| Purpose:The aim of this study is to explore the characteristics of TCM syndromes in patients with malignant tumors complicated with jaundice on the basis of the eight principles of syndrome differentiation,and provide the reference for clinical TCM syndrome differentiation and treatment.Material and method:The clinical data were collected from patients with malignant tumors who presented jaundice hospitalized in the Oncology Department of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from March 2017 to July2018.A retrospective study was conducted with 64 selected patients who met the inclusion and exclusion criteria.The database was established by Excel software,which includes gender,age,location of the lesion,previous history of the treatment of Western medicine,symptoms and signs,and liver function.And the data were input into SPSS 22.0 statistical software.The numbers and frequency of patients were counted by descriptive analysis.According to the diagnostic criteria of syndrome differentiation of the Eight Principles,the symptoms and signs of patients were performed by single syndrome analysis,and the characteristics of complex syndrome of malignant tumors with jaundice were summarized and analyzed with a combination of the single syndrome.Differences in liver function indicators among the single syndromes were further analyzed.Results:1.A total of 64 cases were observed,including 40 males(62.50%)and 24 females(37.50%).The ratio of males to females was about 1.67:1.The median age was 64 years,and the average age was 65.83(+8.63).There were 11 cases of hepatocellular jaundice,34 cases of obstructive jaundice and 19 cases of hepatocellular jaundice with obstructive jaundice.2.Previously,20(31.25%)in 64 patients with malignant tumors and jaundice had not received systemic western medicine treatment,and 44(68.75%)had received western medicine treatment.Among them,24 cases received chemotherapy(54.55%),21 casesreceived surgical operation(47.73%),9 cases received radiotherapy(20.45%),9 cases received targeted therapy(20.45%),7 cases received biliary drainage or biliary stent(15.91%),3 cases received endocrine therapy(6.82%),3 cases received radiofrequency ablation(6.82%)and 2 cases received biotherapy(4.55%).3.The common TCM symptoms in frequency of malignant tumor patients with jaundice are poor appetite,fatigue and lassitude,yellow urine,abdominal pain,insomnia,abdominal distention,short urine,nausea,vomiting,and pain in the ribs;the common signs in frequency are yellowish stain,abdominal bulging,swelling of the limbs,red tongue,dark red tongue,thin body,thin yellow tongue coating,white and greasy tongue coating,etc.4.64 cases of malignant tumors complicated with jaundice were analyzed by the eight principles syndrome differentiation of traditional Chinese medicine.Single syndrome: 0 cases(0.00%)of exterior syndrome,64 cases(100.00%)of interior syndromes,14 cases(21.89%)of cold syndrome,11 cases(17.19%)of heat syndrome,39 cases(60.94%)of no obvious cold-heat syndrome,and 0 cases(0.00%)of cold-heat syndrome,31 cases(48.45%)of deficiency syndrome,8 cases(12.50%)of excess syndrome,and 25 cases(39.06%)of both deficiency and excess syndrome.Compound syndromes: 25 cases(39.06%)were mixed syndromes of deficiency and excess,and there were 14 cases of deficiency-cold syndrome(21.89%),9 cases of deficiency-interior syndrome(14.06%),8 cases of deficiency-heat syndrome(12.50%),5 cases of deficiency-interior syndrome(7.81%)and 3 cases of excess-heat syndrome(4.69%).5.There was a significant difference in ALP between cold and heat syndromes(P < 0.05).There was no significant difference in TBIL,DBIL,IBIL,TBA,GGT,ALT and AST between cold and heat syndromes(P > 0.05).There was a significant difference in ALP among heat syndrome,cold syndrome and no obvious cold-heat syndrome(P < 0.05),but there was no significant difference between cold syndrome and no obvious cold-heat syndrome(P > 0.05).There was no significant difference in liver function between deficiency and excess syndrome(P > 0.05).Conclusion:1.Cold,heat,deficiency and excess are the main principles of differentiation of symptoms and signs of malignant tumors with jaundice.2.TCM syndromes of malignant tumor patients with jaundice generally tend to be deficiency syndrome,and the pathogenesis is characterized by the mixture of deficiency and excess.In clinical treatment,both strengthening the body and eliminating pathogenic factors should be taken into account.According to the cold and heat attributes of the disease,treatment methods such as warming yang and clearing away heat should be applied.3.Alkaline phosphatase is correlated with heat syndrome. |
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