Cancer Syndromes And Their Correlations With Clinical Practice And Thrombelastograph Testing

Background:According to the report, about15%of the cancer patients had clinically overt venous thromboembolism, which is the most common complication in these patients and as the second cause of death. Taken active measures to prevent and treat hypercoagulable state has important positive significance in improve the overall quality of life of patients with malignant tumor. A lot of basic and clinical studies have proved that traditional Chinese medicine can effectively improve the hypercoagulable states of cancer patients, and have no significant adverse reactions. Traditional Chinese medicine has a large advantage in prevention and treatment of hypercoagulable state. However, current clinical research of traditional Chinese medicine on cancerous hypercoagulable state is relatively small, the differential treatment is confusion, and has lots of subjective intervention factors. That’s greatly limitied the TCM treatment in clinical application for cancer patients with highcoagulation state. Coagulation is a very complex process, which involves the interaction of many factors. The traditional laboratory coagulation check only isolated parts of the clotting process, and can not understand the whole picture. Thrombelastogram can graphically dynamic, full monitoring the whole process of blood coagulation, from start to clot formation and fibrinolysis, comprehensive testing and evaluate coagulation factors, platelet function, fibrinogen and fibrin dissolution conduct and the results are fast and accurate, can better for clinical services. On this basis, we use thrombelastograph detection value as judged by a hypercoagulable state exploration targets, carried out a study to explore the relationship of cancer patients between TCM syndromes and thrombelastograph testing and its relevance to clinical practice.Objectiver:Throughout the clinical research, study the correlation between cancer hypercoagulable state and tumor stage, KPS score and prior treatment. Analysis of the common syndrome distribution in cancer patients. Explore the relationship between cancer hypercoagulable state and TCM syndromes, and through clinical trials to further evaluate the clinical efficacy of improving cancer patients with hypercoagulable states by the therapeutic methods of Warming Yang and Invigorating Qi, promoting blood circulation and resolving phlegm.Methods:Part one:We took the outpatients with cancer form Dongzhimen hospital during September2013and2014January as study cases, developed investigation table and collected case. Use descriptive research method to recognize the patient’s general information, disease information, thrombelastograph index distribution and TCM syndromes. Then learn the ratio of tumor lesion site, clinical stage, KPS score and prior treatment in the hypercoagulable group. Third, analyze the relationship between cancerous hypercoagulable state and TCM syndromes. Forth, analyze the relationship between the syndromes and thrombelastograph index as R, K, Angle, MA and CI. Part two:We took the out and hospitalized patients with hypercoagulable state form Dongzhimen hospital during October2013and2014January for the study. Analyze thrombelastograph indicators and safety targets before and after the treatment. Observe the clinical efficacy and safety by the therapeutic methods of Warming Yang and Invigorating Qi, promoting blood circulation and resolving phlegm. Results:①In the collected215cases, qi deficiency, blood stasis, qi stagnation, phlegm, yang deficiency were common clinical syndromes, and its constituent ratio was83.26%,66.05%,64.19%,52.09%and50.70%respecily.②In the cancer patients the relationship between hypercoagulable states and chemotherapy, radiation therapy was not show (P>0.05), while the tumor lesion site, clinical stage, KPS score, surgical treatment has a certain relationship (P<0.05).③In various syndromes, the yang deficiency and coagulated cold syndrome closely related with hypercoagulable state (P<0.05), and has higher hypercoagulable states incidence compared with non-yang deficiency and coagulated cold syndrome patients.④The different syndromes (type two combination) have some differences with TEG index K value, Angle values and CI values (P<0.05), yang deficiency and coagulated cold syndrome group has a higher angle value and CI values.⑤Independent risk factor for the occurrence of cancer patients with blood hypercoagulable are:tumor stage, tumor location, yang deficiency and coagulated cold syndrome and Angle value.⑥After taking the Chinese medicine, the patients’ thrombelastograph index angle value, MA value, CI values were all decreased, K values was rised (P<0.05).⑦The therapeutic methods of Warming Yang and Invigorating Qi, promoting blood circulation and resolving phlegm can improve the quality of life of cancer patients with hypercoagulable state (P<0.05).⑧Biochemical parameters before and after treatment showed no significant change (P>0.05), and adverse reactions did not occur. Conclusion:①Yang deficiency and coagulated cold syndrome is closely related to hypercoagulable state.②Tumor lesion site, clinical stage, KPS score, surgery and cancer treatment are have a certain relevance with hypercoagulable state.③Qi deficiency, blood stasis, qi stagnation, phlegm, Yang deficiency are common clinical syndromes in cancer patients, and yang qi, blood and Warming Yang and Invigorating Qi, promoting blood circulation and resolving phlegm and Qi method can be used as one of a basic treatment strategies in malignancies.④The rapeutic method of Warming Yang and Invigorating Qi, promoting blood circulation and resolving phlegm can improve the hypercoagulable state in patients with malignant tumors.⑤Warming Yang and Invigorating Qi, promoting blood circulation and resolving phlegm method can improve the quality of life of malignancy hypercoagulable state.⑥The rapeutic method of Warming Yang and Invigorating Qi, promoting blood circulation and resolving phlegm has a good clinical safety.