摘要
目的研究癌因性疲乏(CRF)中医证候要素和证候类型分布规律。方法对2021年1-12月就诊于中国中医科学院西苑医院肿瘤科门诊及病房的肿瘤患者进行横断面调查,通过描述性分析对比CRF与非CRF患者在中医证素、症状及舌脉上的分布差异,并对CRF的中医症状进行聚类分析,总结CRF常见中医证型。结果共纳入306例肿瘤患者,229例(75%)为CRF,77例(25%)为非CRF。气虚、血虚、寒湿是CRF常见的虚性和实性证素,肝虚、阴虚、血瘀证素在非CRF中发生的频率高于CRF。CRF患者中频率大于50%的中医症状从高到低依次为乏力>气短>失眠或多梦>神疲>健忘>懒言>急躁易怒或抑郁喜叹息;出现频次最高的舌象、舌苔和脉象分别为舌淡、苔白腻或白滑、脉虚。77例非CRF患者频率大于30%的症状由高到低分别为急躁易怒或抑郁喜叹息>失眠或多梦>气短>口干咽燥>腰脊酸痛(外伤性除外)>肢体麻木>健忘。出现频次较高的舌象、舌苔和脉象分别为舌淡、舌红或少苔、无苔,脉细。通过聚类分析得出气血两虚证、心肝血虚证、肾阳虚证、气阴两虚证、脾虚气滞证、寒湿困脾证6种CRF常见证型。结论CRF是不同类型肿瘤普遍存在的症状,总体以虚证为主,气虚、血虚为其常见证素,常见高频症状及舌脉为乏力、气短、神疲、健忘、舌淡、脉细,常见中医证型可初步总结为气血两虚证、心肝血虚证、肾阳虚证、气阴两虚证、脾虚气滞证、寒湿困脾证6种。
Objective:To investigate the distribution patterns of TCM syndrome elements and syndrome types in cancer-related fatigue(CRF).Methods:A cross-sectional survey was conducted on tumor patients attending the outpatient clinic and wards of the Department of Oncology,Xiyuan Hospital of China Academy of Chinese Medical Sciences from January to December 2021.Descriptive analysis was used to compare the distribution difference of TCM syndrome elements,symptoms and tongue symptoms of CRF and non-CRF patients.The TCM symptoms of CRF were clustered to summarize the common TCM syndromes of CRF.Results:A total of 306 tumor patients were finally included,of which 229(75%)were CRF and 77(25%)were non-CRF.Qi deficiency,blood deficiency,and cold-dampness were the most common deficiency and excess syndrome elements in CRF,and liver deficiency,yin deficiency,and blood stasis syndrome elements occurred more frequently in non-CRF than in CRF.TCM symptoms with a frequency greater than 50%in CRF patients,from high to low,were:fatigue>shortness of breath>insomnia or dreaminess>mental fatigue>forgetfulness>lazy speech>impatience,irritability,depression with sighing.The most frequent tongue symptoms,tongue coating,and pulse symptoms were respectively pale tongue,white and greasy coating or smooth white,and pulse deficiency.The symptoms with greater than 30%frequency in 77 non-CRF patients were,from highest to lowest:impatience and irritability or depression with sighing>insomnia or dreaminess>shortness of breath>dry mouth and throat>lumbar spine pain(excluding traumatic)>numbness of limbs>forgetfulness.The highest-ranked tongue,tongue coating,and pulse symptoms were pale tongue,red tongue or less coating,no coating,and thin pulse,respectively.Through clustering analysis,six common syndromes of CRF were obtained,including qi and blood deficiency syndrome,heart and liver blood deficiency syndrome,kidney yang deficiency syndrome,qi and yin deficiency syndrome,spleen deficiency and qi stagnation syndrome,and cold dampness and spleen stagnation syndrome.Conclusions:CRF is a common symptom of different types of tumors.Generally,deficiency syndrome is the main symptom.Qi deficiency and blood deficiency are the common syndrome elements.Common symptoms of high frequency and tongue and pulse are fatigue,shortness of breath,mental fatigue,forgetfulness,pale tongue and thin pulse.The common TCM syndrome types can be preliminarily summarized into 6 types:qi and blood deficiency syndrome,heart and liver blood deficiency syndrome,kidney yang deficiency syndrome,qi and yin deficiency syndrome,spleen deficiency and qi stagnation syndrome,cold dampness and spleen stagnation syndrome.
作者
谷珊珊
许云
王菲叶
龚璐天
王晶惠
郭欣煜
付力
史纪言
Gu Shanshan;Xu Yun;Wang Feiye;Gong Lutian;Wang Jinghui;Guo Xinyu;Fu Li;Shi Jiyan(Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China;Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《国际中医中药杂志》
2024年第8期972-979,共8页
International Journal of Traditional Chinese Medicine
基金
国家重点研发计划(2018YFC1707406)
国家自然科学基金(82074414)
中国中医科学院科技创新工程重大攻关项目(CI2021A01807)
育苗基金培育专项(ZZ11-069)。
关键词
肿瘤
癌因性疲乏
横断面调查
中医证素
中医症状
聚类分析
Neoplasms
Cancer-related fatigue
Cross-sectional Isurvey
TCM syndrome element
TCM symptoms
Clusteranalysis
