宫颈癌放射性直肠炎中医证候分布规律及影响因素分析OA

Objective:To analyze the distribution pattern and characteristics of traditional Chinese medicine(TCM)syndromes in cervical cancer-related radiation proctitis(RP),and to explore the correlation between its influencing factors and syndrome distribution.Methods:A total of 424 patients with cervical cancer-related RP admitted to the Department of Oncology,Shanxi Academy of Traditional Chinese Medicine from January 2020 to December 2023 were enrolled.Personal data,TCM syndrome information,and previous treatment history were collected and analyzed.Results:The main clinical manifestations of the 424 patients with cervical cancer-related RP included tenesmus,hematochezia,anal pain,diarrhea,abdominal pain,and mucosanguineous stools.The distribution of TCM syndromes in descending order of frequency was:syndrome of toxin damaging the collateral vessels due to heat,syndrome of yin deficiency and fluid depletion,syndrome of intermingled heat and cold,syndrome of spleen deficiency and dampness obstruction,and syndrome of spleen-kidney yang deficiency.Significant differences were observed in the distribution of TCM syndromes across subgroups of clinical stage,tumor size,radiotherapy duration,RTOG/EORTC grade,mean radiation dose,RP stage,pelvic inflammation,and intestinal polyps(P＜0.01,P＜0.05).Logistic regression analysis indicated that clinical stage Ⅲ-Ⅳ was positively correlated with syndrome of yin deficiency and fluid depletion and syndrome of spleen-kidney yang deficiency;tumor size＞4 cm,radiotherapy duration＞6 weeks,mean radiation dose＞60 Gy,and pelvic inflammation were positively correlated with syndrome of toxin damaging the collateral vessels due to heat and syndrome of yin deficiency and fluid depletion;the occurrence of syndrome of toxin damaging the collateral vessels due to heat was negatively correlated with RTOG/EORTC grade but positively correlated with syndrome of yin deficiency and fluid depletion;the occurrence of syndrome of yin deficiency and fluid depletion and syndrome of spleen-kidney yang deficiency was negatively correlated with RP stage;and intestinal polyps were positively correlated with syndrome of intermingled heat and cold.Conclusion:The most common TCM syndrome type in patients with cervical cancer-related RP is syndrome of toxin damaging the collateral vessels due to heat.Clinical stage,tumor size,radiotherapy duration,RTOG/EORTC grade,mean radiation dose,RP stage,pelvic inflammation,and intestinal polyps are all influencing factors for TCM syndromes.