Study On Evolution Of TCM Syndromes In Per Ioperative Period Of Lung Adenocarcinoma Based On EGFR Gene Status

ObjectiveThis topic studies the evolution of TCM syndromes in different EGFR gene states during perioperative period of lung adenocarcinoma,provides TCM differentiation basis for the treatment of lung adenocarcinoma during perioperative period,and provides TCM theoretical basis for the treatment of lung adenocarcinoma with integrated traditional Chinese and Western medicine and its standardized diagnosis and treatment system.MethodsA retrospective clinical case study method was used to design the technical route of the subject study and select cases strictly according to the inclusion and exclusion criteria.The general information of patients' gender,age,symptoms and signs,tongue coating,pulse,tumor markers,pathological types,TNM stages and other clinical data were recorded in detail in the established case information collection table,and patients were collected.On the first day,the first day,the third day and the seventh day after the operation,the data of four TCM diagnoses were analyzed according to the relevant diagnostic and syndrome differentiation criteria.ResultsThis study included 106 patients with lung adenocarcinoma with different EGFR gene status.The patients were compared and analyzed on the first day before operation,the first day after operation,the third day after operation and the seventh day after operation to explore the changes of TCM syndromes.1.Spleen deficiency and phlegm-dampness were the main types of preoperative syndromes,with 36 cases(33.96%).2.The type of phlegm-heat obstruction in lung increased significantly after operation.On the first day after operation,the syndrome of phlegm-heat obstruction in lung was predominant.Compared with the results on the third and seventh days after operation,the type of phlegm-heat obstruction in lung on the seventh day after operation was significantly reduced,mainly due to deficiency of both Qi and Yin.The type of phlegm-heat obstruction in lung began to increase gradually in patients with adenocarcinoma 3.The main syndromes of mutant group on the first day before operation,the first day after operation,the third day and the seventh day after operation were qi stagnation and blood stasis type,phlegm-heat obstruction of lung type,qi stagnation and blood stasis type,qi stagnation and blood stasis type;the main syndromes of wild group on the first day before operation,the first day,the third day and the seventh day after operation were spleen deficiency and phlegm-dampness type,spleen deficiency and phlegm-dampness type,Qi-Yin Deficiency After statistical analysis at the same time point,the difference of syndromes between mutation group and wild group has statistical significance,so the syndrome of qi stagnation and blood stasis,phlegm-heat obstructing lung type is the main type of mutation perioperative period,while the deficiency syndrome of spleen deficiency and phlegm dampness,deficiency of both qi and Yin type or deficiency and excess syndrome are the main type of wild perioperative period.4.In the perioperative period,the deficiency of both qi and Yin accounted for 18.97%on the first day before operation,25.86%on the first day after operation,29.31%on the third day after operation and 37.93%on the seventh day after operation in the wild group.The deficiency of both qi and Yin showed an increasing trend in the perioperative period,and occupied the main position of each syndrome on the third and seventh day after operation.Therefore,the main symptoms of wild-type lung adenocarcinoma patients during perioperative period are deficiency of both qi and yin.5.In the perioperative period of 48 mutant group,qi stagnation and blood stasis were predominant one day before operation(31.25%),phlegm-heat obstruction of the lung and qi stagnation and blood stasis were predominant one day after operation(43.75%,29.17%)and qi stagnation and blood stasis were predominant three and seven days after operation(39.58%,45.83%).This indicated that the main syndrome of EGFR mutant patients during perioperative period was qi stagnation and blood stasisConclusion1.The syndrome of phlegm-heat obstruction in lung cancer patients increased significantly in a short period of time after operation,and decreased significantly one week after operation.Qi stagnation and blood stasis and deficiency of both Qi and Yin were the main types in one week after operation.Surgery had certain influence on the distribution of syndrome of lung cancer.2.Different types of EGFR have some relationship with the evolution of perioperative syndromes of adenocarcinoma.The main syndromes of EGFR mutant type are syndrome of excess,while those of wild type are syndrome of deficiency and impurity of deficiency and excess.Therefore,for mutant adenocarcinoma patients,perioperative treatment should be based on eliminating pathogens,while for wild adenocarcinoma patients,perioperative treatment should be based on strengthening the body.3.The perioperative syndromes of mutant adenocarcinoma patients were mainly qi stagnation and blood stasis,while those of wild type patients were mainly Qi-Yin deficiency.