Explore The Correlation Between TCM Syndrome Types And Peripheral Blood Lymphocyte Levels In Patients With Stage Ⅳ Colorectal Cancer And The Characteristics Of Beneficiaries Of TCM Treatment

In this study,we retrospectively analyzed the clinical data of patients with stage Ⅳ colorectal cancer,combined with the"guidelines for the diagnosis and treatment of common diseases in anorectal Department of traditional Chinese medicine"and our tutor’s experience,formulated the standard of TCM syndrome types,and analyzed the correlation between TCM Syndrome Types and lymphocyte subsets count level of patients with stage Ⅳ colorectal cancer,Objective to summarize the relationship between TCM Syndrome Types and survival time and the characteristics of the people who benefit more,and to further explore the correlation between TCM Syndrome Types and immune function level and survival prognosis of patients with stage Ⅳ colorectal cancer,so as to provide basis and reference for disease monitoring and prognosis judgment.1.Research purposeRelevant reports show that the mortality rate of colorectal cancer in China ranks the second in the world^[1],and the situation is grim.Traditional Chinese medicine treatment can effectively improve the immune function of patients and prolong the survival period.However,in clinical work,it is found that different stage Ⅳ colorectal cancer patients have different benefits from traditional Chinese medicine treatment,which may be related to different syndrome types and different immune function levels of patients.At present,there is a lack of research on the relationship between TCM Syndrome Types and immune function,as well as prognosis of patients with stage Ⅳ colorectal cancer.Therefore,this study aims to preliminarily explore the relationship between TCM Syndrome Types and immune function and prognosis of patients with stage Ⅳ colorectal cancer,and provide reference for further individualized and precise TCM treatment.2.Research methodsPart Ⅰ:Based on the inclusion criteria,this study retrospectively analyzed 119 patients with stage Ⅳ colorectal cancer in the oncology ward of the First Affiliated Hospital of Tianjin University of traditional Chinese medicine from January 2019 to January 2021.The basic population information,TCM syndrome data,absolute and relative counts of lymphocyte subsets were collected,and the database was established.SPSS 24.0 software was used for statistical analysis,and logistic regression analysis was used to preliminarily explore the correlation between lymphocyte subsets count and TCM Syndrome Types in patients with stage Ⅳ colorectal cancer.Part Ⅱ:Based on the inclusion criteria,this study retrospectively analyzed 224 patients with stage Ⅳ colorectal cancer who died in the oncology ward of the First Affiliated Hospital of Tianjin University of traditional Chinese medicine from January 2013 to January 2021 by consulting the medical record system and telephone follow-up.According to the survival time,the patients were divided into two groups:the control group and the observation group.The basic information of patients and the treatment time of traditional Chinese medicine were collected.SPSS 24.0 statistical software was used for analysis,Kaplan Meier and log rank test were used for univariate survival analysis,survival curve was drawn,and Cox proportional hazards regression model was used for analysis.Objective to summarize the factors that may affect the survival time of patients with stage Ⅳ colorectal cancer,and to provide reference for clinical screening of patients who benefit more from traditional Chinese medicine treatment.3.Research resultsPart Ⅰ:1.Basic information of patients:in this part of the study,the ratio of male to female is about 1.429:1,the age of onset is mainly concentrated in 61-80 years old,the primary site is colon,liver and lung are the main metastatic sites,adenocarcinoma is the main pathological type,and the malignant degree is mainly moderately differentiated.2.The absolute counts of lymphocyte subsets in patients with stage Ⅳ colorectal cancer were significantly lower than the normal range,while in the relative count,only the relative count of B lymphocyte in patients with deficiency of both qi and blood was lower than the normal range.3.In patients with stage Ⅳ colorectal cancer,there was a significant difference in the absolute count of T-suppressor/toxic lymphocytes between liver kidney yin deficiency syndrome and damp heat accumulation syndrome（P<0.05）;There was significant difference in the absolute count of T helper/induced lymphocyte between spleen kidney yang deficiency syndrome and damp heat accumulation syndrome（P<0.05）.The lower the absolute count of T helper/induced lymphocyte,the more likely it is to be spleen kidney yang deficiency syndrome;The lower the relative count of NK cells,the more likely it is to be diagnosed as liver kidney yin deficiency syndrome;The lower the absolute count of B lymphocyte,the more likely it is to be damp heat accumulation syndrome.Part Ⅱ:In 224 patients with stage Ⅳ colorectal cancer,the survival time of patients with qi stagnation and blood stasis syndrome and damp heat accumulation syndrome was significantly longer than that of the other three syndrome groups（P<0.05）;In terms of TCM treatment time,the survival time of patients with treatment time≥12 months was significantly longer than that of patients with treatment time<6 months（P<0.05）.Cox regression analysis showed that the survival time of patients with stage Ⅳ colorectal cancer who took traditional Chinese medicine for more than one year and whose syndrome differentiation was qi stagnation and blood stasis syndrome or damp heat accumulation syndrome was longer.4.Conclusion1.The immune function of patients with stage Ⅳ colorectal cancer was significantly lower than the normal level,mainly reflected in the absolute number of immune cells decreased,but the degree of differentiation and development did not change significantly,but with the progress of the patient’s disease,it will still lead to the abnormal differentiation and development of some immune cells.2.The decrease degree of lymphocyte subsets in patients with stage Ⅳ colorectal cancer was different among different syndrome types.3.In patients with stage Ⅳ colorectal cancer,the number of lymphocyte subsets in patients with liver kidney yin deficiency syndrome and spleen kidney yang deficiency syndrome was significantly different from those with damp heat accumulation syndrome.Considering that the immune function of patients with liver kidney yin deficiency syndrome and spleen kidney yang deficiency syndrome was lower than those with damp heat accumulation syndrome.4.The count of lymphocyte subsets in different TCM syndrome types of stage Ⅳ colorectal cancer patients has different decreasing trend.Considering the decrease of different immune indexes,it can play a certain auxiliary role in the judgment of TCM syndrome types.5.Long term Chinese medicine treatment can prolong the survival time of patients with stage Ⅳ colorectal cancer,the TCM syndrome type of patients has a certain correlation with the prognosis,and the survival time of patients with empirical syndrome may be longer than that of patients with deficiency syndrome.