中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

Distribution pattern of traditional Chinese medicine syndromes and analysis of influencing factors in pancreatic cancer

DOI: 10.12449/JCH250320
Research funding:

The Fourth National Medical Master Inheritance Workshop (Teaching Letter of the Chinese Medicine Administrator 2022245 1123-04);

Construction of the National TCM Inheritance and Innovation Center (202203);

Shanxi Provincial Natural Science Basic Surface Project (202103021224437);

Shanxi Provincial Clinical Medical Research Center of Traditional Chinese Medicine (Cultivation) (Jinke She [2019] No.61);

Shanxi Provincial Medical Science and Technology Innovation Team Project of Shanxi Provincial Health Commission (2020TD04);

Shanxi Provincial Medical Science and Technology Major Science and Technology Research Special Project of Shanxi Provincial Health Commission (2022XM10)

More Information
  • Corresponding author: WANG Xixing, wangxx315@163.com (ORCID: 0000-0003-2444-7248)
  • Received Date: 2024-08-13
  • Accepted Date: 2024-08-28
  • Published Date: 2025-03-25
  •   Objective  To investigate the influencing factors for traditional Chinese medicine (TCM) syndromes in pancreatic cancer by analyzing 608 cases, and to provide a theoretical reference for TCM syndrome differentiation and standardized treatment of pancreatic cancer.  Methods  A total of 608 patients with a pathological or clinical diagnosis of pancreatic cancer who were admitted to Shanxi Institute of Traditional Chinese Medicine, The Affiliated Hospital of Shanxi University of Chinese Medicine, and Shanxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to December 2023 were enrolled, and TCM syndrome differentiation was performed. The chi-square test was used for comparison of categorical data between groups. The clinical data with statistical significance between groups were included in the regression analysis, and the unordered polytomous logistic regression model was used to investigate the influencing factors for the TCM syndrome of pancreatic cancer.  Results  For the 608 patients with pancreatic cancer, common initial symptoms included abdominal pain (32.40%), abdominal distension (23.85%), fatigue (16.12%), and emaciation (10.03%), and the main clinical symptoms included poor appetite (75.97%), abdominal pain (67.27%), fatigue (61.84%), abdominal distension (57.40%), and emaciation (53.62%). There were significant differences between the patients with different TCM syndromes of pancreatic cancer in sex (χ2=62.823, P<0.001), disease duration (χ2=14.868, P=0.011), clinical stage (χ2=21.006, P<0.001), lymph node metastasis (χ2=2.205, P=0.032), surgery (χ2=38.008, P<0.001), chemotherapy (χ2=21.384, P<0.001), radiotherapy (χ2=17.510, P=0.004), and immunotherapy (χ2=18.573, P=0.002). The logistic regression analysis showed that male sex was a protective factor against Qi and blood deficiency syndrome (odds ratio [OR]=0.081, 95% confidence interval [CI]: 0.031‍ ‍—‍ ‍0.213, P<0.001), Qi stagnation and blood stasis syndrome (OR=0.100, 95%CI: 0.041‍ ‍—‍ ‍0.247, P<0.001), and syndrome of Yin deficiency with internal heat (OR=0.158, 95%CI: 0.057‍ ‍—‍ ‍0.444, P<0.001), while it was a risk factor for the syndrome of damp-heat accumulation (OR=2.378, 95%CI: 1.074‍ ‍—‍ ‍5.266, P=0.033); the course of the disease of<1 year was a protective factor against Qi and blood deficiency syndrome (OR=0.167, 95%CI: 0.073‍ ‍—‍ ‍0.383, P<0.001), syndrome of spleen-kidney Yang deficiency (OR=0.183, 95%CI: 0.089‍ ‍—‍ ‍0.378, P<0.001), and syndrome of Yin deficiency and internal heat (OR=0.164, 95%CI: 0.070‍ ‍—‍ ‍0.385, P<0.001); clinical stage Ⅰ/Ⅱ/Ⅲ was a risk factor for damp-heat accumulation (OR=2.793, 95%CI: 1.259‍ ‍—‍ ‍6.196, P=0.012) and Qi stagnation and blood stasis syndrome (OR=7.863, 95%CI: 2.808‍ ‍—‍ ‍22.020, P<0.001); lymph node metastasis was a risk factor for Qi and blood deficiency syndrome (OR=4.005, 95%CI: 1.477‍ ‍—‍ ‍10.861, P=0.006); surgical treatment was a risk factor for Qi and blood deficiency syndrome (OR=4.151, 95%CI: 1.916‍ ‍—‍ ‍8.995, P<0.001), syndrome of spleen-kidney yang deficiency (OR=5.352, 95%CI: 2.436‍ ‍—‍ ‍11.759, P<0.001), Qi stagnation and blood stasis syndrome (OR=2.334, 95%CI: 1.071‍ ‍—‍ ‍5.088, P=0.033), and syndrome of Yin deficiency and internal heat (OR=4.167, 95%CI: 1.789‍ ‍—‍ ‍9.707, P<0.001); chemotherapy was a protective factor against damp-heat accumulation (OR=0.188, 95%CI: 0.082‍ ‍—‍ ‍0.428, P<0.001); radiotherapy was a risk factor for damp-heat accumulation (OR=2.571, 95%CI: 1.151‍ ‍—‍ ‍5.746, P=0.021) and syndrome of Yin deficiency with internal heat (OR=8.384, 95%CI: 3.348‍ ‍—‍ ‍20.997, P<0.001); immunotherapy was a risk factor for Qi and blood deficiency syndrome (OR=2.114, 95%CI: 1.021‍ ‍—‍ ‍4.379, P=0.044).  Conclusion  Sex, course of the disease, clinical stage, presence or absence of lymph node metastasis, surgery, chemotherapy, radiotherapy, and immunotherapy are the main influencing factors for the TCM syndrome of pancreatic cancer.

     

  • [1]
    LI TJ, YE LY, JIN KZ, et al. Advances in basic research, clinical diagnosis and treatment of pancreatic cancer in 2023[J]. China Oncol, 2024, 34( 1): 1- 12. DOI: 10.19401/j.cnki.1007-3639.2024.01.001.

    李天骄, 叶龙云, 金凯舟, 等. 2023年度胰腺癌研究及诊疗新进展[J]. 中国癌症杂志, 2024, 34( 1): 1- 12. DOI: 10.19401/j.cnki.1007-3639.2024.01.001.
    [2]
    KHALAF N, EL-SERAG HB, ABRAMS HR, et al. Burden of pancreatic cancer: From epidemiology to practice[J]. Clin Gastroenterol Hepatol, 2021, 19( 5): 876- 884. DOI: 10.1016/j.cgh.2020.02.054.
    [3]
    SIEGEL RL, MILLER KD, FUCHS HE, et al. Cancer statistics, 2022[J]. CA Cancer J Clin, 2022, 72( 1): 7- 33. DOI: 10.3322/caac.21708.
    [4]
    Chinese Society for Clinical Oncologists, Expert Committee on Pancreatic Diseases, China International Exchange and Promotive Association for Medical and Health Care, Expert Committee on Abdominal Neoplasms, China Medicine Education Association. Expert consensus on the MDT model of pancreatic cancer in China(2020 version)[J]. J Clin Hepatol, 2020, 36( 9): 1947- 1951. DOI: 10.3969/j.issn.1001-5256.2020.09.007.

    中国医师协会肿瘤医师分会, 中国医疗保健国际交流促进会胰腺疾病专家委员会, 中国医药教育协会腹部肿瘤专家委员会. 中国胰腺癌多学科综合治疗模式专家共识(2020版)[J]. 临床肝胆病杂志, 2020, 36( 9): 1947- 1951. DOI: 10.3969/j.issn.1001-5256.2020.09.007.
    [5]
    CAO MM, CHEN WQ. Epidemiology of cancer in China and the current status of prevention and control[J]. Chin J Clin Oncol, 2019, 46( 3): 145- 149. DOI: 10.3969/j.issn.1000-8179.2019.03.246.

    曹毛毛, 陈万青. 中国恶性肿瘤流行情况及防控现状[J]. 中国肿瘤临床, 2019, 46( 3): 145- 149. DOI: 10.3969/j.issn.1000-8179.2019.03.246.
    [6]
    HUA YQ, LIU LM, CHEN Z, et al. Modern interpretation of the theoretical system of Chinese medicine syndrome treatment in pancreatic cancer[J]. Chin J Integr Tradit West Med, 2019, 39( 1): 107- 110. DOI: 10.7661/j.cjim.20181031.362.

    花永强, 刘鲁明, 陈震, 等. 胰腺癌中医证治理论体系的现代认识[J]. 中国中西医结合杂志, 2019, 39( 1): 107- 110. DOI: 10.7661/j.cjim.20181031.362.
    [7]
    WANG XH, LIU XY, FU WS. Research progress of TCM therapy for pancreatic cancer[J]. Chin J Integr Trad West Med Dig, 2022, 30( 4): 303- 307.

    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, 30( 4): 303- 307.
    [8]
    HUANG JH, ZHONG MZ, CAO PG. Diagnosis& treatment of clinical oncology[M]. Changsha: Hunan Science& Technology Press, 2010: 325- 329.

    黄俊辉, 钟美佐, 曹培国. 临床肿瘤诊断与治疗学[M]. 长沙: 湖南科学技术出版社, 2010: 325- 329.
    [9]
    General Office of National Health Commission. Standard for diagnosis and treatment of pancreatic cancer(2022 edition)[J]. J Clin Hepatol, 2022, 38( 5): 1006- 1015. DOI: 10.3969/j.issn.1001-5256.2022.05.007.

    国家卫生健康委办公厅. 胰腺癌诊疗指南(2022年版)[J]. 临床肝胆病杂志, 2022, 38( 5): 1006- 1015. DOI: 10.3969/j.issn.1001-5256.2022.05.007.
    [10]
    BAI XL, MA T, LIANG TB. Update of the 8th edition of AJCC cancer staging for pancreatic cancer[J]. Chin J Pract Surg, 2017, 37( 2): 146- 148. DOI: 10.19538/j.cjps.issn1005-2208.2017.02.11.

    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. DOI: 10.19538/j.cjps.issn1005-2208.2017.02.11.
    [11]
    ZHANG BL, WU MH. Internal medicine of traditional Chinese medicine[M]. Beijing: China Press of Traditional Chinese Medicine, 2017.

    张伯礼, 吴勉华. 中医内科学[M]. 北京: 中国中医药出版社, 2017.
    [12]
    HUANG LZ. Integrated traditional Chinese and western medicine oncology[M]. Beijing: China Press of Traditional Chinese Medicine, 2020: 231- 232.

    黄立中. 中西医结合肿瘤病学[M]. 北京: 中国中医药出版社, 2020: 231- 232.
    [13]
    LIN HS. Guidelines of diagnosis and therapy in oncology with traditional Chinese medicine[M]. Beijing: People’s Medical Publishing House, 2014: 400- 416.

    林洪生. 恶性肿瘤中医诊疗指南: 2014年版[M]. 北京: 人民卫生出版社, 2014: 400- 416.
    [14]
    LI JB, MA L. Terminology Specification for Common Clinical Symptoms of Traditional Chinese Medicine(Revised)[M]. Beijing: China Medical Science and Technology Press, 2015.

    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.
    [15]
    NI Y, GUO XD, WANG JX, et al. Review on traditional Chinese medicine treatment of pancreatic cancer[J]. J Basic Chin Med, 2023, 29( 12): 2117- 2122. DOI: 10.19945/j.cnki.issn.1006-3250.2023.12.010.

    倪琰, 郭晓冬, 王静霞, 等. 胰腺癌中医治疗评述[J]. 中国中医基础医学杂志, 2023, 29( 12): 2117- 2122. DOI: 10.19945/j.cnki.issn.1006-3250.2023.12.010.
    [16]
    MIAO R, ZHANG Z, LI FJ, et al. ZHANG Peitong’s clinical experience on treating pancreatic cancer with“strengthening body and treating cancer”[J]. Liaoning J Tradit Chin Med, 2023, 50( 9): 36- 39. DOI: 10.13192/j.issn.1000-1719.2023.09.008.

    缪锐, 张铮, 李凤杰, 等. 张培彤“扶正抗癌”治疗胰腺癌临床经验[J]. 辽宁中医杂志, 2023, 50( 9): 36- 39. DOI: 10.13192/j.issn.1000-1719.2023.09.008.
    [17]
    XIAO X, WANG XQ, ZUO JH, et al. JIA yingjie’s experience in treating pancreatic cancer based on the theory of“Chuzhuo Peiben”[J]. World Chin Med, 2023, 18( 19): 2811- 2814. DOI: 10.3969/j.issn.1673-7202.2023.19.018.

    肖贤, 王晓群, 左金辉, 等. 贾英杰“黜浊培本”论治胰腺癌经验撷英[J]. 世界中医药, 2023, 18( 19): 2811- 2814. DOI: 10.3969/j.issn.1673-7202.2023.19.018.
    [18]
    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. DOI: 10.3322/caac.21660.
    [19]
    YANG H, WANG XK, FAN JH. Present status of epidemiology, risk factors and screening of pancreatic cancer in China[J]. Cancer Res Prev Treat, 2021, 48( 10): 909- 915. DOI: 10.3971/j.issn.1000-8578.2021.21.0789.

    杨欢, 王晓坤, 范金虎. 中国胰腺癌流行病学、危险因素及筛查现况[J]. 肿瘤防治研究, 2021, 48( 10): 909- 915. DOI: 10.3971/j.issn.1000-8578.2021.21.0789.
    [20]
    MIDHA S, CHAWLA S, GARG PK. Modifiable and non-modifiable risk factors for pancreatic cancer: A review[J]. Cancer Lett, 2016, 381( 1): 269- 277. DOI: 10.1016/j.canlet.2016.07.022.
    [21]
    ZHAO JQ, XUE ZM, YANG JP, et al. A case-control study of the risk factors for pancreatic cancer[J]. J Mod Oncol, 2018, 26( 8): 1229- 1232. DOI: 10.3969/j.issn.1672-4992.2018.08.020.

    赵江桥, 薛芝敏, 杨佳平, 等. 胰腺癌相关危险因素的病例对照研究[J]. 现代肿瘤医学, 2018, 26( 8): 1229- 1232. DOI: 10.3969/j.issn.1672-4992.2018.08.020.
    [22]
    AFGHANI E, KLEIN AP. Pancreatic adenocarcinoma: Trends in epidemiology, risk factors, and outcomes[J]. Hematol Oncol Clin North Am, 2022, 36( 5): 879- 895. DOI: 10.1016/j.hoc.2022.07.002.
    [23]
    HALBROOK CJ, LYSSIOTIS CA, PASCA DI MAGLIANO M, et al. Pancreatic cancer: Advances and challenges[J]. Cell, 2023, 186( 8): 1729- 1754. DOI: 10.1016/j.cell.2023.02.014.
    [24]
    YAO DP, ZHANG PT. Analysis of syndrome prognosis of 106 cases of pancreatic cancer[J]. J Tradit Chin Med, 2016, 57( 23): 2017- 2020, 2024. DOI: 10.13288/j.11-2166/r.2016.23.010.

    姚大鹏, 张培彤. 106例胰腺癌患者证候转归情况分析[J]. 中医杂志, 2016, 57( 23): 2017- 2020, 2024. DOI: 10.13288/j.11-2166/r.2016.23.010.
  • Relative Articles

    [1]Zhiyao SHI, Xiaofei FAN, Yu GAO, Shaojian REN, Shiyu WU, Xixing WANG. The distribution pattern of traditional Chinese medicine syndromes and influencing factors for primary liver cancer: An analysis of 415 cases[J]. Journal of Clinical Hepatology, 2025, 41(1): 84-91. doi: 10.12449/JCH250113
    [2]Tianfu LIU, Liang WANG, Lingyi ZHANG. Risk factors for non-neoplastic portal vein thrombosis in patients with liver cirrhosis[J]. Journal of Clinical Hepatology, 2023, 39(9): 2122-2127. doi: 10.3969/j.issn.1001-5256.2023.09.014
    [3]Longzhu HAI, Qiangfu HU, Xiaoyong LI, Peilei GUO, Lingwei YANG. Risk factors for myocardial injury after Nano-Knife surgery in patients with pancreatic cancer[J]. Journal of Clinical Hepatology, 2022, 38(12): 2787-2792. doi: 10.3969/j.issn.1001-5256.2022.12.019
    [4]Chengsi ZHAO, Weijie YAO, Peng YUAN, Zuozheng WANG. Time distribution of risk factors for secondary pancreatic infection in acute pancreatitis[J]. Journal of Clinical Hepatology, 2022, 38(7): 1686-1690. doi: 10.3969/j.issn.1001-5256.2022.07.044
    [5]Yuling DUAN, Zanjie FENG, Guoxin FAN, Lei WANG, Kangwei LIU, Cijun PENG. Risk factors for open pancreatic necrosectomy in patients with severe acute pancreatitis: An analysis based on the surgical step-up approach[J]. Journal of Clinical Hepatology, 2021, 37(4): 893-897. doi: 10.3969/j.issn.1001-5256.2021.04.033
    [6]Chen XU, Wei YANG, Jie GU, Weizhong ZHOU, Haibin SHI. Incidence rates of hyperamylasemia and acute pancreatitis after percutaneous transhepatic biliary stenting and related risk factors[J]. Journal of Clinical Hepatology, 2021, 37(4): 882-887. doi: 10.3969/j.issn.1001-5256.2021.04.031
    [7]Yao ChengZi, Feng Gong, Yu WenSi, Du Huan, Mi Man. Risk factors for the development and progression of nonalcoholic fatty liver disease[J]. Journal of Clinical Hepatology, 2020, 36(2): 433-436. doi: 10.3969/j.issn.1001-5256.2020.02.044
    [8]Ren DanDan, Liu Na, Zhou LuLu, Zhang Nan, Li ChunXia, Dong Bing, Xu GuangHua. Risk factors for hepatitis B virus-related hepatocellular carcinoma[J]. Journal of Clinical Hepatology, 2020, 36(7): 1634-1638. doi: 10.3969/j.issn.1001-5256.2020.07.041
    [9]LIU Hui, LI XianQiu, LUO Gang, TANG ShiXiao. Risk factors for new-onset diabetes after incipient acute pancreatitis[J]. Journal of Clinical Hepatology, 2020, 36(12): 2771-2776. doi: 10.3969/j.issn.1001-5256.2020.12.026
    [10]Cao Yuan, Yao GuoXiang, Shi YiHai. An excerpt of international consensus guidelines for risk factors in chronic pancreatitis (2020)[J]. Journal of Clinical Hepatology, 2020, 36(8): 1720-1722. doi: 10.3969/j.issn.1001-5256.2020.08.008
    [11]Zheng WeiPing, Shen ZhongYang. Risk factors for tumor recurrence after liver transplantation for hepatocellular carcinoma and related control strategies[J]. Journal of Clinical Hepatology, 2019, 35(11): 2391-2395. doi: 10.3969/j.issn.1001-5256.2019.11.003
    [12]Lyu Jing, Dong SiSi, Gu HongTu, Zhao ZhangQing, Liu ChengHai. TCM syndrome characteristics of portal vein thrombosis in patients with liver cirrhosis and related risk factors[J]. Journal of Clinical Hepatology, 2019, 35(10): 2210-2213. doi: 10.3969/j.issn.1001-5256.2019.10.016
    [13]Wang XianPeng, Meng XianZhi. Risk factors for gallstones complicated by acute biliary pancreatitis[J]. Journal of Clinical Hepatology, 2018, 34(8): 1728-1732. doi: 10.3969/j.issn.1001-5256.2018.08.027
    [14]Gao LuHua, Nie QingHe. Research advances in molecular mechanism of mother-to-child transmission of HCV and related risk factors[J]. Journal of Clinical Hepatology, 2017, 33(6): 1082-1087. doi: 10.3969/j.issn.1001-5256.2017.06.013
    [15]Hu WeiLin. Risk factors for hypertriglyceridemia-induced acute pancreatitis[J]. Journal of Clinical Hepatology, 2017, 33(8): 1518-1521. doi: 10.3969/j.issn.1001-5256.2017.08.022
    [16]Wu XiaoQing, Wan Hong. Causes of liver failure and impact analysis of prognostic risk factors[J]. Journal of Clinical Hepatology, 2013, 29(4): 294-296+304.
    [17]Liao Juan, Yuan Cong, Liu Juan, Feng YingChun. Risk factors for peptic ulcer in patients with acute pancreatitis[J]. Journal of Clinical Hepatology, 2013, 29(7): 499-502. doi: 1001-5256 (2013) 07-0499-04
    [18]Dou WeiJia, Zhou Lin, Wu KaiChun. Risk factors of chronic pancreatitis[J]. Journal of Clinical Hepatology, 2011, 27(11): 1180-1183.
    [19]Wang Hong, Wang YingMin, Zhang Bo. Prospective analysis of risk factors for the occurrence of hepatocellular carcinoma in patients with post-hepatitis B cirrhosis[J]. Journal of Clinical Hepatology, 2007, 23(1): 34-35.
    [20]Wang Hong. Risk factors for patients with cirrhosis developed renal dysfunction[J]. Journal of Clinical Hepatology, 2004, 20(2): 101-102.
  • Created with Highcharts 5.0.7Amount of accessChart context menuAbstract Views, HTML Views, PDF Downloads StatisticsAbstract ViewsHTML ViewsPDF Downloads2024-052024-062024-072024-082024-092024-102024-112024-122025-012025-022025-032025-030204060
    Created with Highcharts 5.0.7Chart context menuAccess Class DistributionFULLTEXT: 30.3 %FULLTEXT: 30.3 %META: 62.9 %META: 62.9 %PDF: 6.7 %PDF: 6.7 %FULLTEXTMETAPDF
    Created with Highcharts 5.0.7Chart context menuAccess Area Distribution北京: 2.2 %北京: 2.2 %南宁: 1.1 %南宁: 1.1 %哥伦布: 1.1 %哥伦布: 1.1 %宣城: 1.1 %宣城: 1.1 %弗吉尼亚州: 1.1 %弗吉尼亚州: 1.1 %张家口: 21.3 %张家口: 21.3 %扬州: 1.1 %扬州: 1.1 %杭州: 1.1 %杭州: 1.1 %石家庄: 7.9 %石家庄: 7.9 %芒廷维尤: 32.6 %芒廷维尤: 32.6 %芝加哥: 5.6 %芝加哥: 5.6 %苏州: 1.1 %苏州: 1.1 %西宁: 6.7 %西宁: 6.7 %诺沃克: 1.1 %诺沃克: 1.1 %赣州: 1.1 %赣州: 1.1 %赤峰: 2.2 %赤峰: 2.2 %运城: 1.1 %运城: 1.1 %长春: 10.1 %长春: 10.1 %北京南宁哥伦布宣城弗吉尼亚州张家口扬州杭州石家庄芒廷维尤芝加哥苏州西宁诺沃克赣州赤峰运城长春

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(5)

    Article Metrics

    Article views (55) PDF downloads(6) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return