中晚期非小细胞肺癌气虚证分布与生活质量研究

作者	单位
张培彤	中国中医科学院广安门医院肿瘤科
袁琳	中国中医科学院广安门医院肿瘤科
杨宗艳	中国中医科学院广安门医院肿瘤科
王娜	中国中医科学院广安门医院肿瘤科

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中文摘要:

目的探讨中晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者气虚证的分布与生活质量。方法应用"肺癌患者生活质量测定量表FACT-L(4·0)中文版"对120例中晚期NSCLC患者进行问卷调查,同时进行辨证分型。利用辨证分型结果,围绕气虚证将不同证型患者进行分组比较,探讨中晚期NSCLC气虚证的分布,研究气虚证相关的生活质量特点。结果 120例中晚期NSCLC患者证候以气虚、血瘀、阴虚、痰湿为主,112例中所占比例较大的证型依次为气虚单证34例(30·36%),气虚血瘀证型21例(18·75%),气阴两虚证型12例(10·71%)。气虚证的出现与年龄、性别、病理分型(腺癌/鳞癌)、病程长短无相关性;Ⅳ期NSCLC患者多合并有气虚证(P<0·05)。FACT-L量表的生理状况、情感状况、功能状况项目评分及总分比较,气虚证组(89例)低于非气虚证组(31例),差异有统计学意义(P<0·01,P<0·05)。FACT-L量表的肺癌特异性模块(附加关注领域)评分显示气虚血瘀证>气虚单证>气阴两虚证,差异有统计学意义(P<0·05)。结论气虚证是中晚期NSCLC的主要证型。气虚证患者的生活质量低于非气虚证患者,且随着气虚证加重,生活质量有所降低,提示临床对症治疗气虚证可以有效提高中晚期NSCLC患者的生活质量。

英文摘要:

Objective To study the qi deficiency syndrome distribution and quality of life (QOL) of patients with advanced non-small cell lung cancer (NSCLC). Methods A questionnaire survey was conducted in 120 patients with advanced NSCLC using the QOL scale "Functional Assessment of Cancer Therapy" (FACT-L) (Version 4.0). Meanwhile, syndrome typing was performed. On the basis of results of syndrome typing, patients of different syndrome types were grouped and compared, thus studying the distribution of advanced NSCLC patients of qi deficiency syndrome and qi deficiency syndrome correlated QOL features. Results Qi deficiency, blood stasis, yin deficiency, phlegm and dampness dominated in syndrome types of the 120 patients with advanced NSCLC. Of syndrome types accounting for larger ratios in 112 patients, pure qi deficiency syndrome accounted for 30.36% (34 cases), qi deficiency and blood stasis syndrome for 18.75% (21 cases), both qi and yin deficiency syndrome for 10.71% (12 cases). There was no correlation between the appearance of qi deficiency syndrome and patients′ age, sex, pathological typing (adencarcinoma/squamous carcinoma), or the disease duration. NSCLC patients in phase Ⅳ were mostly complicated with qi deficiency syndrome (P<0.05). Scores of physical states, emotional states, functional states, and total scores in the FACT-L scale were lower in those complicated with qi deficiency syndrome (89 cases) than in those without complicated qi deficiency syndrome (31 cases), showing statistical difference (P<0.01, P<0.05). The scores of the lung cancer specific module (additional concerns) in the FACT-L scale showed statistical difference, sequenced as qi deficiency and blood stasis syndrome>pure qi deficiency syndrome>both qi and yin deficiency syndrome (P<0.05). Conclusions Qi deficiency syndrome is the main syndrome of advanced NSCLC. The QOL of advanced NSCLC patients complicated with qi deficiency syndrome was poorer than those without complicated qi deficiency syndrome. Besides, along with the aggravation of qi deficiency syndrome, the QOL decreased somewhat. It suggested that symptomatic treatment of qi deficiency syndrome could improve advanced NSCLC patients′ QOL.

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