The Clinical Application Of "Traditional Chinese Medicine Constitution Identification + Syndrome Differentiation" Treatment Model In Post-operative Rrectal Cancer

Objective:This study analyzed the distribution and evolution of the constitution and syndrome of patients with rectal cancer during the 1st,4th and 8th chemotherapy cycles by identifying the traditional chinese medicine constitution and syndrome of patients treated with capecitabine+oxaliplatin(XELOX)chemotherapy regimen after rectal cancer surgery,and explored the correlation between the constitution and syndrome;To clarify the impact of the constitution identification+syndrome differentiation treatment model on quality of life,clinical performance,immune function and adverse effects after rectal cancer surgery.Methods:Patients who were diagnosed with rectal cancer and underwent radical rectal cancer surgery after attending the Proctology in Linyi Hospital of Traditional Chinese Medicine from November 2020 to October 2022 were selected.A random number table method was adopted to divide 60 patients into treatment group and control group,and the control group chose XELOX regimen for adjuvant chemotherapy after surgery,while the treatment group was treated with constitution identification+syndrome differentiation on the basis of adjuvant chemotherapy.(1)To observe the distribution of constitution and syndrome of patients in both groups during 1.4.8 chemotherapy cycles in order to explore the internal pattern of constitution and syndrome;(2)Patients’clinical efficacy and quality of life were assessed by the TCM syndrome score and KPS questionnaire before treatment,after cycle 4 and cycle 8 of treatment;(3)Lymphocyte subpopulation,tumour markers,blood count,liver and kidney function were detected.SPSS26.0 software was applied for statistical analysis.Results:1.The distribution of TCM syndrome:among patients who underwent XELOX chemotherapy after rectal cancer surgery,Damp-Heat accumulation syndrome and Liver-Kidney Yin deficiency syndrome were the common evidence patterns.In the treatment group,the first chemotherapy cycle was dominated by the Damp-Heat accumulation syndrome(43.3%),the fourth chemotherapy cycle by the Damp-Heat accumulation syndrome(43.3%)and the eighth chemotherapy cycle by the Liver-Kidney Yin deficiency syndrome(50.0%);In the control group,the first chemotherapy cycle was dominated by the Damp-Heat accumulation syndrome(40.0%),the fourth chemotherapy cycle was dominated by the Spleen-Kidney Double Deficiency syndrome(46.7%),and the eighth chemotherapy cycle was dominated by the Qi-Blood Deficiency syndrome(46.7%).The differences in the distribution of TCM syndrome were statistically significant(P<0.05).2.Patterns of TCM constitution identification:Among patients undergoing XELOX chemotherapy after rectal cancer surgery,the common constitutions are Damp-Heat constitution,Yang-Deficiency constitution and Yin-Deficiency constitution.In the treatment group,the first chemotherapy cycle was dominated by damp-heat constitution(26.7%),the fourth chemotherapy cycle by damp-heat constitution(36.7%)and the eighth chemotherapy cycle by yin-deficiency constitution(46.7%).The control group had a predominantly damp-heat constitution in the first chemotherapy cycle(26.7%),a predominantly yang-deficiency constitution in the fourth chemotherapy cycle(36.7%)and a predominantly qi-deficiency constitution in the eighth chemotherapy cycle(33.3%).The difference in the distribution of TCM constitution was statistically significant(p<0.01).3.The correlation between constitution and syndrome:Damp-Heat accumulation syndrome is more common with damp-heat constitution,the syndrome of Toxin resistance was more common in Qi-depression constitution,the syndrome of double deficiency in the spleen and kidney was more common in Yang-deficiency constitution,the syndrome of the liver and kidney was more common in Yin-deficiency constitution,and the syndrome of deficiency in both Qi and blood was more common in Qi-deficiency constitution.After statistical analysis,there was a significant correlation between constitution and syndrome.4.Quality of life and TCM syndrome scores:The quality of life scores and the TCM symptom scores increased in both the treatment and control groups.There was a difference in the quality of life scores and TCM syndrome scores between the two groups after cycle4 and cycle 8(p<0.05).The treatment group was superior to the control group in improving the quality of life and clinical symptoms.5.Immune function:The levels of lymphocyte subsets(CD3~+,CD4~+,CD8~+,NK cells)were increased in both the treatment and control groups.In particular,there was a significant difference in CD3~+between the two groups after the fourth and eighth cycle of treatment(P<0.01);after the eighth cycle of treatment,there was a statistically difference in CD4~+and CD8~+levels when comparing the two groups(P<0.05);after the eighth cycle of treatment,there was a significant difference in NK cell levels between the two groups(P<0.01).The treatment group was better than the control group in improving immune function.6.Tumour marker status:Carcinoembryonic antigen and glycoantigen 19-9 counts decreased in both the treatment and control groups.There was a difference in CEA and CA19-9 between the two groups after the eighth cycle of treatment(P<0.05).The treatment group was able to effectively reduce the level of tumour markers compared to the control group.7.Adverse reactions:The incidence of adverse reactions in the treatment group was significantly lower than that in the control group.Adverse reactions in the treatment group were mainly granulocytopenia,malaise and leucopenia;in the control group,adverse reactions were mainly leucopenia,granulocytopenia,malaise,nausea and vomiting.However,there was no statistically significant difference(P>0.05).Conclusion:1.There were differences in the distribution of TCM syndrome and TCM constitution in each cycle of chemotherapy between the treatment and control groups;the TCM syndrome and TCM constitution of rectal cancer patients in general showed a tendency to change from actual to deficiency after surgery,and there was a certain pattern between the distribution of constitution and TCM syndrome.2.The"traditional chinese medicine constitution identification+syndrome differentiation of traditional chinese medicine"treatment model can improve the quality of life of rectal cancer patients after surgery,effectively improve clinical symptoms,enhance immune function,lower tumour marker levels and reduce the occurrence of adverse reactions.