The Study On Regularity Of Traditional Chinese Medicine Syndrome In Advanced Non-small Cell Lung Cancer

ObjectiveThere is still a lack of intensive studies on regularity of traditional Chinese medicine (TCM) syndrome in advanced non-small cell lung cancer (NSCLC) so far. The purpose of this study was to investigate the relationships between the distributions of TCM syndromes of advanced NSCLC and the gender, age, smoking, pathological type, location, surgery, chemotherapy, radiotherapy and Karuafsky scores (KPS), and to discover their intrinsic regularity by conducting a standardized research through modern diagnostic and therapeutic methods. The study may help to increase the knowledge of regularity of TCM syndrome in advanced NSCLS, so that to guide the clinical therapy. And it may also be beneficial to improve the clinical therapeutic effect in patients with advanced NSCLS, which could provide some references for clinical and basic research on NSCLS of TCM.MethodsOne hundred and twenty-four patients who accorded with the inclusion criteria were included in the study. The following data of the patients such as the name, gender, age, smoking, pathological type, TNM classification, surgery, chemotherapy, radiotherapy, information from the TCM four diagnostic methods and brief process of the treatment were collected and recorded. The clinical symptoms were graded according to the symptomatic grading and quantifying table from the "Guidelines for Clinical Research of New Drugs of Traditional Chinese Medicine". The KPS scores were assessed on the basis of performance status scoring criteria. And the syndrome differentiation of TCM was according to the "Guidelines for Clinical Research of New Drugs of Traditional Chinese Medicine". The relationships between TCM syndrome and the gender, age, smoking, pathological type, surgery, chemotherapy, radiotherapy and KPS scores were studied and analyzed. All of the data were analyzed with SPSS 17.0 software, and finally come to the conclusions. Single factor analysis using the X2 test and FISHER test, multi-factor analysis using binary Logistic regression analysis.ResultsAdvanced NSCLS mostly happened in people who were more than 50 years old and it affects more men than women. The main pathological types were adenocarcinoma and squamous cell carcinoma, the incidence of adenocarcinoma was slightly higher than squamous cell carcinoma, and the pathological staging revealed stage IV in most cases.37.9 percent of patients received operation therapy, half of patients received chemotherapy, and 24.19 percent of patients received radiotherapy. The KPS scores were more than 70 in only 6 cases (4.84%), more than 60 in 34 cases (27.42%), equal or lesser than 60 in 72.58 percent of all cases. The syndrome of qi-deficiency plus phlegm-damp were observed in 72 cases (58.06%), the syndrome of deficiency of both qi and yin in 29 cases (23.39%), the syndrome of qi stagnation and blood stasis in 18 cases (14.52%), the syndrome of yin deficiency and heat-toxin in 5 cases (4.03%). The distributions of TCM syndromes of advanced NSCLC showed significant correlation with age, TNM classification, chemotherapy, radiotherapy and KPS scores (P<0.05), and had no significant correlation with gender, smoking, pathological type, location and surgery (P>0.05). However, there was a significant correlation between pathological type and smoking (P<0.05). Multiple factors analysis shows the age is the only independent factor of qi-deficiency plus phlegm-damp.Conclusions1. The phlegm, deficiency and blood stasis were the main syndrome elements of advanced NSCLS, and the symptoms of intermingled deficiency and excess were the main clinical manifestations. The syndrome of qi-deficiency plus phlegm-damp was the main syndrome type of advanced NSCLS.2. The distributions of TCM syndromes of advanced NSCLC showed significant correlation with age, TNM classification, chemotherapy, radiotherapy and KPS scores, and had no significant correlation with gender, smoking, pathological type, location and surgery. However, there was a significant correlation between pathological type and smoking.3. The age is the only independent factor of qi-deficiency plus phlegm-damp. The older people have more chance of getting the syndrome of qi-deficiency plus phlegm-damp.4. The pathogenesis of advanced NSCLC was deficiency in origin and excess in superficiality. The asthenia in origin was deficiency of both qi and yin, and the excess in superficiality was phlegm-damp and blood stasis. Therefore, treating disease from the root, treating both manifestation and root cause of disease, strengthening the body resistance to eliminate pathogenic factors which gave priority to strengthening healthy energy and supplemented with eliminating pathogens were the basic treatment principles of advanced NSCLC. The combination of traditional Chinese and western medicine, in addition with multidisciplinary and comprehensive treatment may be the optimal treatment model of advanced NSCLC.