| Objective: Through the collection of traditional Chinese medicine(TCM)in hubei province hospital see a doctor and treatment of patients with gastric cancer data,survival time,for each group of gender,age,age,smoking history,drinking history,past medical history,symptoms start,high risk,the degree of differentiation,clinical stage,TCM syndrome types,operation method and treatment factors such as statistical analysis,understand the TCM syndrome type of gastric adenocarcinoma in the distribution characteristics of the relevant background,analysis of relevant factors and the prognosis of gastric adenocarcinoma.Methods: 107 cases of gastric adenocarcinoma treated by traditional Chinese medicine in our hospital from December 2012 to January 2017 were collected for retrospective study.Collectrelated information(gender,age,age,smoking history,drinking history,past medical history,symptoms start,high risk,the degree of differentiation,clinical stage,TCM syndrome types,operation method,treatment),using statistical methods to analyze the traditional Chinese medicine syndrome type in the history of age,sex,smoking,drinking,past medical history,symptoms start,the onset of disease,degree of differentiation,the distribution characteristics of each clinical stage;By the method of product limit,gender,age,age,smoking history,drinking history,past medical history,symptoms start,high risk,the degree of differentiation,clinical stage,TCM syndrome types,operation method and treatment prognosis of single factor analysis;COX regression model method is used for gender,age,smoking history,drinking history,past medical history,location,degree of differentiation,clinical stage,TCM syndrome types,radical prostatectomy and combination of Chinese and western treatment of multiple factors regression analysis risk.Results : 1.Background analysis: in the background analysis of 107 patients,the ratio of males to females was2.69:1.The number of females was 29,and the overall survival rate was 17.24%.There were 78 males with a survival rate of21.79%.The onset of the minimum age is 28 years old,the biggest onset age was 86 years old,the average age was 58.68 + /-58.68,the median onset age was 59 years old,and focus on the onset of aged 45-75 age group,accounting for more than 81.31%.Each group with a history of smoking and drinking had 15 cases.Always clear with chronic group a total of 55 cases(51.4%),hypertension,16 cases(15.0%),coronary heart disease(CHD)in 5 cases(4.67%),and hepatitis b and/or schistosomiasis liver 6 cases(5.60%),7 cases of gallbladder related diseases(6.54%),13 cases of gastritis or gastric ulcer(12.15%),there are at least two or more types of disease,8 cases(7.47%).Starting symptoms for medical examination found 12cases(11.20%),obstruction symptoms,10 cases(9.34%),abdominal distension 21 cases(19.62%),42 patients(39.25%),abdominal pain was thin 7 cases(6.54%),dark,bloody 9 cases(8.41%),vomiting,hematemesis,3 cases(2.80%)and perforation in 3 patients(2.80%).The pathogenic sites were found in 18 cases(16.82%)of cardiac and gastric fundus,14cases(13.08%)of gastric body,64 cases(59.81%)of gastric pylorus and 11 cases(10.28%)of residual stomach.Analysis of differentiation degree showed that there were 2 cases with high differentiation(1.9%),30 cases with medium differentiation(28.3%),58 cases with low differentiation(54.7%)and 17 cases without differentiation(15.0%).The staging analysis included5 cases in phase I(4.7%),16 cases in phase II(15.1%),53 cases in phase III(50.0%)and 33 cases in phase IV(30.2%).There was a correlation between the previous history and the first symptom,the previous history and the onset site,and the onset site(P < 0.05).Previous history,differentiation degree and clinical stage;The location of the disease was correlated with differentiation degree and clinical stage(P < 0.05).2,analysis of TCM syndrome types: distribution of TCM syndrome types: diseases make stomach syndrome(4 cases of death),6 cases of gastric heat injury Yin 6 cases(3 cases ofdeath),spleen and stomach weak the 26 cases(20 cases)death,phlegmy wet condenses the 33 cases(28 deaths),spleen and stomach deficiency cold syndrome in 11 cases(9 deaths),qi deficiency syndrome of 25 cases(21 deaths).According to the survival status,gender,age group,previous history,first symptom,location,differentiation degree and clinical stage,TCM syndrome types were statistically analyzed.The mortality rates of spleen and stomach weakness,phlegm and blood deficiency syndrome were in the top 3.The overall survival rate of all syndromes was not high,especially the syndrome of stomach,spleen and stomach deficiency and cold,and the syndrome of stomach heat injury.Both men and women are more common with phlegm dampness coagulation syndrome,spleen and stomach weakness syndrome and qi and blood deficiency syndrome,and phlegm dampness coagulation syndrome is the first.The young group(under 35 years old)was distributed in spleen and stomach weakness syndrome,phlegm dampness coagulation syndrome,spleen and stomach deficiency cold syndrome and qi and blood deficiency syndrome.The age groups of 45 ~ 55 and 65 ~ 75 were distributed in all types of syndromes,mainly including spleen and stomach weakness syndrome,phlegm wet coagulation syndrome and qi and blood deficiency syndrome.55 ~ 65 age group are mainly distributed in the spleen and stomach weak syndrome and phlegm wet condenses the set of the two kind of this syndrome,age group(75 and older)mainly distributed in the spleen and stomach weak syndrome,phlegm wet condensation and deficiency of qi and blood,three groups.The components of hypertension were distributed in two groups: spleen and stomach weaknesssyndrome and qi and blood deficiency syndrome.The components of coronary heart disease were distributed in spleen and stomach weakness syndrome and qi and blood deficiency syndrome.Hepatitis b and/or schistosomiasis groups were distributed in all syndrome groups.In the cholecystose-related disease group,except for the Yin syndrome group of gastric heat injury,all the other syndromes were found.Gastritis and/or gastric ulcer groups were distributed except the spleen and stomach deficiency syndrome group,mainly in the spleen and stomach weakness syndrome and the qi and blood deficiency syndrome group.The proportion of the first symptoms was in sequence: liver qi and stomach syndrome group: obstruction,abdominal pain > abdominal distension,no symptoms;Gastric heat wound Yin syndrome group: abdominal pain>asymptomatic>abdominal distension;Spleen and stomach weakness syndrome group: abdominal pain > abdominal distension > wasting >without symptoms,black stool,hematochezia,perforated >obstruction;Phlegm wet coagulation syndrome group: abdominal pain > abdominal distension > obstruction > wasting,asymptomatic>black stool,hematochezia;Spleen and stomach deficiency cold syndrome group: abdominal pain > without symptoms>vomiting,hematemesis,perforation;Deficiency of qi and blood deficiency syndrome group: abdominal pain>black stool,convenient blood>abdominal distension>obstruction>without symptoms,vomiting,hematemesis>emaciated.Except for the syndrome group of stomach heat injury Yin syndrome,the main pathogenesis of gastric pylorus is stomach pylorus.In each syndrome type,the occurrence rate of the pathogenic sites wasin sequence: hepatogastric syndrome group: gastric pylorus>,cardiac,gastric fundus,and residual stomach;Gastric heat wound Yin syndrome group: > gastric pylorus > residual stomach;Spleen and stomach weakness syndrome group: gastric pylorus>residual stomach>cardiac body,gastric fundus>body;Phlegm-dampness coagulation syndrome group: gastric pylorus>,cardiac and gastric fundus>.Spleen and stomach deficiency cold syndrome group: gastric pylorus>gastric body> cardiac and gastric fundus;Deficiency of qi and blood deficiency syndrome group: gastric pylorus>residual stomach>cardiac body,gastric fundus>body.In each syndrome type,the cell differentiation degree appears in the sequence of:liver qi and stomach syndrome group: low differentiation>in differentiation,not differentiation;Gastric heat wound Yin syndrome group: moderate differentiation > low differentiation;Spleen and stomach weakness syndrome group:low differentiation > middle differentiation,no differentiation;Phlegm wet coagulation syndrome group: >undifferentiated > was highly differentiated in low differentiation >.Spleen and stomach deficiency syndrome group: > did not differentiate in low differentiation>;Deficiency syndrome group:>undifferentiated>was highly differentiated in poorly differentiated>.Each card type ratio in order: clinical staging in diseases with make stomach syndrome group: ? period>? period;Thermal injury stomach Yin syndrome group: ?,? percentage;Weak spleen and stomach syndrome group: ? period>? period>? period;Phlegmy wet condensation syndrome group: ? period>? period>? period>? period;Spleen deficiency cold syndrome group: ? period>? period>?,? period;Qi deficiency syndrome group: ?period>? period>? period.3.Survival analysis: the 1-year survival rate of 107 patients was 50.47%,3-year survival rate was 28.97%,and5-year survival rate was 23.36%.The mean survival time was35.70 + 4.40 months,and the median survival time was 21 months.With the passage of time,the survival rate of patients gradually declined.Using the product of the limit method,to gender,age,age,smoking history,drinking history,past medical history(high blood pressure,coronary heart disease,hepatitis b and/or schistosomiasis liver and/or gastric ulcer,gastritis,gallbladder related diseases),first symptoms,high risk,the degree of differentiation,clinical stage and TCM syndrome type and the single factor analysis of life.It was concluded that gender,age,smoking and drinking history,location,differentiation degree,clinical stage,radical surgery and combination of Chinese and western treatment were the prognostic factors of gastric adenocarcinoma.COX regression model analysis,the history of sex,age,smoking history,drinking history,history of hypertension,coronary heart disease,liver disease,stomach disease history,location,degree of differentiation,clinical stage,each type of syndrome,and there are no conduct combined treatment of Chinese and western have no conduct radical into the covariate multi-factor survival analysis.Finally concluded that the history of drinking,degree of differentiation,clinical stage,the risk factors of death in patients with TCM syndrome typeis,the patients with a history of alcohol has more risk of death,the doctor of traditional Chinese medicine syndrome type of spleen and stomach weak and deficiency of qi and blood,the risk of death.Conclusion: 1.The age of gastric cancer is between 45 and75 years old.The proportion of patients with hypertension and stomach disease was the highest.The first symptom is usually abdominal pain,followed by abdominal distension.The most common tumor site is the gastric pylorus.The degree of differentiation is usually low,followed by middle,and high.The clinical stage was ? period and ? period.Previous history was correlated with differentiation degree,clinical stage,location,differentiation degree and clinical stage.2.Syndrome type analysis of Chinese medicine: syndrome type analysis of Chinese medicine: syndrome type distribution of Chinese medicine is characterized by spleen and stomach weakness,phlegm-dampness coagulation and deficiency of qi and blood.Both men and women are more common with phlegm dampness coagulation syndrome,spleen and stomach weakness syndrome and qi and blood deficiency syndrome,and phlegm dampness coagulation syndrome is the first.The age span of spleen and stomach weakness syndrome and phlegm-dampness coagulation syndrome is large,and the proportion of all age groups is high.Abdominal pain and abdominal distension are the first symptoms of various syndromes.In all types of syndromes,except the syndrome of stomach heat wound Yin is more common in the body of stomach,the other types of syndromes are mostly caused by pylorus in the stomach.The main syndromes of gastric heatwound Yin were middle differentiation,while the other syndromes were low differentiation.Thermal injury stomach Yin syndrome with ? stage gastric cancer,the spleen and stomach deficiency cold syndrome was ? stage gastric cancer,more than the type to ? stage gastric cancer.Hypertensive disease is distributed in the syndrome of spleen and stomach weakness and deficiency of qi and blood.Coronary heart disease is distributed in spleen and stomach weakness syndrome and qi and blood deficiency syndrome.Hepatitis b and/or schistosomiasis are distributed in each syndrome group.Cholecystosis-related diseases can be found in all types except Yin syndrome caused by gastric fever.Gastritis and/or gastric ulcer disease are distributed except spleen and stomach deficiency and cold syndrome.3.Survival analysis: 1-year survival rate was 50.47%,3-year survival rate was 28.97%,and 5-year survival rate was23.36%.The mean survival time was 35.70 + /-4.40 months,and the median survival time was 21.00 months.Over time,the survival rate declined.Gender,age,smoking history,drinking history,onset site,differentiation degree,clinical stage,TCM syndrome type,radical surgery and combination of Chinese and western therapy are the prognostic factors of gastric cancer.Among them,patients with a history of drinking are more at risk of death,while those with TCM syndrome of spleen and stomach weakness and deficiency of qi and blood are more at risk of death. |
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