目的:探讨恶性肿瘤患者使用免疫检查点抑制剂(Immune Checkpoint Inhibitors,ICI)治疗后发生腹泻的中医证型分布,并研究患者的基本资料、饮酒史、发病季节、治疗史、腹泻严重程度分级、远处转移、Karnofsky功能状态评分法(Karnofsky Performance Status Scale,KPS)评分与中医证型分布的相关性.方法:收集使用ICI治疗后发生腹泻的54例就诊于辽宁中医药大学附属医院的肿瘤患者的临床资料,使用SPSS软件统计分析患者发生腹泻的中医证型分布特点,并研究患者的年龄、性别、饮酒史、发病季节、化疗史、靶向治疗史、腹泻严重程度分级、远处转移、KPS评分与腹泻中医证型分布是否具有相关性.结果:ICI治疗后肿瘤患者腹泻的中医证型分布共有 4 类,分别为脾胃虚弱证、湿热内蕴证、脾肾阳虚证、肝郁脾虚证,其中脾胃虚弱证例数最多,湿热内蕴证例数最少.患者的年龄、饮酒史、化疗史、远处转移、KPS评分在中医证型分布上存在差异性,差异具有统计学意义(P＜0.05).对差异有统计学意义的单因素进行多因素回归分析后,发现化疗史和远处转移是独立影响因素.结论:肿瘤患者ICI治疗后腹泻的中医证型以脾胃虚弱证为主;年龄、饮酒史、化疗史、远处转移、KPS评分与中医证型分布有关;既往有化疗患者发生的腹泻偏于脾胃虚弱证,远处转移这一因素会使证型偏向脾肾阳虚证.
An analysis of TCM syndrome type distribution and related factors of diarrhea in tumor patients after immunotherapy
Objective:To explore the distribution of TCM syndrome types of diarrhea in patients with malignant tumor after ICI treatment,and to study the correlation between patients'basic information,drinking history,onset season,treatment history,diarrhea severity grade,distant metastasis,and KPS score and TCM syndrome types distribution.Methods:The clinical data of 54 tumor patients with diarrhea after ICI treatment in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine was collected,and the distribution characteristics of TCM syndrome types in patients with diarrhea were statistically analyzed using SPSS software.The correlation between the patients'age,gender,drinking history,onset season,chemotherapy history,targeted therapy history,diarrhea severity grade,distant metastasis,KPS score and TCM syndrome distribution of diarrhea was studied.Results:The TCM syndrome types of diarrhea in patients treated by ICI were divided into 4 categories,which were spleen and stomach weakness syndrome,damp-heat intrinsic syndrome,deficiency of spleen and kidney Yang(阳)syndrome,and liver depression and deficiency of spleen syndrome.Among them,spleen and stomach weakness syndrome had the largest number and damp-heat intrinsic syndrome had the least number.Patients'age,drinking history,chemotherapy history,distant metastasis and KPS score were different in TCM syndrome type distribution,with statistical significances(P<0.05).Multivariate regression analysis of single factor with a statistical significance differency showed that chemotherapy history and distant metastasis were independent factors.Conclusion:The spleen and stomach weakness syndrome was the main symptom of diarrhea after ICI treatment.Age,drinking history,chemotherapy history,distant metastasis and KPS score were related to the distribution of TCM syndromes.The syndrome type of diarrhea in patients with previous chemotherapy tends to be the spleen and stomach weakness syndrome,and the factor of distant metastasis make the syndrome tends to be the spleen and deficiency of kidney Yang syndrome.
NETL
NSTL
万方数据
维普
