Study On The Difference Of TCM Syndrome Types And Clinical Characteristics Between Type Ⅰ And Type Ⅱ Endometrial Cancer

[Objective]To Compare type Ⅰ and type Ⅱ endometrial cancer differences in clinical characteristics and TCM syndrome type distribution,discusses the influencing factors of EC TCM syndrome type distribution,in order to provide theoretical basis for for the dialectical prevention and treatment of EC with traditional Chinese medicine.[Methods]The inpatient data of 97 patients pathologically diagnosed with EC in the department of gynecology of Dongzhimen hospital and Dongfang hospital of Beijing university of traditional Chinese medicine from May 2005 to May 2019 were collected.According to the clinicopathological results,they were divided into two groups:type Ⅰ EC group and type Ⅱ EC group.The clinical data of 2 groups of patients were retrospectively analyzed to summarize and compare the differences between type Ⅰ EC and type Ⅱ EC patients in age,ethnicity,marital status,pregnancy or menstrual history,previous related diseases,clinical symptoms,endometrial thickness,body mass index,distribution of TCM syndrome type,and the influencing factors of the differences in TCM syndromes were analyzed.[Results]1.General conditions:The average age of type Ⅰ and type Ⅱ EC patients were 52.87± 11.83 years old,56.67±9.90 years old,the average age of menarche were 13.78±1.74 years old,14.10±1.85 years old,and the average age of menopausal patients were 46.24±14.84 years old,and 50.76±4.32 years old.There were no statistically significant difference between the average age,average age of menarche and average age of menopausal of two type patients(P>0.05).The mean ET of typeⅠ and type Ⅱ EC patients were 15.12±7.15mm and 11.17±5.64mm,and the difference between mean ET of two types was statistically significant(P<0.05).The type I and type II EC patients in of Child-bearing period were 44 cases(65.67%)and 28 cases(93.33%),and there was statistically significant difference in the number of of Child-bearing period between two groups(P<0.05).The menopausal of type Ⅰand type Ⅱ EC patients were 42(62.69%)and 25(83.33%),and the difference was statistically significant between two groups(P<0.05).The overweight and obesity patients of type Ⅰ and type Ⅱ EC were 60 cases(89.55%)and 13 case(43.33%),and there was statistical difference(P<0.05).The major clinical manifestations of Type Ⅰ and type Ⅱ EC patients was abnormal vaginal bleeding,and their age of onset was mainly from 51 to 60 years old,and their age of menarche was mainly at 13 years old.Most of the patients had delayed menopause,and the number of pregnancies was 0-1,and uterine cavity operation.The proportion of endometrial hyperplasia,uterine fibroids,dyslipidemia,hypertension,diabetes and so on in type Ⅰ and type Ⅱ endometrial cancer patients were higher.There was no significant difference between the two types(P>0.05).2.TCM syndrome type:The TCM syndrome of Type I EC were followed by:Deficiency of spleen-kidney yang(35 cases)(52.24%),Deficiency of liver-kidney yin(13 cases)(19.40%),Dampness-heat and stasis-toxin(13 cases)(19.40%),and Phlegm-dampness stagnation(6 cases)(8.96%).The TCM syndrome of TypeⅡ EC were followed by:Deficiency of liver-kidney yin(15 cases)(50.00%),Dampness-heat and stasis-toxin(9 cases)(30.00%),Deficiency of spleen-kidney yang(5 cases)(16.67%),and Phlegm-dampness stagnation(1 case)(3.33%).There was a statistically significant difference in the distribution of TCM syndromes between type I and type II EC(P<0.05).3.Syndrome type influencing factors:age,body mass index and EC syndrome type distribution were correlated(P<0.05).In the group of 51～60 years old,the Deficiency of liver-kidney yin was the main one,while in other age groups,the Deficiency of spleen-kidney yang was the main one.In the normal weight group,the main TCM syndromes were Deficiency of liver-kidney yin,while in the overweight and obesity groups,the main TCM syndromes were Deficiency of spleen-kidney yang.Combined with hypertension,diabetes mellitus,uterine cavity operation,number of pregnancy,childbirth and EC TCM syndrome distribution were independent from each other(P>0.05).[Conclusion]1.The distribution of TCM syndrome type of type Ⅰ and type Ⅱ EC is different.Type Ⅰ EC is dominated by the Deficiency of spleen-kidney yang,while type Ⅱ EC is dominated by the Deficiency of liver-kidney yin,indicating that kidney deficiency may be the main factor of EC.2.There is a difference in the average ET of type Ⅰ and Ⅱ EC,and the average ET of type Ⅰ EC is larger than that of type Ⅱ.In clinic,patients diagnosed with EC can be identified as type Ⅰ and type Ⅱ EC by ultrasound detection of ET.3.The distribution of EC syndrome types in different BMI and age is different.In the overweight and obesity groups,the TCM syndrome types were mainly the Deficiency of spleen-kidney yang.The proportion of overweight and obesity in type ⅠEC was high,indicating that active control of BMI in overweight and obese patients could reduce the risk of EC(especially type Ⅰ EC).51～60 years old is the peak period of EC,during which the main TCM syndromes are Deficiency of liver-kidney yin.Clinical attention should be paid to the pathogenesis of Deficiency of liver-kidney yin in the treatment of EC patients aged 51～60 years.