| Objectives To explore the correlation between TCM constitution,syndrome differentiation and prognostic factors as well as serum lung system tumor markers in lung cancer patients,so as to provide new ideas and objective theoretical basis for TCM individualized treatment of lung cancer patients.Methods A total of 135 patients with lung cancer were selected who were hospitalized from October 2018 to October 2019 in the Department of Traditional Chinese Medicine Oncology,Tangshan People's Hospital(Cancer Hospital)affiliated to North China University of Science and Technology.The questionnaire of Constitution,Syndrome type and Related Factors of Lung cancer patients was used to conduct one-by-one questionnaire survey and collect clinical data.Prognostic factors such as general condition of lung cancer patients,TCM constitution,syndrome differentiation,TNM staging,pathological type,KPS score and smoking index were investigated.As well as detected the serum lung system tumor markers,such as Carcino-embryonic Antigen(CEA),Neuron Specific Endase(NSE),Incineration 19 Fragment(CYFRA21-1),Squamous Cell Carcinoma Antigen(SCC)and Progastin-releasing Peptide(Pro-GRP).SPSS 22.0 statistical software was used for data analysis,and P < 0.05 was considered statistically significant.Results 1.Among the 135 patients with lung cancer,92 were male(68.15%)and 43 were female(31.85%).Patients aged between 60 and 70 years old accounted for 48.89%.The number of patients with smoking index < 400 was higher,accounting for 64.44%.Patients with no significant weight loss were more,accounting for 64.44%.Patients with no family history of lung cancer were more,accounting for 83.70%.The number of patients with KPS score higher than 80 was 73.33%.The pathological type was NSCLC,accounting for 80.00%.TNM stage ? patients more,accounting for 54.81%.2.The TCM constitution distribution of 135 lung cancer patients was as following: Yin deficiency quality 32 cases(23.70%),Yang deficiency quality 21 cases(15.56%),Qi deficiency quality 19 cases(14.07%),Qi stagnation quality 15 cases(11.11%),phlegm-dampness quality 15 cases(11.11%),damp and hot quality 11 cases(8.15%),mild quality 11 cases(8.15%),blood stasis quality 9 cases(6.67%)and special quality 2 cases(1.48%).Distribution of TCM syndromes was as following: 47 cases(34.81%)with deficiency of qi and Yin,33 cases(24.44%)with deficiency of Yin and heat,29 cases(21.48%)with stagnation of qi and blood,26 cases(19.26%)with deficiency of qi and phlegm-dampness.3.Distribution of TCM syndrome in lung cancer patients with different physical types have significant differences(P < 0.001).Lung cancer patients with Yang deficiency and Qi deficiency mainly have qi and Yin deficiency syndrome.Patients with yindeficiency lung cancer were mainly characterized by deficiency of qi and Yin and deficiency of heat and toxicity,patients with phlegm-dampness were mainly characterized by deficiency of qi and phlegm-dampness,while patients with dampness-heat quality were mainly characterized by Yin deficiency and heat toxicity,while patients with blood stasis and qi stagnation were mainly characterized by qi and blood stasis.There were significant differences in the distribution of syndrome types between patients with mild and biased constitution lung cancer(P < 0.05).4.Rank sum test was used to analyze the expression levels of tumor markers in patients with different constitutions.CEA and CYFRA21-1 contents were different in patients with lung cancer with nine constitutions.CEA contents ranged from high to low were blood stasis,Yin deficiency,qi stagnation,qi stagnation,Yang deficiency,Yang deficiency,qi deficiency,phlegm-dampness and phlegm-dampness.From high to low,the content of CYFRA21-1 is in descending order: special intrinsic quality,Yang deficiency quality,qi deficiency quality,Yin deficiency quality,blood stasis quality,damp-heat quality,phlegm-dampness quality,mild quality and gas stagnation quality.CEA and CYFRA21-1 levels in patients with biased constitution lung cancer were significantly higher than those in patients with moderate constitution lung cancer(P < 0.05).While there is no difference in the expression levels of NSE,SCC and Pro-GRP between patients with mild and biased constitution lung cancer(P > 0.05).NSE levels in patients with concurrent lung cancer were significantly higher than those in patients with single lung cancer(P < 0.05).There is no difference in the expression of CEA CYFRA21-1 SCC and Pro-GRP levels in patients with mild and biased tumor-lung cancer(P > 0.05).5.The distribution of nine TCM constitutions in terms of gender,family history and TNM stage was statistically different(P < 0.05).The majority of male patients were Yin deficiency(32.61%),and the majority of female patients were qi deficiency(23.26%).Patients with family history were mainly hot and humid(22.73%).lung cancer patients in period ? and period ? were priority to phlegm wet mass,lung cancer patient in period ?were given priority to Yang deficiency quality,and lung cancer patient in period ?were given priority to Yin deficiency quality.There was no difference in the distribution of the factors affecting the prognosis of lung cancer.While the distribution of single constitution and facultative constitution at different TNM stages was statistically different.Among them,lung cancer patients in period ?,?,?,and ? were all given priority to single quality,however,the composition ratio of single quality in lung cancer patient in period ?and ? were greater than lung cancer patient in period ? and ?,the composition ratio of facultative constitution in lung cancer patient in period ? and ? were greater than lung cancer patient in period ? and ?.6.Rank sum test was used to analyze the expression levels of tumor markers in patients with different syndromes.Among them,CEA content in lung cancer patients with four syndromes ranged from the highest to the lowest,which were Qi and blood stasis syndrome,Yin deficiency,heat toxicity syndrome,qi deficiency and Yin deficiency syndrome,phlegm-dampness syndrome.NSE content in lung cancer patients with four syndromes ranged from the highest to the lowest,which were Qi and Yin deficiency syndrome,qi and blood stasis syndrome,Yin deficiency heat poison syndrome,qi deficiency phlegm dampness syndrome.There are no statistical differences in the contents of cyfra21-1,SCCA and Pro GRP in the four types of lung cancer patients(P > 0.05).7.The distribution of TCM syndromes in TNM stage and weight loss was significantly different(P < 0.05).Patients with no physical decline were mainly characterized by deficiency of qi and Yin,while patients with weight loss were mainly characterized by deficiency of Yin and heat toxicity.lung cancer patients in period ? and? are given priority to with deficiency of phlegm dampness syndromes,lung cancer patients in period ? are given priority to with qi and Yin deficiency syndrome and Yin deficiency toxic heat syndrome,lung cancer patients in period ? are given priority to with qi and Yin deficiency syndrome.8.The syndrome of qi and blood stasis was positively correlated with KPS score,and negatively correlated with smoking index and TNM stage.In other words,compared with the syndrome of qi and Yin deficiency,patients with high KPS score,advanced TNM stage and non-smoking patients were more likely to have qi and blood stasis syndrome.Qi deficiency and phlegm-dampness syndrome were positively correlated with smoking index and negatively correlated with TNM stage.That is to say,compared with the syndrome of qi deficiency and Yin deficiency,patients with late TNM stage and smoking were more likely to have qi deficiency and phlegm-dampness syndrome.The syndrome of Yin deficiency and heat toxicity was positively correlated with KPS score,and negatively correlated with weight loss and TNM stage,namely,the syndrome of qi and Yin deficiency.Patients with high KPS score,advanced TNM stage and no weight loss were more likely to have the syndrome of Yin deficiency and heat toxicity.Conclusions 1.The TCM constitutions of lung cancer patients were mainly composed of Yang deficiency,Yin deficiency and qi deficiency,while the distribution of TCM syndromes is mainly characterized by the deficiency of qi and Yin and the deficiency of Yin and the toxicity of heat.The distribution of TCM syndromes in patients with different constitutions of lung cancer was significantly different.2.The expression of tumor markers is different among different TCM constitutions and syndromes of lung cancer patients.The detection of tumor markers may provide reference for the diagnosis and dialectics of lung cancer in TCM.3.Among the prognostic factors of lung cancer,gender,smoking index,family history of lung cancer,weight loss,KPS score,especially TNM stage are closely related to TCM constitution and TCM syndrome type.It is suggested that TCM constitution,syndrome type,TNM stage and other factors should be taken into comprehensive consideration in the treatment and prognosis of lung cancer,so as to make full use of TCM advantages to correct biased constitution and adopt the overall diagnosis and treatment mode of "body differentiation-disease differentiation-syndrome differentiation",which is of great significance for improving the clinical efficacy and improving the quality of life and prognosis of malignant tumor patients.Figure 0;Table 18;Reference 108... |
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