【摘要】 目的：分析宫颈癌放射性直肠炎（RP）中医证候分布规律及特点，探讨其影响因素与证候分布的相关性。方法：选取2020年1月至2023年12月在山西省中医药研究院肿瘤科住院部收治的424例宫颈癌RP患者，统计并分析个人资料、中医证候信息、既往治疗情况等。结果：424例宫颈癌RP患者临床主要表现为里急后重感、便血、肛门疼痛、腹泻、腹痛、黏液脓血便等。中医证候分布按频次从高到低依次为热毒伤络证、阴虚津亏证、寒热错杂证、脾虚湿阻证、脾肾阳虚证。中医证候在临床分期、肿瘤大小、放疗时间、RTOG/EORTC分级、平均受照剂量、RP分期、盆腔炎症、肠道息肉等分组分析中存在显著性差异（P<0.01,P<0.05）。Logistic回归分析提示，临床分期Ⅲ～Ⅳ期与阴虚津亏证、脾肾阳虚证呈正相关；肿瘤大小>4 cm、放疗时间>6周、平均受照剂量>60 Gy、盆腔炎症均与热毒伤络证、阴虚津亏证呈正相关；热毒伤络证的发生与RTOG/EORTC分级呈负相关，但和阴虚津亏证呈正相关；阴虚津亏证、脾肾阳虚证的发生与RP分期呈负相关；肠道息肉与寒热错杂证呈正相关。结论：宫颈癌RP患者的中医证型以热毒伤络证最为多见。患者的临床分期、肿瘤大小、放疗时间、RTOG/EORTC分级、平均受照剂量、RP分期、盆腔炎症、肠道息肉等均是中医证候的影响因素。更多还原

【Abstract】 Objective: To analyze the distribution pattern and characteristics of traditional Chinese medicine(TCM) syndromes in cervical cancer-related radiation proctitis(RP), and to explore the correlation between its influencing factors and syndrome distribution. Methods: A total of 424 patients with cervical cancer-related RP admitted to the Department of Oncology, Shanxi Academy of Traditional Chinese Medicine from January 2020 to December 2023 were enrolled. Personal data, TCM syndrome information, and previous treatment history were collected and analyzed. Results: The main clinical manifestations of the 424 patients with cervical cancer-related RP included tenesmus, hematochezia, anal pain, diarrhea, abdominal pain, and mucosanguineous stools. The distribution of TCM syndromes in descending order of frequency was: syndrome of toxin damaging the collateral vessels due to heat, syndrome of yin deficiency and fluid depletion, syndrome of intermingled heat and cold, syndrome of spleen deficiency and dampness obstruction, and syndrome of spleen-kidney yang deficiency. Significant differences were observed in the distribution of TCM syndromes across subgroups of clinical stage, tumor size, radiotherapy duration, RTOG/EORTC grade, mean radiation dose, RP stage, pelvic inflammation, and intestinal polyps(P<0.01, P<0.05). Logistic regression analysis indicated that clinical stage Ⅲ–Ⅳ was positively correlated with syndrome of yin deficiency and fluid depletion and syndrome of spleen-kidney yang deficiency; tumor size >4 cm, radiotherapy duration >6 weeks, mean radiation dose >60 Gy, and pelvic inflammation were positively correlated with syndrome of toxin damaging the collateral vessels due to heat and syndrome of yin deficiency and fluid depletion; the occurrence of syndrome of toxin damaging the collateral vessels due to heat was negatively correlated with RTOG/EORTC grade but positively correlated with syndrome of yin deficiency and fluid depletion; the occurrence of syndrome of yin deficiency and fluid depletion and syndrome of spleen-kidney yang deficiency was negatively correlated with RP stage; and intestinal polyps were positively correlated with syndrome of intermingled heat and cold. Conclusion: The most common TCM syndrome type in patients with cervical cancer-related RP is syndrome of toxin damaging the collateral vessels due to heat. Clinical stage, tumor size, radiotherapy duration, RTOG/EORTC grade, mean radiation dose, RP stage, pelvic inflammation, and intestinal polyps are all influencing factors for TCM syndromes.更多还原