临床肝胆病杂志2025，Vol.41Issue(3)：528-535,8.DOI:10.12449/JCH250320
胰腺癌中医证候分布规律及影响因素分析
Distribution pattern of traditional Chinese medicine syndromes and analysis of influencing factors in pancreatic cancer
摘要
Abstract
Objective To investigate the influencing factors for traditional Chinese medicine(TCM)syndromes in pancreatic cancer by analyzing 608 cases,and to provide a theoretical reference for TCM syndrome differentiation and standardized treatment of pancreatic cancer.Methods A total of 608 patients with a pathological or clinical diagnosis of pancreatic cancer who were admitted to Shanxi Institute of Traditional Chinese Medicine,The Affiliated Hospital of Shanxi University of Chinese Medicine,and Shanxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to December 2023 were enrolled,and TCM syndrome differentiation was performed.The chi-square test was used for comparison of categorical data between groups.The clinical data with statistical significance between groups were included in the regression analysis,and the unordered polytomous logistic regression model was used to investigate the influencing factors for the TCM syndrome of pancreatic cancer.Results For the 608 patients with pancreatic cancer,common initial symptoms included abdominal pain(32.40%),abdominal distension(23.85%),fatigue(16.12%),and emaciation(10.03%),and the main clinical symptoms included poor appetite(75.97%),abdominal pain(67.27%),fatigue(61.84%),abdominal distension(57.40%),and emaciation(53.62%).There were significant differences between the patients with different TCM syndromes of pancreatic cancer in sex(χ2=62.823,P<0.001),disease duration(χ2=14.868,P=0.011),clinical stage(χ2=21.006,P<0.001),lymph node metastasis(χ2=2.205,P=0.032),surgery(χ2=38.008,P<0.001),chemotherapy(χ2=21.384,P<0.001),radiotherapy(χ2=17.510,P=0.004),and immunotherapy(χ2=18.573,P=0.002).The logistic regression analysis showed that male sex was a protective factor against Qi and blood deficiency syndrome(odds ratio[OR]=0.081,95%confidence interval[CI]:0.031-0.213,P<0.001),Qi stagnation and blood stasis syndrome(OR=0.100,95%CI:0.041-0.247,P<0.001),and syndrome of Yin deficiency with internal heat(OR=0.158,95%CI:0.057-0.444,P<0.001),while it was a risk factor for the syndrome of damp-heat accumulation(OR=2.378,95%CI:1.074-5.266,P=0.033);the course of the disease of<1 year was a protective factor against Qi and blood deficiency syndrome(OR=0.167,95%CI:0.073-0.383,P<0.001),syndrome of spleen-kidney Yang deficiency(OR=0.183,95%CI:0.089-0.378,P<0.001),and syndrome of Yin deficiency and internal heat(OR=0.164,95%CI:0.070-0.385,P<0.001);clinical stage Ⅰ/Ⅱ/Ⅲ was a risk factor for damp-heat accumulation(OR=2.793,95%CI:1.259-6.196,P=0.012)and Qi stagnation and blood stasis syndrome(OR=7.863,95%CI:2.808-22.020,P<0.001);lymph node metastasis was a risk factor for Qi and blood deficiency syndrome(OR=4.005,95%CI:1.477-10.861,P=0.006);surgical treatment was a risk factor for Qi and blood deficiency syndrome(OR=4.151,95%CI:1.916-8.995,P<0.001),syndrome of spleen-kidney yang deficiency(OR=5.352,95%CI:2.436-11.759,P<0.001),Qi stagnation and blood stasis syndrome(OR=2.334,95%CI:1.071-5.088,P=0.033),and syndrome of Yin deficiency and internal heat(OR=4.167,95%CI:1.789-9.707,P<0.001);chemotherapy was a protective factor against damp-heat accumulation(OR=0.188,95%CI:0.082-0.428,P<0.001);radiotherapy was a risk factor for damp-heat accumulation(OR=2.571,95%CI:1.151-5.746,P=0.021)and syndrome of Yin deficiency with internal heat(OR=8.384,95%CI:3.348-20.997,P<0.001);immunotherapy was a risk factor for Qi and blood deficiency syndrome(OR=2.114,95%CI:1.021-4.379,P=0.044).Conclusion Sex,course of the disease,clinical stage,presence or absence of lymph node metastasis,surgery,chemotherapy,radiotherapy,and immunotherapy are the main influencing factors for the TCM syndrome of pancreatic cancer.关键词
胰腺肿瘤/证候/危险因素/保护因素Key words
Pancreatic Neoplasms/Symptom Complex/Risk Factors/Protective Factors引用本文复制引用
石智尧,武时瑜,任少键,刘懿禅,尹艺杰,高宇,王晞星..胰腺癌中医证候分布规律及影响因素分析[J].临床肝胆病杂志,2025,41(3):528-535,8.基金项目
第四届国医大师传承工作室项目(国中医药办人教函2022245号1123-04) （国中医药办人教函2022245号1123-04）
国家中医药传承创新中心的建设项目(202203) （202203）
山西省自然科学基础面上项目(202103021224437) （202103021224437）
山西省中医临床医学研究中心(培育)项目(晋科社[2019]61号) （培育）
山西省卫生健康委员会山西省医学科技创新团队项目(2020TD04) （2020TD04）
山西省卫生健康委员会山西省医学重大科技攻关专项(2022XM10) The Fourth National Medical Master Inheritance Workshop(Teaching Letter of the Chinese Medicine Administrator No.20222451123-04) （2022XM10）
Construction of the National TCM Inheritance and Innovation Center(202203) （202203）
Shanxi Provincial Natural Science Basic Surface Project(202103021224437) （202103021224437）
Shanxi Provincial Clinical Medical Research Center of Traditional Chinese Medicine(Cultivation)(Jinke She[2019]No.61) （Cultivation）
Shanxi Provincial Medical Science and Technology Innovation Team Project of Shanxi Provincial Health Commission(2020TD04) （2020TD04）
Shanxi Provincial Medical Science and Technology Major Science and Technology Research Special Project of Shanxi Provincial Health Commission(2022XM10) （2022XM10）
