湖南中医杂志2025，Vol.41Issue(11)：35-41,7.DOI:10.16808/j.cnki.issn1003-7705.2025.11.008
进展期胃癌不同阶段中医临证医案"症-机-药"规律研究
"Syndrome-mechanism-medicine"rules in traditional Chinese medicine clinical medical records for different stages of advanced gastric cancer
摘要
Abstract
Objective:To summarize the experience and syndrome differentiation-based treatment rules for different stages of advanced gastric cancer in traditional Chinese medicine(TCM)clinical medical records.Methods:CNKI,VIP,and SinoMed were searched for articles on TCM clinical medical records for advanced gastric cancer published from January 1,2000 to June 30,2025.The articles were screened based on inclusion and exclusion criteria,and then key data were extracted to establish a TCM treatment database.R-4.1.1 was used to perform association rule analysis and clustering analysis.Results:A total of 240 articles were included,including 96 medical records(40.13％)for perioperative period,79 medical records(32.89％)for convalescence stage,and 65 medical records(26.98％)for the stage of palliative care,and these articles involved 296 clinical symptoms,225 pathogeneses,and 300 drugs.There were characteristic association rules in different stages of advanced gastric canc-er:in the perioperative period,there was a close association between vital Qi injury-related symptoms such as fatigue and lassitude,with Qi and blood deficiency along with weakness of spleen and stomach as the core pathogen-esis,and Poria cocos and Atractylodes macrocephala Koidz.were used in combination for strengthening the spleen and benefiting Qi;in the convalescence stage,there were significant symptoms of spleen and stomach disorders such as epigastric pain and anorexia,and the core drugs tangerine peel and Hedyotis diffusa were added for regulating Qi and clearing residual toxin,respective;in the stage of palliative care,the symptoms of excess pathogen such as heart-burn and acid reflux coexisted with weakened body resistance,with a prominent intermingled toxin-stasis syndrome,and Atractylodes macrocephala Koidz.combined with Radix Glycyrrhizae was used for strengthening vital Qi,while Pinellia ternata and Poria cocos were used for eliminating pathogens,achieving the effect of tonification and purgation in combination.Conclusion:Advanced gastric cancer is a syndrome of deficiency in origin and excess in superficiality.There are different pathogeneses and treatment methods for the different stages of advanced gastric cancer,i.e.,strengthening vital Qi and invigorating the spleen to repair vital Qi in the perioperative period,strengthening vital Qi and eliminating residual toxin in the convalescence stage,and emphasizing tonification and purgation in combination to balance vital Qi and pathogens in the stage of palliative care.The"syndrome-mechanism-drug"rules revealed in this study can provide a reference for staged TCM adjuvant therapy for advanced gastric cancer.关键词
胃癌/进展期/中医药辅助治疗/关联规则/临床症状/病机Key words
advanced gastric cancer/adjuvant therapy with traditional Chinese medicine/association rule/clinical symptoms/pathogenesis分类
医药卫生引用本文复制引用
宋佳杰,曹莹,王文萍..进展期胃癌不同阶段中医临证医案"症-机-药"规律研究[J].湖南中医杂志,2025,41(11):35-41,7.基金项目
辽宁省中医大师(辽宁省名中医)传承工作室建设项目(辽中医药综合字[2021]32号) （辽宁省名中医）
辽宁省中医药多学科交叉创新团队项目"中西医结合胃癌综合防治新策略研究"项目 （）
辽宁省"兴辽英才计划"基金项目(XLYC1802008) （XLYC1802008）
辽宁省教育厅2022年度高等学校基本科研项目(LJKQZ20222391) （LJKQZ20222391）
