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目的:研究老年晚期非小细胞肺癌患者氩氦刀冷冻治疗前后的证候类型分布及变化规律,探讨主要证候要素及其影响因素。方法:共收集104例患者,分别于术前1天、术后1周、术后1个月、术后3个月进行辨证,总结证候类型变化规律。结果:(1)104例患者在4个时点共出现27个中医证型,主要以气虚痰湿、气虚痰湿+其他要素、气虚+其他要素3种形式为主。(2)获取病性类证候要素共8个,出现频次排前4位的有气虚(84例)、痰湿(61例)、阴虚(63例)、血瘀(23例)。各时点气虚证素证素频次在疾病发展过程中始终保持较高水平。(3)在证型虚实方面,各时点均以虚实夹杂证最多,虚实夹杂证术后3月例数(74例)比术前(59例)增多,差异具有统计学意义(P<0.05)。(4)气虚为最主要的证候要素,其影响因素为年龄和PS评分,随着年龄增长和PS评分升高,气虚发生风险越高。结论:气虚合并其他要素是老年晚期非小细胞肺癌患者贯穿氩氦刀冷冻治疗前后最主要的证型;年龄>75岁和PS评分升高,气虚发生风险更高。
OBJECTIVE: To study the distribution and variation of syndrome types before and after Cryosurgery in elderly patients with advanced non-small cell lung cancer (NSCLC), and discuss the main syndromes and their influencing factors. Methods: A total of 104 patients were collected, one day before surgery, one week after surgery, one month after surgery and three months after operation. The syndrome types were summarized. Results: (1) A total of 27 TCM syndromes were found in 104 patients at 4 time points, mainly in the forms of Qi-deficiency and phlegm-dampness, phlegm-dampness + other factors, Qi deficiency and other factors. (2) There were 8 elements of pathological syndromes, 84 cases of phlegm (61 cases), 63 cases of Yin deficiency (63 cases) and 23 cases of blood stasis (4 cases). Qi deficiency syndrome at all times the frequency of prime factors in the disease development process has always been to maintain a high level. (3) In the aspect of the syndromes of the syndromes, the syndromes of the actuals and the patients were the most in all time points, and the number of cases in March (74 cases) increased more than that before the operation (P <0.05) ). (4) qi deficiency is the most important syndrome elements, the influencing factors are age and PS score, with age and PS score increased, the higher the risk of qi deficiency. Conclusion: The combination of Qi deficiency and other factors is the most important syndrome before and after cryosurgery treatment in elderly patients with advanced non-small cell lung cancer. Patients aged 75 years or older with PS score have a higher risk of Qi deficiency.