| Purpose of research:The distribution and variation of TCM syndrome types in patients with esophageal cancer before and after radiotherapy were summarized,and the relationship between TCM syndrome types,clinical characteristics and laboratory indicators before and after radiotherapy was discussed,so as to provide objective basis for syndrome differentiation and classification of esophageal cancer,and give full play to the advantages of integrated Chinese and western medicine in the treatment of disease.Research methods:A total of 168 patients with esophageal cancer from September 2020to March 2022 were selected from the Department of Radiotherapy of Gansu Cancer Hospital,Gansu Provincial People’s Hospital and the First Hospital of Lanzhou University who met the inclusion criteria.The four diagnosis information was collected clinically,and the clinical Observation Form was filled in.The syndrome differentiation was conducted based on the four diagnosis information,and the distribution and change of TCM syndrome types before and after radiotherapy were summarized.Multiple Logistic regression method was used to study the influencing factors of TCM syndrome types before and after radiotherapy,and univariate analysis of variance was used to compare the differences between groups.Results:1.Distribution of TCM syndrome types in patients with esophageal cancer before radiotherapy:the syndrome of phlegm and blood stasis(43.4%)>that of phlegm and qi obstruction(32.1%)>that of yin deficiency and internal heat(20.2%)>that of qi deficiency and yang deficiency(5.4%).The syndrome of phlegm and qi obstruction and blood stasis and phlegm obstruction were the main TCM syndromes of esophageal carcinoma before radiotherapy.2.The distribution of TCM syndrome types in patients with esophageal cancer after radiotherapy was as follows:Yin deficiency and internal heat syndrome(45.8%)>blood stasis and phlegm stagnation syndrome(26.8%)>Qi deficiency and Yang micro syndrome(17.3%)>Spittoon and qi deficiency and Yang micro syndrome(10.1%).TCM syndrome types after radiotherapy were mainly Yin deficiency and internal heat syndrome.3.Comparison of TCM syndrome types before and after radiotherapy:the syndrome of spittoon and gas interresistance decreased from 32.1%before radiotherapy to 10.1%,reducing by 22%;the syndrome of blood stasis and phlegm stagnation decreased from 43.4%before radiotherapy to 26.8%,which decreased by 16.6%;the syndrome of Yin deficiency and internal heat increased from 20.2%to 45.8%,increasing by 25.6%;the syndrome of qi deficiency and Yang increased 11.9%from 5.4%to 17.3%before radiotherapy.TCM syndrome type change before and after the radiotherapy chi-square,X~2=52.293,P<0.001,the changes of TCM syndrome types in patients with esophageal cancer before and after radiotherapy were statistically significant,and the difference was significant.4.The relationship between TCM syndrome types and clinical characteristics of patients with esophageal cancer before and after radiotherapy:multiple Logistic regression analysis showed that TCM syndrome types of patients with esophageal cancer before radiotherapy were correlated with gender,age,site of disease,KPS score and myelosuppression grade(P<0.05);TCM syndrome type was correlated with KPS score,short-term efficacy and myelosuppression grade after radiotherapy(P<0.05).5.The clinical objective index level the differences between different syndrome types after radiation therapy:(1)The different TCM syndrome types in the WBC(F=8.316,P=0.000)statistically significant differences in the distribution of;Between two groups:deficiency of fame with nitrogen resistance syndrome,blood stasis,phlegm stagnation syndrome,Yin deficiency and internal(P=0.000,P=0.000,P=0.001)compared with the difference is statistically significant.(2)The TCM syndrome type of Hb(F=8.043,P=0.000)statistically significant differences in the distribution of;Compare between two groups,nitrogen transresistance certificate Yin asthenia and internal heat,deficiency and fame card(P=0.000,P=0.000)compared with the differences statistically significant;Yin asthenia and internal heat,deficiency and blood stasis and phlegm stagnation syndrome fame card(P=0.034,P=0.001)compared with the difference is statistically significant.(3)The TCM syndrome type of CEA(Z=15.147,P=0.002)in the distribution of the difference is statistically significant;Comparison between groups:blood stasis and phlegm stagnation syndrome nitrogen transresistance Yin asthenia and internal heat,deficiency syndrome,fame card compared(P=0.024,P=0.001,P=0.001)difference is statistically significant.(4)The TCM syndrome type in SCC(Z=10.124,P=0.018),the distribution of the difference of statistical learning significance;Yin asthenia and internal heat and compare between two groups,nitrogen transresistance syndrome,blood stasis phlegm stagnation(P=0.023,P=0.004)compared with the difference is statistically significant.(5)The TCM syndrome type of CA19-9(Z=6.344,P=0.096)there was no statistically significant difference of distribution.(6)The TCM syndrome types of CYFRA21-1(Z=7.391,P=0.060)the distribution of the difference have no sense of statistics.Conclusion:The distribution of TCM syndrome types in patients with esophageal cancer before and after radiotherapy showed a certain regularity,and the probability of TCM syndrome type changing into Yin deficiency and internal heat syndrome increased after radiotherapy.The type of TCM syndrome before radiotherapy was correlated with sex,age,site of disease,KPS score,myelosuppression score and grade of radiation esophagitis.The TCM syndrome type was correlated with KPS score,short-term efficacy and myelosuppression score after radiotherapy.The clinical objective index of white blood cells,hemoglobin,carcinoembryonic antigen,scaly skin cells antigens in esophageal cancer after radiotherapy differences between different TCM syndrome type distribution. |
