tongue, greasy moss, fat big teeth mark tongue, pulse slip, secondary symptom was yellow face or chest tightness (P0. 001). Conclusion the main syndromes of NSCLC patients after targeted drug therapy are deficiency of lung yin, deficiency of qi and yin and deficiency of lung and spleen qi, the core type of which is deficiency of lung yin.
【作者单位】：上海龙华医院肿瘤科;复旦大学附属华东医院中医科;
【基金】：国家自然科学基金委员会资助项目(No.81573890) 上海市进一步加快中医药事业发展三年行动计划(No.CCCX-3-3001) 国家中医药管理局中医临床研究基地业务建设科研专项课题(No.JDZX2015069) 龙华医院第三批中青年名中医培养计划(No.RC-2017-01-10)
【分类号】：R734.2

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