摘要
目的观察中医药联合辅助化疗对早期非小细胞肺癌术后患者舌象变化规律的影响。方法将149例Ib-Ⅲa期非小细胞肺癌术后患者随机分为治疗组(79例)和对照组(70例),两组术后均予辅助化疗,治疗组在辨证的基础上加予中药治疗,对照组在辨证的基础上加予中药安慰剂治疗。28d为1个疗程,共治疗4个疗程,分别于化疗前、第一疗程后、第二疗程后、第三疗程后采用TDA-1小型舌象仪收集舌象数据,观察舌象变化情况。结果①第一疗程后与化疗前组内比较,治疗组各舌象参数差异无统计学意义(P>0.05),对照组舌苔指数taiClrL、taiClrR、taiClrG、taiClrB、taiClrI、taiClrY值升高(P<0.05),舌质指数zhiClrY值升高(P<0.05);第二疗程后与化疗前组内比较,两组各舌象参数差异无统计学意义(P>0.05);第三疗程后与化疗前组内比较,治疗组各舌象参数差异无统计学意义(P>0.05),对照组舌质指数zhiClrL、zhiClrB、zhiClrG、zhiClrI、zhiClrY值升高(P<0.05),zhiClrLa、zhiClrS值下降(P<0.05),舌苔指数taiClrL、taiClrR、taiClrG、taiClrB、taiClrI、taiClrY值升高(P<0.05),taiClrLa、taiClrS值下降(P<0.05)。②组间第一疗程后比较,治疗组taiClrLb、taiClrH值低于对照组(P<0.05),zhiClrCb、taiClrCb值高于对照组(P<0.05);组间第二疗程后、第三疗程后比较,各舌象参数差异无统计学意义(P>0.05)。③气虚型患者分层分析,第一疗程后与化疗前组内比较,治疗组ZhiR、TaiR值下降(P<0.05),对照组taiClrL、TaiG、zhiClrB、zhiClrG、taiClrR、taiClrG、taiClrB、taiClrI、taiClrY值升高(P<0.05),taiClrLa、ZhiR、TaiR,zhiClrS、taiClrS值下降(P<0.05);第二疗程后与化疗前组内比较,治疗组各舌象参数差异无统计学意义(P>0.05),对照组ZhiG、TaiG值升高(P<0.05),zhiClrLa、taiClrLa、ZhiR、zhiClrS、zhiClrCr、taiClrCr值下降(P<0.05);第三疗程后与化疗前组内比较,治疗组各舌象参数差异无统计学意义(P>0.05),对照组zhiClrL、taiClrL、ZhiG、TaiG、zhiClrB、zhiClrR、zhiClrG、taiClrR、taiClrG、taiClrB、zhiClrI、taiClrI、zhiClrY、taiClrY值升高(P<0.05),zhiClrLa、taiClrLa、ZhiR、TaiR、zhiClrS、taiClrS、taiClrCr值下降(P<0.05)。④气虚型患者分层分析,组间第一疗程后比较,治疗组zhiClrL、zhiClrR、zhiClrI、zhiClrY、zhiCon、zhiENT、zhiMEAN、taiClrH、taiCon、taiENT、taiMEAN值低于对照组(P<0.05),zhiASM值高于对照组(P<0.05);组间第二疗程后比较,治疗组TaiG、taiClrH值低于对照组(P<0.05),舌苔红色成分taiClrLa值高于对照组(P<0.05);组间第三疗程后比较,zhiClrI值低于对照组(P<0.05)。结论化疗后,早期非小细胞肺癌术后患者舌质转淡、转紫,舌苔变厚,中医辨证论治可增加患者舌质的红色成分,降低舌质亮度,使舌质颜色由淡向淡红转变,舌质、舌苔纹理变得更细腻,舌苔由厚向薄转化。
Objective To observe the changes of tongue image parameters in patients with early non-small cell lung cancer(NSCLC)treated by Chinese herbal medicine(CHM)combined with chemotherapy.Methods Totally 149 postoperative NSCLC patients with stage Ib-IIIa were randomly divided into two groups with 79 cases in the treatment group and 70 in the control group.Both groups were treated with chemotherapy after operation.Based on syndrome differentiation,the treatment group was also treated with CHM and the control group with placebo.Twenty-eight days was considered as one course of treatment,and the treatment consisted of 4 courses.Before the treatment and after the first,second,and third chemotherapy,tongue image data was collected by the TDA-1 small tongue imager to observe the change of tongue image.Results①After the first course of treatment,compared with the group before chemotherapy,there was no significant difference in tongue parameters in the treatment group(P>0.05);the tongue coating index taiClrL taiClrR,taiClrG,taiClrB,taiClrI,and taiClrY increased(P<0.05),and the tongue quality index zhiClrY increased(P<0.05)in the control group.After the second course of treatment,compared with the group before chemotherapy,there was no significant difference in tongue parameters between the two groups(P>0.05).After the third course of treatment,compared with the group before chemotherapy,there was no significant difference in tongue parameters in the treatment group(P>0.05);the tongue quality index zhiClrL,zhiClrB,zhiClrG,zhiClrI and zhiClrY increased(P<0.05),and the values of zhiClrLa,zhiClrS decreased in the control group(P<0.05);the tongue coating indexes taiClrL,taiClrR,taiClrG,taiClrB,taiClrI,and taiClrY increased(P<0.05),and the values of taiClrLa and taiClrS decreased in the control group(P<0.05).②Compared between groups after the first course of treatment,the values of taiClrLb and taiClrH in the treatment group were lower than those in the control group(P<0.05),and the values of zhiClrCb and taiClrCb were higher than those in the control group(P<0.05).There was no significant difference in tongue parameters between the groups after the second course and after the third course(P>0.05).③In the subgroup analysis of patients with qi deficiency syndrome,after the first course of treatment and compared with those before chemotherapy,the values of ZhiR and TaiR decreased in the treatment group(P<0.05),the values of taiClrL,TaiG,zhiClrB,zhiClrG,taiClrR,taiClrG,taiClrB,taiClrI and taiClrY increased(P<0.05),and the values of taiClrLa,ZhiR,TaiR,zhiClrS and taiClrS decreased in the control group(P<0.05);after the second course of treatment,there was no significant difference in tongue parameters in the treatment group compared with those before chemotherapy(P>0.05);in the control group,the values of ZhiGr and TaiG were higher than those before chemotherapy(P<0.05),and the values of zhiClrLa,taiClrLa,ZhiR,zhiClrS,zhiClrCr,and taiClrCr were lower than those before chemotherapy(P<0.05);after the third course of treatment,compared with those before chemotherapy,there was no significant difference in the parameters of tongue in the treatment group(P>0.05);after the third course of treatment,the values of zhiClrL,taiClrL,ZhiG,TaiG,zhiClrB,zhiClrR,zhiClrG,taiClrR,taiClrG,taiClrB,zhiClrI,taiClrI,zhiClrY and taiClrY increased(P<0.05),and the values of zhiClrLa,taiClrLa,ZhiR,TaiR,zhiClrS,taiClrS and taiClrCr decreased(P<0.05)in the control group.④In the subgroup analysis of the patients qi deficiency syndrome,the values of zhiClrL,zhiClrR,zhiClrI,zhiClrY,zhiCon,zhiENT,zhiMEAN,taiClrH,taiCon,taiENT and taiMEAN were lower(P<0.05),and zhiASM value was higher in the treatment group than in the control group after the first course of treatment(P<0.05);After the second course of treatment,the values of TaiG and taiClrH in the treatment group were lower than those of the control group(P<0.05),and taiClrLa value of the red tongue coating was higher than that of the control group(P<0.05);after the third course of treatment,the value of ZhiClrI was lower than that of the control group(P<0.05).Conclusion After chemotherapy,the tongue quality of early NSCLC patients became pale and purple and tongue coating thickened.The treatment based on traditional Chinese medicine(TCM)syndrome differentiation can increase the red component of tongue quality,reduce the brightness of tongue quality,and make tongue color change from light to light red,tongue quality,tongue coating texture become more delicate,tongue coating change from thick to thin.
作者
焦丽静
李嘉旗
龚亚斌
陈佩奇
许玲
JIAO Lijing;LI Jiaqi;GONG Yabin;CHEN Peiqi;XU Ling(Institute of Clinical Immunology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Department I of Oncology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Tumor Institute of Traditional Chinese Medicine,Shanghai Academy of Traditional Chinese Medicine,Shanghai 200032,China)
出处
《上海中医药杂志》
2020年第2期21-27,共7页
Shanghai Journal of Traditional Chinese Medicine
基金
上海市科委科研计划项目(16401970700)
中华中医药学会青年人才托举工程项目(QNRC2-C15).
关键词
非小细胞肺癌
早期
术后
辅助化疗
中医药疗法
舌象
舌诊仪
non-small cell lung cancer
early stage
postoperation
adjuvant chemotherapy
TCM therapy
tongue image
tongue diagnostic instrument
作者简介
焦丽静,女,硕士,助理研究员,主要从事中医药治疗恶性肿瘤的研究工作;通讯作者:许玲,主任医师,博士研究生导师。E-mail:xulq67@aliyun.com
