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一项借助实验室指标对结直肠癌术前患者进行中医辨证的探索性研究。

An exploratory study on TCM syndrome differentiation in preoperative patients with colorectal cancer assisted by laboratory indicators.

作者信息

Wang Ya-Nan, Zou Min, Wang Dou, Zhang Zhi-Kuan, Qu Lian-Ping, Xu Jing, Shi Cai-Dong, Gao Feng

机构信息

Clinical College of Chinese Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, China.

Department of Colorectal & Anal Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou 730050, China.

出版信息

Heliyon. 2022 Aug 14;8(8):e10207. doi: 10.1016/j.heliyon.2022.e10207. eCollection 2022 Aug.

Abstract

OBJECTIVE

This paper aims to explore the relationship between the syndrome differentiation of traditional Chinese medicine (TCM) in colorectal cancer and the clinical laboratory indicators of patients, and to further seek the laboratory indicators to assist TCM syndrome differentiation.

METHODS

From May 2020 to June 2021, 122 colorectal cancer patients with a clear pathological diagnosis who had not undergone surgery or chemotherapy were classified according to the TCM syndrome classification. The clinical laboratory indicators of 122 patients with preoperative colorectal cancer were collected, and the correlation between preoperative colorectal cancer TCM syndromes and Karnofsky score and clinical laboratory indicators was analyzed. The indicators affecting TCM syndromes were included in the disordered multivariate logistic regression analysis model to analyze the relative risk of the influencing factors.

RESULTS

The syndromes of colorectal cancer patients were classified into excess syndrome, deficiency syndrome, and syndrome of intermingled deficiency & excess. The differences in total bilirubin (TBIL), hemoglobin (HB), uric acid (UA), and hematocrit (HCT) between the three groups were statistically significant ( < 0.05). The indexes such as TBIL, HB, UA, and HCT in preoperative patients with excess syndrome of colorectal cancer were higher than those in patients with syndrome of intermingled deficiency & excess and deficiency syndrome, and the comparison between groups using the LSD method showed that UA and HCT were different between the excess syndrome and deficiency syndrome groups ( < 0.05). Multivariate logistic regression analysis indicated that Gender, Tumor location, TNM stage, Total protein (TP), Red blood cell (RBC), HB, HCT, Platelet (PLT) and Fibrinogen (FIB) were all risk factors affecting TCM syndromes of preoperative colorectal cancer ( < 0.05).

CONCLUSION

There is a correlation between the TCM syndromes of colorectal cancer and the clinical laboratory indicators of the patients. Gender, Tumor location, TNM stage, TP, RBC, HB, HCT, PLT and FIB are the risk factors of TCM syndrome differentiation in preoperative patients with colorectal cancer. TBIL, UA, HB, and HCT may be the four relevant indicators of TCM syndrome differentiation in colorectal cancer.

摘要

目的

探讨结直肠癌中医辨证与患者临床实验室指标之间的关系,并进一步寻找辅助中医辨证的实验室指标。

方法

选取2020年5月至2021年6月未接受手术或化疗且病理诊断明确的122例结直肠癌患者,按照中医证候分类进行归类。收集122例术前结直肠癌患者的临床实验室指标,分析术前结直肠癌中医证候与卡氏评分及临床实验室指标的相关性。将影响中医证候的指标纳入无序多分类logistic回归分析模型,分析各影响因素的相对危险度。

结果

将结直肠癌患者的证候分为实证、虚证、虚实夹杂证。三组间总胆红素(TBIL)、血红蛋白(HB)、尿酸(UA)、血细胞比容(HCT)差异有统计学意义(P<0.05)。术前结直肠癌实证患者的TBIL、HB、UA、HCT等指标高于虚实夹杂证和虚证患者,采用LSD法进行组间比较,实证与虚证组间UA和HCT差异有统计学意义(P<0.05)。多因素logistic回归分析显示,性别、肿瘤部位、TNM分期、总蛋白(TP)、红细胞(RBC)、HB、HCT、血小板(PLT)、纤维蛋白原(FIB)均为术前结直肠癌中医证候的危险因素(P<0.05)。

结论

结直肠癌中医证候与患者临床实验室指标之间存在相关性。性别、肿瘤部位、TNM分期、TP、RBC、HB、HCT、PLT、FIB是术前结直肠癌患者中医辨证的危险因素。TBIL、UA、HB、HCT可能是结直肠癌中医辨证的四个相关指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40cc/9404354/d009f1ffcf0d/gr1.jpg

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