Regional Differences Of TCM Prescriptions And Syndromes And Clinical Research Of Advanced Pancreatic Cancer

Objective:1.By searching database literature,this paper aims to expatiate the understanding of modern and modern doctors on the classification of pancreatic cancer syndrome types,preliminarily summarize the common witness types and the distribution of syndrome elements of pancreatic cancer,and analyze and discuss the understanding and research of various doctors on the pathogenesis and evolution of pancreatic cancer.2.Based on data mining technology,retrospective analysis of the syndromes,pathogenesis and prescription medication rules of advanced pancreatic cancer in different regions(south and north)were analyzed to provide important data support for the treatment of pancreatic cancer by traditional Chinese medicine.3.The purpose of this paper is to use prospective study,to analyze the clinical effect of integrated traditional Chinese and western medicine treatment of advanced pancreatic cancer,so as to provide reference for improving the accuracy and clinical efficacy of pancreatic cancer syndrome differentiation.Methods:1.According to the retrieval strategy,the literatures that met the standards of inclusion and exclusion criteria were retrieved from the self-built Chinese database until November 21,2018.After collation,verification,data extraction and specification,frequency analysis was used to count the common TCM syndromes of pancreatic cancer,and disease syndrome element and disease location syndrome element analysis was conducted to preliminary explore the core pathogenesis of pancreatic cancer.2.Multi-center retrospective collection of general data,medical history information and TCM four diagnosis data of patients with advanced pancreatic cancer who met the inclusion criteria from January 2016 to November 2020 was conducted to establish Epidata database for data entry.IBM SPSS Statistics 26.0 and IBM SPSS Modeler 18.0 were used to conduct descriptive Statistics,Apriori association rule analysis,factor analysis,visualization,etc.,to explore the core pathogenesis,prescriptions and drug compatibility of TCM in the treatment of advanced pancreatic cancer,and extracts the core pathogenesis and prescription medication rule of advanced pancreatic cancer in different regions(south and north).3.By using the multicenter,prospective cohort study design,we collected ?-?pancreatic cancer cases from January 2019 to November 2020,established EpiData database,summarized the patient's general condition information,medical history information,treatment,medication,living conditions,life quality and inspection check information.According to the grouping criteria,patients were divided into western medicine group and integrated traditional Chinese and western medicine treatment group.We used SAS 9.4 and IBM SPSS Statistics 26.0 statistical software package to analyze and evaluate the survival conditions the quality of life and tumor markers rise trend.Results:1.Literature research results showed that the disease sites of advanced pancreatic cancer are mainly in the liver and spleen.At present,the common clinical syndrome types are dampness-heat accumulation type,qi stagnation and blood stasis type,spleen deficiency dampness-block type,Yin deficiency and internal heat type,and spleen deficiency and qi stagnation type.The most common syndromes are dampness,heat,qi stagnation,blood stasis.Spleen deficiency is the key to the pathogenesis and treatment of pancreatic cancer.Conclusion:The main sites of advanced pancreatic cancer are liver and spleen,and the core sites are spleen.Spleen deficiency is the key to its pathogenesis and treatment.The syndromes of advanced pancreatic cancer include dampness,heat,qi stagnation,blood stasis,Yin deficiency,poison,qi deficiency,blood deficiency,Yang deficiency,cold,phlegm,and qi deficiency.Among them,dampness,heat,qi stagnation,qi deficiency and blood stasis are the main pathological changes of pancreatic cancer.The most common complex syndrome types of advanced pancreatic cancer are dampness-heat accumulation,qi stagnation and blood stasis,dampness-obstruction of spleen deficiency,Yin deficiency and qi stagnation of spleen deficiency.2.Retrospective clinical studies based on 256 patients showed that the main sites of advanced pancreatic cancer are spleen,liver,stomach and gallbladder,especially the spleen and liver,which may involve kidney,lung and heart,and the spleen is the core site of the disease.The southern sites tend to the spleen and stomach,while the northern sites tend to the liver,gallbladder,kidney and lung.The common syndromes of pancreatic cancer include qi stagnation,qi deficiency,dampness,heat,phlegm,blood stasis,Yang deficiency,blood deficiency,water stagnation,Yin deficiency,cold.Qi deficiency and Qi stagnation are the main deficiency syndrome elements and solid syndrome elements respectively.Spleen deficiency(spleen qi deficiency)and Qi stagnation are the core pathogenesis of the disease.Qi stagnation of spleen deficiency,dampness of spleen deficiency,spittoon condensation of spleen deficiency,dampness and heat accumulation,qi stagnation and blood stasis syndrome are common syndromes.In the south,Qi stagnation and Qi deficiency are the most common pathogenesis,while in the north,dampness,blood stasis,Yang deficiency,cold,phlegm and heat are the most common pathogenesis.Through drug association rule analysis,it can be seen that the most commonly used prescriptions for advanced pancreatic cancer are the addition and subtraction of Sijunzi Decoction,Yigong powder,Liujunzi Decoction and Xiangsha Liujunzi Decoction.The network diagram of core drugs was drawn by association strength,and the core prescription drugs were obtained as follows:Atractylodes,Poria Cocos,Tangerine Peel,Astragalus membranaceus,Pinellia,Chicken Root,Malt,Paeonia lactiflora,Codonopsis Radix.The combination of various drugs can play the effect of invigorating qi,invigorating spleen,gasifying dampness,resolving phlegm and dissipating food.Conclusion:The core site of advanced pancreatic cancer is in the spleen,and the spleen and stomach sites are more common in the south,while the liver,gallbladder,kidney and lung sites are more common in the north.Spleen deficiency(Spleen qi deficiency)and Qi stagnation were the core pathogenesis of the disease.The characteristics of Qi stagnation and Qi deficiency were more common in the south.On the basis of this,the pathogenesis of the disease in the north was manifested as dampness,blood stasis,Yang deficiency,cold,phlegm and heat.The most commonly used prescriptions for pancreatic cancer were the addition and subtraction of Sijunzi decoction,Yigong powder,Liujunzi decoction and Xiangsha Liujunzi decoction,and the core prescription drugs were Atractylodes Atractylodes,Poria Cocos,Tangerine Peel,Astragalus membranaceus,Pinellia pinellia,Chicken Root,Malt,Paeonia lactiflora,Codonopsis Radix.In terms of treatment,both the south and the north pay attention to invigorating qi and invigorating spleen,regulating qi and dissipating food,but the north also pays attention to clearing away heat and dampness,resolving phlegm and dispersing constipation,promoting blood circulation and removing blood stasis.It fully reflects the guiding role and rationality of the theory of "treatment in accordance with three categories of etiological factors" in the clinical differentiation and treatment of cancer,and fills the blank of the research on the regional differences of the prescriptions and symptoms of advanced pancreatic cancer.3.Results of prospective clinical studies based on 138 patients showed that group was an independent factor for pancreatic cancer survival(P<0.05).Compared to the Western medicine group,integrative treatment of traditional Chinese and western medicine can prolong the overall survival time of pancreatic cancer(P<0.05).The stratified analysis results showed that integrative treatment of traditional Chinese and western medicine can prolong the overall survival of patients with high or moderately differentiation(408.00 days vs 228.00 days,P=0.0232),IV stage(408.00 days vs 308.00 days,P=0.0370),regional lymph node metastasis(423.00 days vs.349.00 days,P=0.0297),and without post-diagnosis treatment history(390.00 days vs.255.00 days,P=0.0412).The differences among groups were statistically significant(P<0.05).CA50 in the integrated Chinese and western medicine group showed a decreasing trend after treatment,and the difference between the two groups was statistically significant(P<0.05).In terms of TCM symptom scale,the improvement of total score,fatigue,nausea and vomiting,pain and insomnia in the integrated TCM and western medicine group were better than those in the western medicine group.Integrated treatment of traditional Chinese and western medicine can improve the emotional function,cognitive function,general health status,fatigue,nausea and vomiting,pain,insomnia symptoms.The integrated of traditional Chinese and western medicine in the treatment of advanced pancreatic cancer provides solid and reliable data support for clinical work.Conclusion:Group is an independent factor affecting the survival of advanced pancreatic cancer.The integration of traditional Chinese and western medicine can prolong OS,reduce tumor markers,improve fatigue,nausea and vomiting,pain and insomnia,and improve the emotional function,cognitive function and general health status of patients with advanced pancreatic cancer compared to the western medicine group.