| ObjectiveThe main aim of this paper is to explore the distribution of TCM syndrome types in different stages of left-sided and right-sided colon cancer,by comparing the clinical symptoms of left-sided and right-sided colon cancer patients at the time of initial treatment.Researching the incidence of spleen deficiency syndrome in left-sided and right-sided colon cancer patients and the related factors affecting the spleen deficiency syndrome,and to explore the prognostic relationship of colon cancer between spleen deficiency syndrome and non-spleen deficiency syndrome,so as to provide a reference for further study on left-sided and right-sided colon cancer in traditional Chinese medicine.Methods1.The distribution of the syndrome distribution of TCM in different stages of left-sided and right-sided colon cancer:According to the primary tumor site,a total of 155 cases of colon cancer were selected according to the inclusion criteria,it was divided into 86 cases of right-sided colon cancer group and 69 cases of left-sided colon cancer group with the boundary of spleen flexure.According to the type of data,Pearson Chi-square test,Fisher exact probability method,independent sample T test and Mann-Whitney U rank test were used to analyze the general data of the two groups.The clinical staging of the enrolled cases was based on the TNM staging criteria established by the American Joint Committee on Cancer(AJCC),the right-sided and left-sided of the colon cancer TCM syndrome referring to the Colon cancer for TCM syndrome differentiation in the“Specialty Cooperative Collaborative Group on Colorectal Cancer Diagnosis and Treatment Plan of the State Administration of Traditional Chinese Medicine”.Fisher exact probability method or the Pearson chi-square test was used to analyze the the differences of TCM syndromes between the two groups.2.The analysis of related factors of left-sided and right-sided colon cancer with spleen deficiency syndrome:According to the syndrome differentiation criteria of“Chinese medicine deficiency syndrome reference standard”,the left-sided and right-sided colon cancers are differentiated by syndrome standard of spleen deficiency syndrome.Using Pearson Chi-square test、Fisher exact probability method to analysis the distribution of spleen deficiency syndrome in the two groups.Using logistic regression analysis and linear regression analysis to explore the factors affecting spleen deficiency syndrome in stage Ⅲ-Ⅳ.3.The survival analysis of spleen deficiency syndrome in stage Ⅲ-Ⅳ:Researching 66 cases of colon cancer in all follow-up cases,the Fisher exact test or Pearson chi-square test was used to compare the differences of overall survival between two groups.Kaplan-Meier method,log-rank test and COX proportional hazards regression model were used to analyze the survival rate.Results1.Distribution of TCM syndrome:155 cases were included in this study,right-sided colon cancers were noted in 86(55.48%)cases,including 6,27,25,28 patients in stage Ⅰ,Ⅱ,Ⅲ,Ⅳ,respectively,and left-sided colon cancers were noted in 69(44.52%)cases,with 4,20,21,24 patients in stage Ⅰ,Ⅱ,Ⅲ,Ⅳ.The symptoms of abdominal discomfort(abdominal distension and abdominal pain),hematochezia and melena in the two groups were significantly different.The statistical showed that there was no significant difference in TCM syndrome between left-sided and right-sided colon cancer in stage I andⅡ.The two groups were mainly phlegm dampness and syndrome of internal binding of static blood and poison.Yang deficiency of spleen and renal and phlegm dampness tend to be larger in stage Ⅲ between two groups.There are significant differences between Yang deficiency of spleen and renal in stageⅣ.Right-sided colon cancer in stage Ⅲ and Ⅳ is the most common with Yang deficiency of spleen and renal,and the most common left-sided colon cancer with phlegm dampness.2.Related factors of spleen deficiency:spleen deficiency was the most common in stage Ⅲ and Ⅳ,especially in right-sided colon cancer.The stageⅢ and Ⅳ colon cancers with spleen deficiency were correlated with albumin,hemoglobin and PS scores,and positively correlated with CEA.3.Survival analysis:66 cases were included in the survival analysis.There was a statistically significant difference in OS between stageⅢ and Ⅳ in colon cancers,especially in one-year survival rate.Grouping in different Syndrome was revealing no remarkable difference between spleen-deficiency syndrome group and non-spleen-deficiency syndrome group.6 months,1 year,2 year survival rate between the two groups were no remarkable difference.Univariate analysis shows the stage,surgery,CA199 affect the prognosis of colon cancer,and surgery is the protective factor affecting the survival of colon cancer,CA199 is a risk factor for OS.ConclusionThe syndrome in Traditional Chinese medicine of left-sided and right-sided colon cancer is different.In stage Ⅰ and Ⅱ left-sided and right-sided colon cancers are dominated by phlegm-inducing internal arrest syndromes and internal detoxification syndromes.In stage Ⅲ-Ⅳ of colon cancer,right-sided colon cancer is mostly the Yang deficiency of spleen and renal while left-sided colon cancer is Phlegm dampness.The incidence of spleen deficiency syndrome in right-sided colon cancer is higher than the left-sided colon cancer.The spleen deficiency syndrome is correlated with albumin,hemoglobin,PS score and CEA increase.In this study,spleen deficiency syndrome had no significant effect on the prognosis of colon cancer,but the effect of spleen deficiency syndrome on the prognosis of colon cancer deserves further study. |
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