摘要
目的:分析腹腔镜结直肠癌根治术患者术前体质及术后中医证候特征,探索其证候演变规律.方法:纳入广东省中医院胃肠外科2015年1月—2018年12月收治的179例行腹腔镜结直肠癌根治术患者,建立中医证候要素数据库,归纳总结高频证候要素及其中医证候演变规律.结果:术前体质:87.7％的患者为偏颇体质,其中虚证(气虚质、阴虚质、阳虚质)57例,占31.8％;实证(血瘀质、特禀质、痰湿质、气郁质和湿热质)100例,占55.9％;平和质22例,占12.3％;术前偏颇体质患者术后排气较平和质患者延迟.术后症状分布:术后1 d频次超过50％的症状依次为:肠鸣音异常、未排便、神疲、乏力、未排气、懒言、腹胀、气短8项;至术后4 d起,无超过50％的脾胃气虚气滞证证候要素;但出院当日仍有超过10％患者存在神疲、乏力、气短、懒言等虚证表现.术后证型演变规律:术后1 d,符合脾胃气虚气滞证的虚实夹杂证型有151例,占比84.4％,而虚证和实证表现的分别有16例和11例,均占比不足10％.至出院当日,仍有24.6％患者存在虚实夹杂表现,20.1％患者存在虚证表现.结论:腹腔镜结直肠癌根治术后患者以脾胃气虚气滞证为主要证型,术前偏颇体质患者更易产生排气排便延迟等胃肠功能障碍症状.
Abstract
Objective To explore the evolution of spleen and stomach Qi deficiency and Qi stagnation syndrome in patients undergoing laparoscopic radical resection of colorectal cancer by analyzing their preoperative distribution of TCM constitution and postoperative TCM syndrome elements.Methods 179 cases of laparoscopic radical resection of colorectal cancer admitted to the Gastrointestinal Surgery Department of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2015 to December 2018.Patients undergoing laparoscopic radical resection of colorectal cancer were included to establish a database of TCM syndrome elements for summarizing the high-frequency syndrome elements and evolution law.Results Preoperative distribution of TCM constitution:Before surgery,87.7％of patients had a biased constitution,including 57 cases of deficiency syndrome(Qi deficiency,Yin deficiency,Yang deficiency),accounting for 31.8％,100 cases of empirical syndrome(blood stasis,intrinsic quality,phlegm dampness,Qi stagnation,and damp heat),accounting for 55.9％,and 22 cases of peaceful quality,accounting for 12.3％.Postoperative symptom distribution:On the first day after surgery,the symptoms with a frequency exceeding 50％were:abnormal bowel sounds,no first bowel movement,mental fatigue,fatigue,no exhaust,lazy speech,abdominal distension,and shortness of breath.Starting from 4 days after surgery,there are no elements of spleen and stomach Qi deficiency and Qi stagnation syndrome with a frequency exceeding 50％.However,on the day of discharge,more than 10％of patients still exhibit deficiency symptoms such as fatigue,fatigue,shortness of breath,and lazy speech.The evolution law of postoperative TCM syndrome:On the first day after surgery,there were 151 cases of mixed syndrome of deficiency and excess that were consistent with spleen and stomach Qi deficiency and Qi stagnation syndrome,accounting for 84.4％.In addition,there were 16 cases of deficiency syndrome and 11 cases of excess syndrome,both accounting for less than 10％.On the day of discharge,24.6％of patients still had a mixture of deficiency and excess,and 20.1％of patients had deficiency symptoms.Conclusion After laparoscopic radical resection of colorectal cancer,the main symptoms are spleen and stomach Qi deficiency and Qi stagnation,and patients with preoperative biased constitution are more likely to experience gastrointestinal dysfunction symptoms,such as delayed exhaust and defecation.
基金项目
国家区域中医(专科)诊疗中心建设专项资金资助(国中医药医政函[2018]205号)
广东省中医院临床研究专项(YN10101902)
广州中医药大学"双一流"与高水平大学学科协同创新团队项目(2021xk48)
广州市科技计划项目(2024A03J0041)
维普
万方数据