摘要
目的:研究恶病质的发生规律,分析影响生存期的因素,为进一步前瞻性临床研究提供研究依据。方法:制订病例调查表,主要以体质量为指标采集近4年在西苑医院肿瘤科住院治疗的癌症恶病质病例,调查患者一般情况、相关生化指标和中医证型变化,进行治疗方式多因素分析。结果:癌症恶病质几乎可以发生于各种肿瘤,生存期为(179±12)d,中位生存期149d。生存时间与患者肿瘤类型、分期、转移情况均无直接联系,而与静点扶正中药和中医食疗的治疗影响呈正相关(t=2.17,P<0.034;t=1.99,P=0.05)。甲羟孕酮和静脉高营养的干预并未使患者的生存期显著延长。癌症恶病质患者的生活质量和营养状况呈恶化趋势,中医证型转归由阴虚证和阳虚证趋向阴阳两虚证,各虚证证型对生存期的影响不显著(χ2=3,P=0.22)。结论:恶病质临床特征符合中医“虚证”表现,属“虚劳”范畴,中医证型的转归符合中医证型转化的特点,扶正制剂在恶病质阶段能够扶助衰竭患者的正气,燮理阴阳,增强对抗肿瘤的能力。基于恶病质治疗现状,应着重于发挥中医整体观念和辨证论治的优势,从“虚”入手,扶正为本,以期最大限度提高患者的生活质量,延长生存期。
AIM:To study occur rule of cancer cachexia,and to a na lyze the factors that influence the survival time so as to p rovide evidences f or more prospective clinical study.METHODS:Questionaries were made by investig ating recent 4-year cancer cachexia patients hospitalizing in the Department of Oncology of Xiyuan Hos-pital by an index of body mass.Multip le linear regr ession result was anal yzed in common conditions and variation of c orrelated bi ochemistry and traditi onal Chinese medicine(TCM)syndrome distribution of canc er cachexia patients.RESULTS:Cancer cachexia almost took place in various kind s of tumors,especially in old males with survival time of(179±12)d and median survival time of 149d.Multiple linear regression result showed that the survival time presented positive correlation wit h TCM strengthening the b ody resista nce injection and TCM diet therapy(t=2.17,P<0.034;t= 1.99,P=0.05),but no correlation with type of tumors,stage of TNM an d metasta-sis.Intervention of provera and int ravenous hyperalimentation of fa t m ilk could not prolong the suvival time notably.TCM syndrome distribution sh owed s ig-nificant difference compared with p retreatment and post-treatment w it h ten-dency from yin or yang deficiency syndrome to both yin and yang defici ency according to the characteristic of s yndrome transformation.Every type of de-ficiency syndrome had no notable eff ect on survival time (χ 2 =3,P=0.22).Clinical characteristic of cancer c achexis accords with defi-ciency syndrome of TCM.TCM should br ing its unique superio rity into full play.According to cachexia characteristic of deficiency syndrome ,TCM mainly depends on differentiation o
出处
《中国临床康复》
CSCD
2004年第2期286-287,共2页
Chinese Journal of Clinical Rehabilitation
