| Objective:Based on cluster analysis,the study was conducted on the collection of four diagnostic information of traditional Chinese medicine in advanced lung cancer patients,to summarize the traditional Chinese medicine syndromes of this disease before and after chemotherapy,explore distribution characteristics of traditional Chinese medicine syndromes in advanced lung cancer patients before and after chemotherapy and the influence of different cycles of chemotherapy in traditional Chinese medicine syndromes,provide reference for accurate differentiation in different stages of chemotherapy,guide the practice of treatment and improve the efficacy of the patients with advanced lung cancer.Methods:The prospective investigation method was used in the research to collect the four diagnostic data of 241 advanced lung cancer patients in Jiangsu province Hospital of Traditional Chinese Medicine from December 2014 to December 2016(including 81 cases before the first chemotherapy,80 cases before the third chemotherapy,80 cases before the fifth chemotherapy).Taking different cycles of chemotherapy as the dividing point,four diagnostic data was collected to set up three databases respectively based on the presence or absence(1,0)of each information in Excel 2013.The frequency and percentage of four diagnostic data of the three groups was counted.SPSS 18.0 was applied to analyze the data by the K-means clustering analysis.Combined with the view of Chinese medicine or integration of Chinese and western medicine experts,the classifications and names of Chinese medicine syndrome types were established on the basis of the results of cluster analysis.Results:Four common clinical data of 81 advanced lung carcinoma patients before the first chemotherapy were:fatigue,red tongue,thin fur,rapid pulse,slippery pulse,white phlegm,thready pulse,soft pulse,pant,poor appetite,white greasy fur,pale tongue or fat tongue side with teeth marks,upset and insomnia,weight loss,tongue with cracks or less fluid,stringy pulse,chest distress,night sweat,reddish tongue,pale complexion.Four common diagnostic messages of 80 patients before the third chemotherapy were:thready pulse,fatigue,thin fur,poor appetite,dry mouth and throat,red tongue,rapid pulse,low voice,pant,upset and insomnia,pale complexion,nausea and vomiting,pale tongue or fat tongue side with teeth marks,night sweat,less fur,dark red tongue or with petechia,stringy pulse,unsmooth pulse,less and sticky phlegm,tongue with cracks or less fluid.Four common diagnostic information of 80 patients before the fifth chemotherapy were:thready pulse,fatigue,dry mouth and throat,thin fur,poor appetite,low voice,pale complexion,red tongue,crimson or purplish red tongue or with ecchymosis,weak pulse,pant,weight loss,pale tongue or fat tongue side with teeth marks,nausea and vomiting,less and sticky phlegm.Four common syndrome types in 81 advanced lung cancer patients before the initial chemotherapy were syndrome of qi deficiency and phlegm-dampness,the deficiency of both qi and yin(qi deficiency mainly),the deficiency of both qi and yin(yin deficiency mainly),syndrome of phlegm-heat stasis in lung.Qi deficiency and phlegm-dampness was most among four types of common Chinese syndromes,accounting for 46.9%;The deficiency of both qi and yin(qi deficiency mainly)and the deficiency of both qi and yin(yin deficiency mainly)accounted for 22.2%and 17.2%respectively;Syndrome of phlegm-heat stasis in lung was least,accounting for 13.5%.Four common syndrome types in 80 patients before the third chemotherapy were syndrome of qi deficiency and blood stasis,the deficiency of both qi and yin(yin deficiency mainly),the deficiency of both qi and yin(qi deficiency mainly),syndrome of qi deficiency and phlegm-dampness.Qi deficiency and blood stasis was most among four syndrome types,accounted for 35.0%;The deficiency of both qi and yin(qi deficiency mainly)and the deficiency of both qi and yin(yin deficiency mainly)accounted for 17.5%and 32.5%respectively;Syndrome of qi deficiency and phlegm-dampness was least,accounting for 15.0%.Among 80 patients before the fifth chemotherapy,the common syndrome types were qi deficiency of lung and spleen(accounted for 35.0%),the deficiency of both qi and yin(accounted for 31.3%),syndrome of vital qi deficiency and stasis-toxin(accounted for 33.8%).Conclusions:Qi deficiency is throughout the whole process of advanced lung cancer before and after the chemotherapy,it is the foundation of the occurrence and aggravation of this disease.The patients before the initial chemotherapy are given priority to Qi deficiency and phlegm-dampness.As the extension of the course and the increase of frequency of chemotherapy,phlegm-dampness pathology reduce gradually,vital qi deficiency is gradually serious,but stasis-toxin has increased.Qi deficiency and the deficiency of both qi and yin are the main deficiency syndromes.Concrete evils are phlegm-dampness,phlegm-heat,stasis-toxin and so on.Different cycles of chemotherapy may be one of the influencing factors to traditional Chinese medicine syndromes of this disease. |
