Characteristics of Traditional Chinese Medicine Syndrome Elements of Advanced Pancreatic Cancer and Regional Distribution Difference between North and South China： Analysis of 256 Cases

JIANG Juling; LIU Rui; CHENG Mengqi; PANG Bo; ZHENG Honggang; HUA Baojin

doi:10.13288/j.11-2166/r.2023.06.010

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Characteristics of Traditional Chinese Medicine Syndrome Elements of Advanced Pancreatic Cancer and Regional Distribution Difference between North and South China： Analysis of 256 Cases

更新时间：2023-03-13

- Characteristics of Traditional Chinese Medicine Syndrome Elements of Advanced Pancreatic Cancer and Regional Distribution Difference between North and South China： Analysis of 256 Cases
- Journal of Traditional Chinese Medicine Vol. 64, Issue 6, Pages: 593-599(2023)
- 作者机构：
  
  1.中国中医科学院西苑医院，北京市海淀区西苑操场1号，100091
  2.中国中医科学院广安门医院
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2023.06.010
  CLC：
- Received：27 May 2022，
  
  Revised：2022-12-25，
  
  Published：17 March 2023
- 稿件说明：
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姜菊玲,刘瑞,程孟祺等.256例晚期胰腺癌患者中医证素特征及南北差异分析[J].中医杂志,2023,64(06):593-599.

JIANG Juling,LIU Rui,CHENG Mengqi,et al.Characteristics of Traditional Chinese Medicine Syndrome Elements of Advanced Pancreatic Cancer and Regional Distribution Difference between North and South China： Analysis of 256 Cases[J].Journal of Traditional Chinese Medicine,2023,64(06):593-599.
姜菊玲,刘瑞,程孟祺等.256例晚期胰腺癌患者中医证素特征及南北差异分析[J].中医杂志,2023,64(06):593-599. DOI： 10.13288/j.11-2166/r.2023.06.010.

JIANG Juling,LIU Rui,CHENG Mengqi,et al.Characteristics of Traditional Chinese Medicine Syndrome Elements of Advanced Pancreatic Cancer and Regional Distribution Difference between North and South China： Analysis of 256 Cases[J].Journal of Traditional Chinese Medicine,2023,64(06):593-599. DOI： 10.13288/j.11-2166/r.2023.06.010.

摘要

目的

探析晚期胰腺癌证素分布特征及南北差异，为中医胰腺癌证候研究及诊疗提供参考。

方法

回顾性收集不同地域256例晚期胰腺癌患者的临床资料，建立EpiData数据库。以秦岭-淮河自然地理分界线为南北地域划分依据，对患者就诊医院所处地理位置及久居地进行综合判断，将患者分为南方组和北方组，对256例总体及不同地域（南方组和北方组）晚期胰腺癌患者的病位证素、病性证素进行描述统计及关联分析，比较不同地域晚期胰腺癌证素差异。

结果

256例晚期胰腺癌患者主要病位证素为脾（681/692，98.41%）、肝（323/692，46.68%）、胃（297/692，42.92%）。病位在脾、胃的南方组患者多于北方组，病位在肝、胆、肾、肺的北方组患者多于南方组（

＜0.05或

＜0.01）；病位在心者两组差异无统计学意义（

＞0.05）。主要病性证素为气滞（639/692，92.34%）、气虚（571/692，82.51%）、湿（350/692，50.58%）。病性证素为气滞、气虚的南方组多于北方组，湿、血瘀、痰、热、阳虚、寒的北方组高于南方组（

＜0.05或

＜0.01）。病性-病位二项关联分析结果显示，南方组和北方组均为气滞+脾组合支持度（94.50%、89.38%）最高。三项关联分析结果显示，南方组和北方组均为气虚+气滞+脾组合支持度（81.00%、74.66%）最高。

结论

晚期胰腺癌的核心病位在脾，主要病位还包括肝、胃。南方患者病位证素以脾、胃为主，北方患者病位证素除脾、胃外，还涉及肝、胆、肾、肺。气滞、气虚、湿、血瘀、痰、热是主要病性证素。南方患者病性证素以气滞、气虚为主，北方患者病性证素除气滞、气虚外，还涉及湿、血瘀、痰、热、阳虚、寒。脾虚（脾气虚）与气滞是晚期胰腺癌的核心病机。

Abstract

Objective

To explore the characteristics of the syndrome elements of advanced pancreatic cancer （APC） and its distribution difference in south and north China， and to provide support for the research on the traditional Chinese medicine （TCM） syndromes of APC as well as the diagnosis and treatment in clinical practice.

Methods

The clinical data of 256 APC patients from different regions were retrospectively collected to establish the EpiData database. The patients were divided into south China group and north China group by comprehensive judgment of the geographical location of the hospitals and the permanent residence of the patients， taking the natural geographical boundary of Qinling Moutains-Huaihe River as the division line of the north and the south China. The syndrome elements related to the nature and the location of APC were descriptively analyzed in overall 256 patients and those in the south and north China separately， and the differences of syndromes of APC were compared between different regions.

Results

The main syndrome elements related to disease location in 256 APC patients were spleen （681/692， 98.41%）， liver （323/692， 46.68%）， and stomach （297/692， 42.92%）. There were more cases in the south China group than in the north group where diseases were located at the spleen and the stomach， while in the north China group more were located at the liver， gallbladder， kidney and lung （

＜0.05 or

＜0.01）. In terms of the disease location at the heart， there was no significant difference between the groups （

＞0.05）. The main syndrome elements of disease nature were

stagnation（639/692， 92.34%），

deficiency（571/692， 82.51%） and dampness（350/692， 50.58%）. When comparing the syndrome elements of disease nature between the different regions of China，

stagnation and

deficiency were more frequent in the south China group， while dampness， blood stasis， phlegm， heat，

yang

deficiency and cold were more common in the north China group（

＜0.05 or

＜0.01）. The location-nature binomial association analysis showed that the combination of spleen and

stagnation had the highest support（94.50%， 89.38%） in both the south and the north groups. The association analysis of there variables showed that the combination of spleen plus

deficiency plus

stagnation had the highest support（81.00%， 74.66%）in both the south group and the north group.

Conclusion

The core location of APC is at the spleen， and the main sites also include liver and stomach. Spleen and stomach are the main syndrome elements of disease location in the south， while additionally liver， gallbladder， kidney and lung are also involved in the north. The main syndrome elements related to the nature of APC are

stagnation，

deficiency， dampness， blood stasis， phlegm and heat. The syndrome elements in the south are mainly

stagnation and

deficiency； in the north， dampness， blood stasis， phlegm， heat，

yang

deficiency and cold are also involved in addition. Spleen deficiency（

deficiency） and

stagnation are the core pathogenesis of APC.

关键词

Keywords

references

SUNG H ， FERLAY J ， SIEGEL RL ， et al . Global Cancer Statistics 2020： GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries ［J］. CA Cancer J Clin ， 2021 ， 71 （ 3 ）： 209 - 249 .

MOYER MT ， GAFFNEY RR . Pancreatic adenocarcinoma ［J］. N Engl J Med ， 2014 ， 371 （ 22 ）： 2139 - 2141 .

VINCENT A ， HERMAN J ， SCHULICK R ， et al . Pancreatic cancer ［J］. The Lancet ， 2011 ， 378 （ 9791 ）： 607 - 620 .

SCHNELLDORFER T ， WARE AL ， SARR MG ， et al . Long-term survival after pancreatoduodenectomy for pancreatic adenocarcinoma： is cure possible？［J］. Ann Surg ， 2008 ， 247 （ 3 ）： 456 - 462 .

GARRIDO-LAGUNA I ， HIDALGO M . Pancreatic cancer： from state-of-the-art treatments to promising novel therapies ［J］. Nat Rev Clin Oncol ， 2015 ， 12 （ 6 ）： 319 - 334 .

王馨慧，刘小英，付文胜 . 胰腺癌的中医药治疗研究进展［J］. 中国中西医结合消化杂志， 2022 ， 04 ： 303 - 307 .

ZHAO C ， GAO F ， LI Q ， et al . The distributional characteristic and growing trend of pancreatic cancer in China ［J］. Pancreas ， 2019 ， 48 （ 3 ）： 309 - 314 .

张晓晓，孙珏，张强，等 . 中医方案治疗晚期胰腺癌的临床分析［J］. 上海中医药大学学报， 2015 ， 29 （ 3 ）： 44 - 49 .

潘岩，刘鲁明，陈震，等 . 中西医结合治疗190例老年胰腺癌的预后分析［J］. 临床肝胆病杂志， 2014 ， 30 （ 4 ）： 330 - 334 .

LI M ， WANG MM ， GUO XW ， et al . Different survival benefits of Chinese medicine for pancreatic cancer： how to choose？［J］. Chin J Integr Med ， 2018 ， 24 （ 3 ）： 178 - 184 .

刘槟，张培彤 . 胰腺癌证候研究现状评述［J］. 中医杂志， 2018 ， 59 （ 15 ）： 1342 - 1345 .

朱文锋，张华敏 . “证素”的基本特征［J］. 中国中医基础医学杂志， 2005 ， 11 （ 1 ）： 17 - 18 .

中国抗癌协会胰腺癌专业委员会 . 中国胰腺癌综合诊治指南（2020版）［J］. 中华外科杂志， 2021 ， 59 （ 2 ）： 81 - 100 .

白雪莉，马涛，梁廷波 . 美国癌症联合委员会第8版胰腺癌分期系统更新简介及解读［J］. 中国实用外科杂志， 2017 ， 37 （ 2 ）： 146 - 148 .

ALLEN PJ ， KUK D ， CASTILLO CF ， et al . Multi-institutional validation study of the American Joint Commission on Cancer（8th edition） changes for T and N staging in patients with pancreatic adenocarcinoma ［J］. Ann Surg ， 2017 ， 265 （ 1 ）： 185 - 191 .

黎敬波，马力 . 中医临床常见症状术语规范（修订）［M］. 北京：中国医药科技出版社， 2015 .

国家技术监督局 . 中医临床诊疗术语：证候部分［M］．北京：中国标准出版社， 1997 .

朱文锋 . 证素辨证学［M］. 北京：人民卫生出版社， 2008 .

张百平 . 中国南北过渡带研究的十大科学问题［J］. 地理科学进展， 2019 ， 38 （ 3 ）： 305 - 311 .

李建超，彭俊，彭清华，等 . 证素及证素辨证研究的思考［J］. 湖南中医药大学学报， 2016 ， 36 （ 2 ）： 3 - 8 .

王彤，吴承玉，杨涛 . 278例胰腺癌证素特征分析［J］. 中国实验方剂学杂志， 2016 ， 22 （ 12 ）： 220 - 223 .

周灏 . 中医藏象脾的实体探析［J］. 光明中医， 2014 ， 29 （ 1 ）： 8 - 9 .

史玉聪，陈孝银 . 中医之胰探微［J］. 实用中医内科杂志， 2018 ， 32 （ 3 ）： 65 - 68 .

刘华，伍静，孙铜林 . 柴芍六君子汤辅助化疗治疗肝郁脾虚型中晚期胰腺癌临床研究［J］. 中国中医药信息杂志， 2018 ， 25 （ 2 ）： 26 - 29 .

马义斌，付海强 . 脾病传肝论治［J］. 新中医， 2016 ， 48 （ 5 ）： 3 - 6 .

姜菊玲，袁奕昕，刘瑞，等 . 从“气机升降”与“传舍”理论浅析胰腺癌转移的病机［J］. 北京中医药， 2020 ， 39 （ 11 ）： 1184 - 1188 .

陈慧芳，曾柏荣 . 从气机升降理论论治胰腺癌［J］. 中国民族民间医药， 2021 ， 30 （ 10 ）： 77 - 79，83 .

盛险峰 . 论淮河在中国古代南北方的分界地位［J］. 古代文明， 2008 ， 2 （ 1 ）： 55 - 64 .

黄大未，杨晋翔，魏玥，等 . 中国南北方地区慢性萎缩性胃炎中医证候对比研究［J］. 北京中医药大学学报， 2013 ， 36 （ 11 ）： 783 - 785 .

黄志杰 . 南北地域病证及治疗特点考辨［J］. 中医函授通讯， 2000 ， 19 （ 2 ）： 13 - 14 .

周明爱，周东浩，李正光，等 . 中医“脾”“胰”辨［J］. 光明中医， 2011 ， 26 （ 3 ）： 417 - 419 .

高宇，马云飞，陈宇晗，等 . 基于癌毒学说论治肿瘤经验［J］. 辽宁中医杂志， 2021 ， 48 （ 12 ）： 42 - 45 .

何姝霖，刘瑞，花宝金 . 花宝金以扶正培本法为基础治疗肿瘤经验［J］. 辽宁中医杂志， 2015 ， 42 （ 9 ）： 1624 - 1625，1822 .

蔡明财，吕伟凤，于晓，等 . 因地制宜思想对中医治疗学的影响［J］. 吉林中医药， 2017 ， 37 （ 11 ）： 1085 - 1088 .

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