| Objective:Ovarian cancer is the malignant tumor with the highest mortality among gynecological cancer diseases.However,due to the different theoretical structure of syndrome differentiation and the understanding of etiology and pathogenesis of ovarian cancer,there are many syndromes differentiation types and no unified syndrome differentiation standard system.Syndrome differentiation and treatment is the essence of traditional Chinese medicine.Zang Xiang syndrome differentiation is one of many syndrome differentiation methods,which is of great significance for more accurate and detailed syndrome differentiation.There is a phenomenon of "covering syndrome with disease" in clinical TCM classification of ovarian cancer.In order to find a more convenient,standardized and flexible syndrome differentiation mode,the "Zang Xiang syndrome differentiation theoretical system" founded by Professor Wu Chengyu is applied to the syndrome differentiation of ovarian cancer to explore its syndrome differentiation law,which is convenient for clinical learning and mastery.Methods:First part is Literature Research:By searching the literature of traditional Chinese and Western medicine,summarize and sort out the TCM disease name,etiology and pathogenesis,syndrome type,treatment and prognosis of ovarian cancer;To screen and sort out the latest research progress of ovarian cancer,understanding the internal essence of ovarian cancer and the pathogenesis characteristics of ovarian cancer in modern molecular biology research.The second part is Retrospective Study:The clinical data of 376 patients with ovarian cancer were collected,including age of onset,initial symptoms,symptoms after treatment,past history and personal history.The patients were divided into three groups(group 1:the pre-treatment group,that is,the group without any treatment;group 2:the treatment group,that is,the group within 6-8 chemotherapy cycles after diagnosis;group 3:the follow-up group,the follow-up group at the last visit:that is,the treatment or observation group after 6-8 cycles of chemotherapy);the patients in the three groups continued to be stratified according to FIGO stages,and each group was divided into four groups(group A:phase Ⅰ group,i.e.patients with FIGO stage Ⅰ;group B:phase Ⅱ group,i.e.patients with FIGO stage Ⅱ;group C:phase Ⅲgroup,i.e.patients with FIGO stage Ⅲ;group D:phase Ⅳ group,i.e.patients with FIGO stageⅣ)The collected clinical cases were recorded with symptoms and signs,and the disease location and disease nature were identified;the data were analyzed by cluster analysis,principal component analysis,frequency distribution statistics and correlation analysis.The distribution laws of disease location,disease nature and disease location combination in different treatment stages and different disease stages of ovarian cancer were analyzed,and the "diagnostic information table of ovarian cancer syndrome" was preliminarily constructed,summarize the basic syndrome of ovarian cancer and the characteristics of disease location and disease nature.The third part is Clinical Application:Based on the research basis of Zang Xiang syndrome differentiation theory,the Zang Xiang syndrome differentiation theory and thinking mode are applied to the syndrome differentiation process of ovarian cancer,highlighting the role of the principles of "syndrome differentiation","combination of principle and flexibility"and "combination of disease and syndrome" in the syndrome differentiation of ovarian cancer,so as to further guide the clinical treatment and medication,in order to improve the efficiency.The fourth part is Discusses:The TCM disease name,location and nature of Zang Xiang disease of ovarian cancer,as well as the application of Zang Xiang syndrome differentiation in ovarian cancer,so as to further standardize the TCM syndrome differentiation of ovarian cancer,so as to better improve the accuracy of syndrome differentiation and provide more reasonable and standardized diagnostic basis for treatment.Results:(1)There were 175 symptoms in group 1,223 symptoms in group 2 and 179 symptoms in group 3.Group 1 included 12 disease sites such as ovary,liver,kidney and uterus,and 10 disease sites such as phlegm,blood stasis and qi stagnation;Group 2 included 13 disease sites such as liver,spleen,heart and kidney,and 13 disease types such as Qi deficiency,qi stagnation,blood stasis and phlegm;Group 3 included 13 diseases of liver,kidney,spleen and heart,and 15 diseases of qi deficiency,blood stasis,phlegm and yin deficiency.(2)Symptom clustering:group 1 clustered into 10 categories,group 2 clustered into 14 categories,and group 3 clustered into 12 categories;Correlation analysis:there were 22 groups in group 1,38 groups in group 2 and 21 groups in group 3;Disease location clustering:group 1 is clustered into 4 categories,group 2 is clustered into 3 categories,and group 3 is clustered into 6 categories;Correlation analysis:there were 22 groups in group 1,2 groups in group 2 and 3 groups in group 3;Disease clustering:group 1 clustered into 4 categories,group 2 clustered into 5 categories,and group 3 clustered into 4 categories;Correlation analysis:5 groups in group 1,3 groups in group 2 and 7 groups in group 3;Disease location combined with disease clustering:group 1 was clustered into 6 categories,group 2 was clustered into 7 categories,and group 3 was clustered into 6 categories;Correlation analysis:there were 48 groups in group 1,4 groups in group 2 and 12 groups in group 3;(3)Based on the symptom distribution of 376 patients with ovarian cancer and the clinical syndrome differentiation experience of their tutors,121 symptoms and tongue and vein manifestations of ovarian cancer were selected to standardize the disease location and disease nature,and the "standardized diagnosis information table of ovarian cancer syndrome" with"disease location and disease nature" as the core was constructed.(4)"Liver phlegm and blood stasis syndrome" is the basic syndrome of ovarian cancer.Referring to the relevant syndrome differentiation standards and combined with the clinical experience of tutor in diagnosing ovarian cancer,the disease location characteristics of liver,kidney,spleen,heart and lung,as well as the disease characteristics of phlegm,blood stasis,Qi stagnation,blood deficiency,yin deficiency,Yang deficiency and drinking cessation of ovarian cancer are formulated.Conclusion:(1)The results of literature research suggest that there is no exclusive TCM disease name for ovarian cancer up to now.At present,it is still based on "syndrome" theory.The category of"syndrome" is general,which generally refers to all benign and malignant tangible real evil.The standardized disease name should clearly indicate the location of the disease,and so should the TCM disease name.Therefore,it is tentatively proposed to take "subnuclear syndrome" as the TCM disease name of ovarian cancer to distinguish it from other diseases,At the same time,according to the clinical manifestations of patients with ovarian cancer,the hypothesis of"subnuclear phlegm and blood stasis block" was put forward.(2)According to the literature,all the five Zang organs can lead to ovarian cancer,and there is no unified standard for the syndrome differentiation of ovarian cancer.The results of this study suggest that the basic location of ovarian cancer is in the liver;The basic disease is phlegm and blood stasis,and the basic syndrome is "liver meridian phlegm and blood stasis syndrome";The location of the disease is kidney and spleen,and the nature of the disease is Qi deficiency,qi stagnation,yin deficiency,Yang deficiency,etc.;The clustering of disease location suggests that ovarian cancer is related to the five Zang organs system in the process of disease,and its disease progression is accompanied by the transmission of disease location;Disease clustering suggests that many diseases are interrelated;Based on the clustering results of disease location and disease nature,the combination law of disease location and disease nature of ovarian cancer was preliminarily analyzed.(3)"Measuring Tibet by signs,syndrome differentiation from symptoms","combination of principle and flexibility" and "combination of diseases and syndromes" are the principles that must be followed when the theoretical system of syndrome differentiation of signs and symptoms is applied to the syndrome differentiation of ovarian cancer;First,disease differentiation is clear.On this basis,syndrome differentiation needs to abide by the combination of disease location and disease differentiation. |
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