| Objective:Under the guidance of Chinese and Western medicine therapies,102 patients with advanced lung adenocarcinoma were observed for changes in symptoms and signs before and after chemotherapy' with AP regimen,and TCM syndrome elements were extracted to prospectively analyze the distribution of TCM syndrome elements before and after chemotherapy.In order to further explore the characteristics of the distribution of syndromes in patients with advanced lung adenocarcinoma and evolution rules,find the key point of TCM pathogenesis,establish the rule of treatment of traditional Chinese medicine,provide basis for the accuracy of TCM syndrome differentiation,and thus more targeted combination of cancerous toxin pathogenesis theory to treat,To better improve the clinical efficacy of traditional Chinese medicine combined with chemotherapy in the treatment of advanced lung cancer.Methods:A total of 102 patients with lung adenocarcinoma treated with AP chemotherapy were collected in Jiangsu Provincial Hospital of Traditional Chinese Medicine and Jiangsu Provincial Tumor Hospital.The clinical TNM classification was ?B-?B,and each patient was observed one time in three days before chemotherapy and eight days after chemotherapy,record the patient's general information,and clinical data such as symptoms,signs,tongue,pulse,etc.With reference to "record syndrome differentiate element" scale to extract syndrome elements,establish a database,and analyze the results by SPSS 19.0 statistical software.Results:(1)A total of 102 patients were enrolled in this study,including 68 males(66.67%)and 34 females(33,33%);7 patients(6.86%)?50 years old,30 patients aged 51-60 years old(29.41%),a total of 48 patients(47.06%)aged 61-70 years,a total of 17 patients(16.67%)>70 years old;a total of 29 patients(28.43%)in ?B phase,and 9 patients(8.82%)in ?C phase,There were 36 cases(35.29%)in the IVA stage,28 cases(27.45%)in the IVB stage;27 cases(26.47%)in the ECOG score of 0,68 cases(66.67%)in the ECOG score of 1 and ECOG score 2 A total of 7 cases(6.86%)were scored.There was no significant difference in the basic data of gender,age,clinical stage,ECOG score(P>0.05).(2)The highest frequency of symptoms before chemotherapy was cough(91.18%),white phlegm(46.08%),fatigue(40.20%),followed by excessive and sticky phlegm(36.27%),yellow sputum(28.43%),thirst(23.53%).Before chemotherapy,the frequency of pale tongue,teeth-marked tongue and red tongue was the highest,accounting for 55.88%,36.27%and 32.35%.Pulse condition is mainly thready pulse(65.69%),followed by slippery pulse(37.25%),rapid pulse(31.37%).Before the chemotherapy,the highest frequency of disease location syndrome elements is lungs(100%),and the main disease syndrome elements were phlegm,Qi deficiency,fluid retention,heat and dampness,accounting for 36.27%,35.29%,34.31%,28.43%,and 26.47%,respectively.(3)Clinical symptoms such as fever,yellow phlegm,excessive and sticky phlegm,and blood in sputum were decreased significantly after chemotherapy;fatigue(63.7%),night sweating(44.12%),poor appetite(24.51%),nausea and vomiting(7.84%)were significantly higher than those before chemotherapy.After chemotherapy,pale tongue(68.63%),less moss(44.12%)were significantly increased compared with the former.After chemotherapy,the highest frequency was thready pulse(89.22%),slippery pulse,rapid pulse decreased 12.74%,14.7%.The frequency of lung was the highest disease location syndrome element before and after chemotherapy,which was 100%and 87.25%,respectively.The frequencies of spleen and kidney after chemotherapy increased by 23.53%and 13.73%,respectively.After chemotherapy,the frequency of qi deficiency and yin deficiency increased significantly,which increased by 16.67%and 26.47%,respectively.Significant statistical differences were observed in the distribution of symptoms,tongue coating,pulse,and syndrome element before and after chemotherapy(P<0.05).Conclusions:The results showed that the changes of the pre-and post-chemotherapy syndromes in patients with advanced lung adenocarcinoma followed a certain pattern before and after chemotherapy.The highest frequency of disease location syndrome elements was lung;the most obvious changes were spleen and kidney;Before the chemotherapy,the main disease syndrome elements were Qi deficiency,phlegm,fluid retention,dampness and heat,Qi deficiency and yin deficiency are the main manifestations after chemotherapy.lt showed that the toxic heat syndrome caused by chemotherapeutic drugs had a damage at vital qi and yin-fluid.Therefore,deficiency of both qi and yin was more common after chemotherapy.Combined with the understanding of toxin pathogenesis theory for lung cancer,patients with advanced lung cancer should be accompanied by eliminating toxin throughout the anti-cancer regimen.Clinically,the methods of tonifying Qi,resolving phlegm,eliminating phlegm,and clearing out heat should be adopted before the AP regimen chemotherapy.After chemotherapy should pay attention to tonifying Qi and nourishing Yin,and adjust the medication with individual differences. |
PDF Full Text Request