TCM Syndrome Factor Of 253 Patients With Intracranial Tumors

ObjectiveThe objective of this study is to explore the basic characteristics of TCM syndromes of intracranial tumor patients, thus providing the basis for the future TCM diagnosis and treatment of intracranial tumor.methodThe study was conducted on the brain tumor patients who had hospitalized in the neurosurgery of Sun Yat-sen University Cancer Center from the August to the November of 2015. Based on literature analyses and expert advice, we derived the distribution characteristics of syndromes kept by intracranial tumor patients in accordance to the following procedure. First, with the help of the software EpiData3.1, we drew up a questionnaire in order to record the clinical data and the four diagnostic information of the patients meeting the inclusion criteria. Then we standardized the data and exported Excel to form a database, with which the statistical software SAS9.4 figured out the frequency of each variable. Also we employed factor analysis to extract the main symptoms, the cluster analysis to the syndrome as well. Finally, under the guidance of diagnostic criteria proposed previously, we classified the outcome of cluster analysis into different types.ResultsWith 22 patients ruled out, a total of 231 suitable candidate, out of 253, were included in the study; and 156 of them had been operated on.Four types of syndromes have been provided by the factor analysis and the cluster analysis towards symptoms and signs of the 231 intracranial tumor patients. Type one contains symptoms of head pain, bitterness in mouth, irritability, rapid pulse, stringy pulse and fever and is regarded as "pathogenic poison invades heart" on the basis of the classification standard of TCM syndromes. Type two is characterized by dizziness, thin lingual fur, deep pulse, dry mouth, weight loss, thready pulse, tinnitus, head tingling, sluggish pulse, stasis of sublingual vein, insomnia, twitching limbs, red tongue and pink tongue. In the standard mentioned above, this is called as "Yin deficiency and stasis". Patients in type three have commonly suffered memory loss, frequent urine, pale mouth, decreased intelligence, loose stools, backache, knee fatigue, mental fatigue and pale tongue. This syndrome is correspondingly referred to as "deficiency of Yang and marrow ". The forth type, whose appellation is "accumulation of phlegm and moisture", includes symptoms of dull pain in head, indented tongue, loss of appetite, nausea and vomiting, big fat tongue, pale complexion, white tongue, greasy tongue, low endurance to cold, reticence, faint breath and weak limb.Two types of syndromes have been provided by the factor analysis and the cluster analysis towards signs of the 156 patients who have experienced craniotomy. Type one consists of symptoms of mental fatigue, loss of appetite, white tongue, weak limb, pale tongue, thready pulse, pale complexion, sluggish pulse, red tongue, stasis of sublingual vein, big fat tongue and mouth pale, and is identified as "qi deficiency and blood stasis" in TCM classification standard. While the other group is considered as "deficiency of qi and Yin" for the presence of symptoms comprising thin lingual fur, fever, deep pulse, reticence, faint breath, memory loss and insomnia.conclusionThe cluster analysis towards the 231 patients has differentiated four types of syndromes from each other. Among the 231 cases,33 are "pathogenic poison invades heart",69 are "Yin deficiency and stasis",70 are "deficiency of Yang and marrow" and the last 59 are "accumulation of phlegm and moisture". Combining the study with expertise, we have concluded that the primary pathological features of the syndromes are weakness, stasis, phlegm and pathogenic poison. In the study, the proportion of Yang deficiency is much higher than that of former ones, which is considered relevant to regional factors as well as lifestyle. As a main cause of brain tumor, Yang deficiency shouldn’t be neglected whereupon Yang-warming therapy has become such an essential remedy as considerable curative effects have been produced since it was acknowledged and put into clinical applications by doctors. The clinical efficacy of TCM for intracranial tumor must be improved in terms of Yang-warming therapy and anti-tumor theory of TCM. The former should be supplied with foundations of clinical trails, while the latter requires data support, hence the urgent need of systematically randomized control study which is multicenter, prospective and of great scale. In this way, intracranial tumor patients are to be blessed with happiness and lead a higher-standard life.The cluster analysis towards the postoperative symptoms and signs of the 156 patients has differentiated two types of syndromes from each other. Of the 156 cases,95 are "qi deficiency and blood stasis" and the other 61 are "deficiency of qi and Yin". We have summarized that the postoperative syndromes of intracranial tumor patients are pathologically characterized by weakness and stasis, which indicates that surgical factors directly alter the syndrome features of intracranial tumor patients. So in the postoperative treatment, enough attention should be paid to qi replenishment, blood nourishment, the promotion of blood circulation, considerate care and timely psychological intervention.