| [Objective]In this study,the distribution of TCM syndromes in primary non-small cell lung cancer(NSCLC)patients admitted to our hospital in recent 7 years(June 2009-2016June)was investigated by retrospective investigation of medical records,to investigate the influence of chemotherapy on the distribution of TCM syndromes in primary NSCLC patients,and to analyze the effects of different chemotherapy regimens(gemcitabine combined cis-dichlorodiamineplatinum(II)and pemetrexed combined cis-dichlorodiamineplatinum(II))on the distribution of TCM syndromes,to investigate the relationship between the distribution of TCM syndromes and the blood toxicity of chemotherapeutic drugs,so as to provide reference for the treatment of primary NSCLC and to alleviate side effects of chemotherapy.[Method]We reviewed the related literatures and made a retrospective questionnaire of lung cancer medical records.The medical records of 161 patients with primary NSCLC who were admitted to the hospital and diagnosed with primary in the past 7 years were collected and analyzed.Before the first course of chemotherapy and three weeks after the first,second,third and fourth course of chemotherapy,a retrospective questionnaire of medical records was completed and syndrome differentiation.All the relevant data were analyzed by SPSS20.0 software.The qualitative data of each group were compared by chi square test,and the one-way qualitative data of multiple groups were tested by Kruskal-Wallis Test.[Results](1)The distribution of TCM syndrome types before and after the first period of chemotherapy: syndrome of the efficiency of qi and phlegm and dampness accounted for 44.10% in the 161 patients before the first course of chemotherapy,and syndrome of deficiency of both qi and yin accounted for 11.80%;syndrome of deficiency of both qi and yin accounted for 29.81% after the first course of chemotherapy,syndrome of the efficiency of qi and phlegm and dampness accounted for 27.95%.The difference was statistically significant between before and after chemotherapy in the distribution of TCM syndrome types(P<0.05);syndrome of the efficiency of qi and phlegm and dampness decreased and syndrome of deficiency of both qi and yin increased after chemotherapy,the difference was statistically significant(P<0.05).(2)The distribution of TCM syndrome types before the first course of chemotherapy and after the second course of chemotherapy: in 109 cases of chemotherapy with two courses,syndrome of the efficiency of qi and phlegm and dampness accounted for44.04% before the first course of chemotherapy,syndrome of deficiency of both qi and yin accounted for 13.76%;syndrome of deficiency of both qi and yin accounted for31.19% after the second course of chemotherapy,syndrome of the efficiency of qi and phlegm and dampness accounted for 25.69%,the distribution of syndrome type before and after two courses of chemotherapy was statistically significant(P < 0.05);syndrome of the efficiency of qi and phlegm and dampness decreases and syndrome of deficiency of both qi and yin increased after chemotherapy,the difference was statistically significant(P<0.05).(3)The distribution of TCM syndrome types before the first course of chemotherapy and after the third course of chemotherapy: in 85 patients of chemotherapy with three courses,syndrome of the efficiency of qi and phlegm and dampness accounted for44.71% before the first course of chemotherapy,syndrome of deficiency of both qi and yin accounted for 15.29%;syndrome of deficiency of both qi and yin accounted for 31.76% after the third course of chemotherapy,syndrome of the efficiency of qi and phlegm and dampness accounted for 20.00%,the distribution of syndrome type before and after three courses of chemotherapy was statistically significant(P < 0.05);syndrome of the efficiency of qi and phlegm and dampness decreased and syndrome of deficiency of both qi and yin increased after chemotherapy,the difference was statistically significant(P<0.05).(4)The distribution of TCM syndrome types before the first course of chemotherapy and after the fourth course of chemotherapy: in 72 patients of chemotherapy with three courses,syndrome of the efficiency of qi and phlegm and dampness accounted for44.44% before the first course of chemotherapy,syndrome of blood stasis with qi stagnation accounted for 26.39% and syndrome of deficiency of both qi and yin accounted for 16.67%;syndrome of blood stasis with qi stagnation accounted for43.05% after the fourth course of chemotherapy,syndrome of deficiency of both qi and yin accounted for 33.33%,syndrome of the efficiency of qi and phlegm and dampness accounted for 18.06%,the distribution of syndrome type before and after four courses of chemotherapy was statistically significant(P<0.05);syndrome of the efficiency of qi and phlegm and dampness decreased,syndrome of deficiency of both qi and yin and syndrome of blood stasis with qi stagnation increased after chemotherapy,the difference was statistically significant(P<0.05).(5)The distribution of TCM syndrome types before and after the first course of chemotherapy which was in gemcitabine combined cis-dichlorodiamineplatinum(II):syndrome of blood stasis with qi stagnation accounted for 24.99% before the first course of chemotherapy which was in gemcitabine combined cis-dichlorodiamineplatinum(II),syndrome of deficiency of both qi and yin accounted for 10.94%;syndrome of blood stasis with qi stagnation accounted for 39.06%,syndrome of deficiency of both qi and yin accounted for 23.44% after chemotherapy,the difference was statistically significant(P<0.05).Syndrome of deficiency of both qi and yin and syndrome of blood stasis with qi stagnation increased after chemotherapy,the difference was statistically significant(P<0.05).(6)The distribution of TCM syndrome types before and after the first course of chemotherapy which was in alimta combined cis-cichlorodiamineplatinum(II):syndrome of the efficiency of qi and phlegm and dampness accounted for 41.67%before the first course of chemotherapy which was in alimta combined cis-cichlorodiamineplatinum(II),syndrome of deficiency of both qi and yin accounted for 25.00%;syndrome of the efficiency of qi and phlegm and dampness accounted for33.33% and syndrome of deficiency of both qi and yin accounted for 33.33% after chemotherapy,the difference was no statistically significant(P>0.05).(7)The blood toxicity after the first course of chemotherapy of different TCM syndrome types before the first course of chemotherapy:Leukopenia: there are 13 cases in different degrees of leucopenia in the syndrome of the efficiency of qi and phlegm and dampness,syndrome of deficiency of both qi and yin were 5 cases,syndrome of yin deficiency with noxious heat emerges were 4cases,syndrome of retention of phlegm-heat in the lung were 7 cases.The difference was no statistically significant between the different TCM syndrome types before the first course of chemotherapy in the degree of leukocyte reduction(P>0.05).Hemoglobin decreased: there are 32 cases in different degrees of hemoglobin decreased in the syndrome of the efficiency of qi and phlegm and dampness,syndrome of deficiency of both qi and yin were 8 cases,syndrome of yin deficiency with noxious heat emerges were 6 cases,syndrome of blood stasis with qi stagnation were 14 cases.The difference was no statistically significant between the different TCM syndrome types before the first course of chemotherapy in the degree ofhemoglobin decreased(P>0.05).Granulocytopenia: there are 10 cases in different degrees of granulocytopenia in the syndrome of the efficiency of qi and phlegm and dampness,syndrome of deficiency of both qi and yin were 6 cases,syndrome of yin deficiency with noxious heat emerges were 4 cases,syndrome of retention of phlegm-heat in the lung were 3cases,syndrome of blood stasis with qi stagnation was 1 case.The difference was statistically significant between the different TCM syndrome types before the first course of chemotherapy in the degree of granulocytopenia(P<0.05).The main occurrence of syndrome of the efficiency of qi and phlegm and dampness is the gradeⅠ and Ⅱin granulocytopenia,the main occurrence of syndrome of deficiency of both qi and yin and syndrome of yin deficiency with noxious heat emerges is the grade Ⅱin granulocytopenia,the main occurrence of syndrome of retention of phlegm-heat in the lung and syndrome of blood stasis with qi stagnation is the grade Ⅰin granulocytopenia.Thrombocytopenia: there are 11 cases in different degrees of thrombocytopenia in the syndrome of the efficiency of qi and phlegm and dampness,syndrome of deficiency of both qi and yin were 4 cases,syndrome of retention of phlegm-heat in the lung was 1 cases,syndrome of blood stasis with qi stagnation were 3 case.The difference was no statistically significant between the different TCM syndrome types before the first coures of chemotherapy in the degree of thrombocytopenia(P>0.05).[Conclusion](1)The chemotherapy has effect on primary NSCLC in the distribution of TCM syndrome types,the syndrome of the efficiency of qi and phlegm and dampness decreases after three periods of chemotherapy than before,syndrome of deficiency of both qi and yin increased after chemotherapy;syndrome of the efficiency of qi andphlegm and dampness decreased after four courses of chemotherapy than before,syndrome of deficiency of both qi and yin and syndrome of blood stasis with qi stagnation increased after chemotherapy;the distribution of TCM syndrome types after the first course of chemotherapy which was in gemcitabine combined cis-dichlorodiamineplatinum(II),syndrome of deficiency of both qi and yin and syndrome of blood stasis with qi stagnation increased;the difference of the distribution of TCM syndrome types before and after the first course of chemotherapy which was in alimta combined cis-cichlorodiamineplatinum(II)was no statistically significant.This shows that chemotherapy may consuming qi,injuring yin and aggregrate blood stasis.Different chemotherapy regimens has different influence in the distribution of TCM syndrome types.(2)Different TCM syndrome types has different blood toxicity after chemotherapy,the difference was statistically significant between the different TCM syndrome types before the first course of chemotherapy in the degree of granulocytopenia,the difference was no statistically significant between the different TCM syndrome types before the first course of chemotherapy in the degree of leucopenia,hemoglobin and thrombocytopenia.This shows that different distribution of TCM syndrome types has different blood toxicity after chemotherapy. |
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