| Purpose:Guided by the theory of Chinese and Western medicine,with the treatment of Dalian Traditional Chinese Medicine Hospital oncology ward,and malignant pleural effusion as the main diagnosis of patients as the research object,collected patients' information just entering the hospital,observed and analyzed the TCM syndrome types of MPE,and the relationship between different TCM syndrome types of KPS score,and the amount of MPE.Hope that it will provide evidence on the treatment based on syndrome differentiation of TCM for the future clinical diagnosis.Material and method:We selected patients with malignant pleural effusion selected according to the inclusion criteria of this topic in Dalian Traditional Chinese Medicine Hospital oncology ward from December 2015 to May 2017,sorted patient information,and entered the formation of a database,a total of 57 cases met the inclusion criteria.Using Excel software to describe counting data of frequency and composition ratio.Using SPSS(Statistic Package For Social Science)19.0 software to screen 57 patients for clinical symptoms,we finally chosed typical symptoms of TCM and tongue,pulse as a research variable,principal component analysis and K-means clustering analysis.The results of rank-sum test and one-way ANOVA were used to compare the pleural effusion and KPS scores of all the syndromes after clustering,P<0.05 was considered as statistically significant.Results: 1.After the frequency statistics of that higher frequency of symptoms are fatigued spirt and lack of strengh,coughing,poor sleep,expectoration,chest tightness and wheezing,dyspnea,loss of appetite,dry mouth;higher frequency of the tongue,pulse are sink and thin pulse,sink and weak pulse,white or thick coating,thin or little coating,light-colored tongue,dark tongue,red tongue.2.Patient's symptoms according to the principal component analysis combined with clinical practice can be summarized as four main components.The first component: fatigued spirt and lack of strengh,coughing;the secend component: expectoration,chest tightness and wheezing,dyspnea;The third component: poor sleep,loss of appetite,dry mouth;the forth component: shortness of breath,chest pain,fever.3.The results of cluster analysis of symptoms,tongue,and pulse are as follows: the first type of symptoms are dyspnea,pricking pain in the chest,coughing,shortness of breath,little sputum,fatigued spirt and lack of strengh,dry mouth,little coating,red tongue with petechiae,thin and weak pulse or rapid and stringed pulse,and contains the main components of one,two,three;the secend type of symptoms are coughing,expectorate white phlegm,chest tightness and wheezing,lack of strengh,loss of appetite,white or thick coating,light-colored tongue,sink and thin pulse or smooth and stringed pulse,and contains the main components of one,three;the third type of symptoms are chest tightness,fixed pain of chest,dyspnea,loss of appetite,dry stool,dark and purple tongue with petechia,white coating,stringed pulse,and contains the main components of two,three;the forth type of symptoms are coughing,chest pain,yellow and excessive phlegm,fever,yellow coating,red tongue,rapid and smooth pulse,and contains the main component of two,four.4.The results of cluster analysis of TCM syndrome types can be summari(1)zed as four types: deficiency of Qi and Yin with stasis toxin type;(2)deficiency of lung and spleen Qi with phlegmatic hygrosis type;(3)qi stagnation and blood stasis type;(4)pulmonary retention of phlegmopyrexia type.5.In patients with clinical observation,the amount of small pleural effusion are in 22 cases,the amount of medium pleural effusion are in 24 cases,the amount of large pleural effusion are in 11 cases.Under the statistical analysis of the amount of pleural effusion and TCM syndrome type in patients with malignant pleural effusion.,the patients with a small amount of pleural effusion are more with deficiency of lung and spleen Qi with phlegmatic hygrosis type,and the patients with the amount of medium pleural effusion are more with deficiency of Qi and Yin with stasis toxin type,and the patients with the amount of large pleural effusion are also more with deficiency of Qi and Yin with stasis toxin type.The rank sum test results showed that the rank average of patients with deficiency of Qi and Yin with stasis toxin type was the highest,and the rank average of pulmonary retention of phlegmopyrexia type was the lowest.P<0.05,and the difference was statistically significant.6.The rank sum test and one-way ANOVA were carried out for the KPS scores of each type of syndrome.Among the patients with functional status,the deficiency of Qi and Yin with stasis toxin type was the most,and the patients with poor functional status were deficiency of Qi and Yin with stasis toxin type and deficiency of lung and spleen Qi with phlegmatic hygrosis type.The variance analysis showed that the KPS score of patients withpulmonary retention of phlegmopyrexia type was the highest,but all of the two were P>0.05,and the difference was not statistically significant.Conclusion:1.Among the patients of malignant pleural effusionin in this research,fatigued spirt and lack of strengh,coughing,expectoration,chest tightness and wheezing,dyspnea are the main clinical symptoms.Poor sleep,loss of appetite,dry mouth,shortness of breath,chest pain,fever are also the common clinical symptoms.2.The TCM syndrome types of malignant pleural effusion included in this research can be divided into four syndromes: deficiency of Qi and Yin with stasis toxin type,deficiency of lung and spleen Qi with phlegmatic hygrosis type,qi stagnation and blood stasis type,pulmonary retention of phlegmopyrexia type.3.The patients with the amount of large pleural effusion in this research are more likely to be characterized by deficiency of Qi and Yin with stasis toxin type.4.The physical function status of the patients in this research is not related to the distribution of the syndrome type,and there is no significant correlation between the score of KPS and the syndrome type. |
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