216例辅助化学治疗期乳腺癌患者中医证候分布和演变规律研究

目的探讨辅助化学治疗期乳腺癌患者的中医证候及其变化规律。方法采集216例辅助化学治疗期乳腺癌患者的四诊信息,通过聚类分析结果结合专家经验归纳出中医证候的分布和演变规律。结果化学治疗开始前患者多表现为脾虚与肝郁两证,第2周期化学治疗结束后患者表现为脾气虚证、肝郁化火证、心肝实热证,第4周期化学治疗结束后患者表现为肝、脾、胃三脏阴血不足为主的证候,第6周期化学治疗结束后患者出现心、肝、脾、胃等多脏腑不足的证候。结论在辅助化学治疗期,患者中医证型总体以虚证为主;在化学治疗前期,主要为肝脾两脏的气病;随着化学治疗的延续,由阳病转为阴病;后期患者逐渐表现为类似五脏羸弱的证候。

Distribution and Evolution of Traditional Chinese Medicine Syndromes in Patients with Breast Cancer during Adjuvant Chemotherapy: A Study of 216 Cases

Objective To investigate the distribution and evolution of traditional Chinese medicine (TCM) syndromes in patients with breast cancer during adjuvant chemotherapy. Methods The information obtained by four diagnostic methods was collected from 216 patients with breast cancer during adjuvant chemotherapy. The distribution and evolution of TCM syndromes were summarized based on cluster analysis results and expert experience. Results Patients mostly showed spleen deficiency and stagnation of liver qi before chemotherapy, exhibited spleen-qi deficiency, liver depression transforming into fire, and excessive heat in the heart and liver after the second cycle of chemotherapy, showed syndromes mainly including yin-blood deficiency of the liver, spleen, and stomach after the fourth cycle of chemotherapy, and had deficiency of multiple organs including the heart, liver, spleen, and stomach after the sixth cycle of chemotherapy. Conclusion For patients with breast cancer, the TCM syndromes mainly include deficiency syndrome during adjuvant chemotherapy; qi diseases of the liver and spleen are the dominant syndromes in the early phase of chemotherapy; yang disease is transformed into yin disease as the chemotherapy proceeds; syndromes similar to weak five viscera gradually appear in the late phase of chemotherapy.