| Objective:By collecting the information of four traditional chinese medicine syndromes of hematological patients undergoing allogeneic hematopoietic stem cell transplantation,the distribution characteristics of TCM syndromes before and after transplantation were summarized,and the distribution of TCM syndromes before and after transplantation was preliminarily discussed by cluster analysis,and the change rules of TCM syndromes before and after transplantation were summarized,so as to provide corresponding objective theoretical basis for TCM clinical diagnosis and treatment of this disease.Methods:A cross-sectional research method was used to collect the TCM syndrome information of hematological patients who underwent allogeneic hematopoietic stem cell transplantation in the Department of Hematology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine from May 2020 to November 2021,one week before transplantation and 30 days after transplantation.The information items of the four TCM diagnoses of the transplanted patients were converted into counting data,and the database was established through WPS OFFICE.The presence or absence of symptoms was 1/0.The original data were imported into SPSS statistic 25.0 for cluster analysis.Taking the individual cases as variables,the Ward method(the least deviation from average square sum method)of cluster analysis was adopted,and the square Euclidean distance was selected for the calculation of distance.Finally,the TCM syndrome types of blood patients before and after transplantation were obtained.Chi-square test was used for the distribution and sex ratio of various diseases after clustering,and Kruskal-wallis H test was used for age.Results:1.A total of 51 patients with hematological diseases were enrolled in this study,with an average age of(27.92±14.03)years,and the ratio of male to female was 1.04:1.According to the disease types,the patients were divided into non-malignant hematological disease group(hereinafter referred to as"non-malignant group")and malignant hematological disease group(hereinafter referred to as"malignant group"),among which 31 patients were in the non-malignant group,17 were male and 14female,with a median age of 21.There were 20 cases in malignant group,including 9 males and 11 females,with a median age of 34(18-47)years;2.Qi deficiency syndrome and blood deficiency syndrome are the most common diseases of blood patients before transplantation,and the disease location is mainly concentrated in spleen,followed by kidney.After transplantation,there are many patients with qi deficiency syndrome,blood deficiency syndrome and blood stasis syndrome.The disease location is mainly concentrated in spleen and stomach,followed by kidney.There were significant differences in the distribution of disease factors and disease location factors before and after transplantation(P=0.016;P=0.016);The blood deficiency syndrome decreased significantly after transplantation,but the blood stasis syndrome increased significantly after transplantation,and the differences were statistically significant(x~2=15.987,P=0.00;X~2=6.411,P=0.011,P<0.05),the disease location in spleen and stomach increased after transplantation,and the differences were statistically significant(X~2=3.4.812,P=0.028;P=0.00),there was no significant difference in other syndrome elements;4.The top 15 symptoms of blood patients before transplantation are:fatigue,pale labial nail color,subcutaneous ecchymosis,sallow complexion,limb burnout,aversion to wind,dizziness,lack of breath,chest tightness,emaciation,pale complexion,palpitation,anorexia,mental fatigue and toothache;Before transplantation,the most common tongue images were white fur,pale fur and thick fur.The most common pulse condition is thin pulse,and the overall tongue pulse symptoms are mainly deficiency;The top 15symptoms in the back row of transplantation are:fatigue,anorexia,emaciation,chest tightness,anorexia,aversion to wind,pale lips,lack of breath and laziness,nausea,vomiting,dark complexion,limb burnout,chills,pale complexion and fullness;Before transplantation,the most common tongue images were tooth-marked tongue,white fur and thick fur.The most common pulse condition is thin pulse,and the symptom of tongue pulse is still deficiency.The frequency of symptoms related to spleen and stomach of middle energizer,such as anorexia,nausea,vomiting,anorexia,weak mouth,teeth-marked tongue and pulse,increased significantly after transplantation,and the symptoms related to blood stasis,such as dark complexion,purple lips,and astringent pulse,also increased to some extent after transplantation.The frequency of four diagnostic information related to blood deficiency,such as sallow complexion,pale labial nail and palpitation,decreased to some extent after transplantation.The frequency of symptoms related to qi deficiency,such as fatigue,limb burnout and mental fatigue,symptoms related to yin deficiency,such as five-upset fever,dry mouth and pulse count,and symptoms related to kidney,such as soreness and weakness of waist and knees,tinnitus and shortness of breath,changed little;5.Through cluster analysis,the syndrome types of patients with hematological diseases before transplantation are summarized as deficiency6.of both qi and yin,deficiency of both qi and blood,deficiency of blood by qi and blood,and deficiency of yang and blood stasis.After transplantation,the syndrome types are mainly deficiency of essence and blood,deficiency of spleen and dampness,deficiency of qi and blood stasis,and consumption of both qi and yin.There is no statistical difference in the overall distribution of syndrome types before and after transplantation in terms of disease types,sex and age.Conclusion:During allogeneic hematopoietic stem cell transplantation,the regularity of syndrome changes in patients with hematological diseases is always due to the fact that the deficiency is not recovered and the excess is gradually rising.The evolution of the disease is mainly based on the deficiency of qi and blood,and further evolves to the excess of blood stasis and dampness.The change of disease location involves many dirty organs,but the middle energizer and kidney are always important;In this study,the evolution of the pathogenesis of patients in the process of transplantation showed certain convergence,suggesting that the clinic can try to look at the post-transplantation state from a holistic perspective and intervene. |
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