| Objective:To study the characteristics of tongue image,pulse image and TCM constitution and syndrome types of patients with advanced non-small cell lung cancer,to extract the common characteristics of syndrome types of such patients,and to explore the correlation between blood stasis syndrome and various factors,,and to provide basis for guiding clinical diagnosis and treatment.Methods:This study collected the patients with advanced non-small cell lung cancer treated in the oncology outpatient department and ward of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from February 2019 to January 2020.The comprehensive diagnosis system of traditional Chinese medicine was used to make objective diagnosis of tongue and pulse,and the diagnosis of constitution was carried out with the help of this system.Used the method of identified single syndrome type first and the combination of single syndrome type to form complex syndrome type to diagnosed the syndrome type.The syndrome types of advanced non-small cell lung cancer patients were divided into seven types:Qi deficiency syndrome,blood deficiency syndrome,Yin deficiency syndrome,Yang deficiency syndrome,phlegm syndrome,blood stasis syndrome,Qi stagnation syndrome,and then according to the different disease positions involved in the deficiency,the deficiency syndrome was divided into heart Qi deficiency syndrome,lung Qi deficiency syndrome,spleen Qi deficiency syndrome,kidney Qi deficiency syndrome,heart blood deficiency syndrome,liver blood deficiency syndrome,heart Yin deficiency syndrome,lung Yin deficiency syndrome,liver Yin deficiency syndrome Kidney Yin deficiency syndrome,heart Yang deficiency syndrome,spleen Yang deficiency syndrome,kidney Yang deficiency syndrome,according to the different disease character,phlegm syndrome was divided into phlegm heat syndrome and phlegm dampness syndrome.Collected the diagnosis results of patients' tongue and pulse,TCM constitution and syndrome type,and the information of patients' sex,age,pathological type,TNM stage,filled in the information collection form,and established a database.Analyzed the distribution of syndrome type,tongue image,pulse image and TCM constitution of patients with advanced non-small cell lung cancer,and to study the characteristics of syndrome type.On this basis,studied the correlation betweenblood stasis syndrome and age,pathological type,TNM stage,syndrome type,TCM constitution,tongue image,pulse image and other factors.Results:(1)In this study,140 patients with advanced non-small cell lung cancer were included.The constitution of patients was mainly Qi deficiency(accounting for 40.0%),Yin deficiency and Yang deficiency(accounting for 20.0% and 12.9%).(2)Light purple tongue and dark red tongue were the most common tongue color(accounting for 31.4% and 24.3%),fat tongue was the most common tongue shape(accounting for 47.1%),47.1% patients had cracks,31.4%patients had teeth marks,all patients had normal tongue state,white was the most common tongue coating color(accounting for 65.7%),Thick and thin were the main quality of coated tongue(accounting for 51.4% and 46.4%),32.9% patients had greasy fur,4.3% patients had peeling fur.The patient's pulse was mainly rapid pulse and thready pulse(accounting for37.1% and 20.7%).(3)The distribution of patients' single syndrome type was mainly deficiency syndrome,in which Qi deficiency syndrome and Yin deficiency syndrome were the main deficiency syndromes,accounting for 78.6% and 41.4% of the total cases,and the syndrome of phlegm and blood stasis were the main excessive syndromes,accounting for54.3% and 40.0% of the total cases,Among them,Qi deficiency syndrome mostly included lung Qi deficiency syndrome,spleen Qi deficiency syndrome,heart Qi deficiency syndrome,accounting for 35.7%,35.9% and 32.9% of the total cases,Yin deficiency syndrome mostly included lung Yin deficiency syndrome,accounting for 23.6% of the total cases,phlegm heat syndrome was more,phlegm dampness syndrome was less,accounting for28.6% and 25.7% of the total cases.(4)The clinical syndrome types of the patients was mainly complex syndrome type(accounting for 98.6% of the total cases).Especially the combination of two syndromes and three syndromes was more(accounting for 78.6% in total),while the combination of four syndromes and five syndromes was less.The syndrome types of the patients were often the combination of deficiency and excess(accounting for 82.1% of the total).The syndrome types were complex and diverse.The combination of Qi deficiency +phlegm,Qi deficiency + Yin deficiency,Qi deficiency + blood stasis were more common in the two syndrome types(accounting for 25.0%,20.8% and 14.6% of the total cases).The combination of Qi deficiency + phlegm+blood stasis,Qi deficiency + phlegm + Qi stagnation were more common in the three syndrome types(accounting for 16.7% and 12.9% of the totalcases).The combination of four and five syndrome types was relatively scattered.The common combination of syndrome was Qi deficiency + phlegm syndrome,Qi deficiency +blood stasis,Qi deficiency + Yin deficiency,Qi deficiency + Qi stagnation,blood stasis +phlegm syndrome,Yin deficiency + phlegm syndrome,accounting for 40.0%,32.1%,29.3%,26.4%,19.3% and 15.7% of the total cases.(5)There was no significant difference in the distribution of syndrome types in different pathological types(P>0.05).In different TNM stages,except for Yin deficiency syndrome,there was no significant difference in the distribution of other syndrome types(P>0.05),however,Yin deficiency syndrome was more common in stage ? than in stage ?b-?c(P<0.05).(6)There were 56 patients with blood stasis syndrome in 140 patients(accounting for 40.0%).Blood stasis syndrome often appeared with Qi deficiency syndrome,phlegm syndrome,Qi stagnation syndrome,Yin deficiency syndrome were also often appeared together with blood stasis syndrome.Combined with the disease positions and disease character,the most common syndrome type that often appeared with blood stasis syndrome was lung qi deficiency syndrome.(7)Statistical analysis showed that there was a significant positive correlation between lung Qi deficiency and blood stasis(P<0.05),there was no significant correlation between blood stasis and age,pathological type,TNM stage,TCM constitution,tongue image,pulse image,other syndrome type,etc(P>0.05).Conclusion:(1)In patients with advanced non-small cell lung cancer,the syndrome types were mostly mixed with deficiency and excess.Deficiency,phlegm and blood stasis often interacted with each other.The disease location was mainly in the lung,often involved in the heart and spleen.(2)We can extract the most common syndrome type combination were Qi deficiency + phlegm syndrome,Qi deficiency + blood stasis,Qi deficiency + Yin deficiency.The complex and diverse syndrome types of patients were formed on this basis with other syndrome types,and Yin deficiency was more obvious in stage IV patients.The patient's constitution,tongue image and pulse image also reflected the overall situation that the patient was mainly characterized by deficiency and the combination of deficiency and excess.(3)Most of the patients with blood stasis syndrome were Qi deficiency and blood stasis,Qi stagnation and blood stasis,phlegm and blood stasis,Yin deficiency and blood stasis,especially Qi deficiency and blood stasis.There was a significant positive correlation betweenblood stasis syndrome and lung Qi deficiency syndrome.It was suggested that according to the characteristics of blood stasis syndrome,on the basis of the application of activating blood circulation and removing blood stasis drugs,it can be combined with invigorating Qi drugs,pay attention to the treatment of invigorating Qi and activating blood circulation,and pay special attention to the situation of blood stasis in the diagnosis of patients with lung Qi deficiency. |
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