Analysis Of TCM Syndrome Types, Clinical Characteristics And TCM Medication Rules In Patients With Bone Metastasis And Pai

Purpose:To explore the correlation between pain degree and clinical characteristics of patients with bone metastasis cancer pain,as well as the syndrome types and medication rules of traditional Chinese medicine(TCM).Material and methods:A retrospective study was conducted to collect the general data,primary tumor,bone metastasis,examination and test,treatment process,and traditional Chinese Medicine four diagnosis data of patients with bone metastases and pain admitted to the Department of Oncology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 1,2021 to September 30,2022.SPSS software was used to perform systematic cluster analysis of TCM clinical symptoms,and a reasonable TCM syndrome type was determined by combining clinical practice and professional knowledge.The pain degree of the included patients were statistically analyzed with general information,disease condition,disease course,clinical indicators,TCM syndrome type and other clinical data.p<0.05 was considered statistically significant.The frequency statistics and classification of Chinese herbal decoction pieces of the included patients were carried out to explore the rules of medication.Results:1.The TCM syndrome types of patients with bone metastasis with pain can be divided into 6syndrome types: qi stagnation and blood stasis syndrome(25.5%),qi and blood deficiency syndrome(23.4%),Yin deficiency and internal heat syndrome(17.0%),spleen and kidney Yang deficiency syndrome(14.2%),phlegm dampness block syndrome(13.5%),heat and poison accumulation syndrome(6.4%).2.Univariate analysis showed that There was no significant difference in the degree of pain between gender,age,primary tumor,smoking index,treatment history,single or multiple bone metastases,whether accompanied by elevated tumor markers,whether accompanied by lymph node metastasis,the number of distant metastases in other organs or parts,the course of primary tumor,TCM syndrome type,deficiency and excess(p>0.05).There were significant differences in the degree of pain with smoking history,previous use of bisphosphonates,pathological fracture,hypercalcemia,ALP elevation,course of bone metastasis,number of pain sites,nature of pain,and characteristics of pain(p< 0.05).3.Multivariate ordinal Logistic regression analysis showed that smoking history,previous use of bisphosphonates,pain nature,pain characteristics,and the number of pain sites were not independent risk factors for pain degree of bone metastasis cancer,and the difference was not statistically significant(p> 0.05).Hypercalcemia,pathological fracture,increased ALP and growing bone metastasis course were independent risk factors affecting the pain degree of bone metastasis cancer,and the difference was statistically significant(p< 0.05).4.In a collection of 141 patients with bone metastatic cancer with pain,there were 81 patients have taken Chinese medicine decoction.Results A total of 192 species of Chinese herbal decoction pieces were collected.The total frequency of using Chinese herbal decoction pieces was 1,959 times,with an average of 24 pieces per prescription.There are 51 species of traditional Chinese medicine with analgesic effect.According to their efficacy,they can be divided into 14 species of promoting blood circulation and blood stasis to relieve pain,8species of promoting qi and pain,5 species of promoting blood circulation and qi to relieve pain,6 species of warming Li powder for cold and pain relief,5 species of clearing heat and knot and pain relief,5 species of eliminating wind and dampness and pain relief,4 species of reinforcing deficiency and strengthening bone and pain relief,2 species of reducing swelling and knot and pain relief,2 species of alleviating pain and 2 species of acid and pain relief.Among them,the proportion of Chinese herbal decoction pieces for removing blood stasis,promoting qi and relieving pain was relatively high.Conclusion:1.According to the clustering results of TCM syndrome types in patients with bone metastasis with pain,qi stagnation and blood stasis syndrome had the highest occurrence rate,followed by qi and blood deficiency syndrome,Yin deficiency and internal heat syndrome,spleen and kidney Yang deficiency syndrome,phlegm-dampness block syndrome,and heat-toxin accumulation syndrome.2.The results of univariate analysis showed that the pain degree of bone metastasis cancer was related to smoking history,previous use of bisphosphonates,pathological fracture,hypercalcemia,ALP elevation,course of bone metastasis,the number of pain sites,the nature of pain,and the characteristics of pain.3.Multivariate ordinal Logistic regression analysis showed that hypercalcemia,pathological fracture,elevated ALP and course of bone metastasis were independent risk factors for pain degree of patients with bone metastases.4.The analysis of traditional Chinese medicine’s regulariy in patients with bone metastasis with pain showed that the application frequency of traditional Chinese medicine decoction pieces for benefiting qi,tonifying deficiency and strengthening health was the highest.Among all the species of traditional Chinese medicines with analgesic effects,the species of removing blood stasis and promoting qi to relieve pain accounted for a relatively high proportion.