大肠癌脾气虚证辨证量化标准的研究

doi:10.3736/jcim20090903

Abstract

Objective

To set a quantified diagnostic standard for large intestinal cancer of spleen qi deficiency syndrome.
Methods

The spleen qi deficiency syndrome was identified by experts on the basis of clinical epidemiological investigation of 311 patients suffering from large intestinal cancer. Corresponding points were assigned to the correlative factors (traditional Chinese medicine symptoms) on the basis of symptom differences between spleen qi deficiency syndrome and non-spleen-qi-deficiency syndrome. The best threshold was determined by receiver operating characteristic curve (ROC) according to syndrome differentiation from expert team, and the quantified diagnostic standard was established. The syndrome identification from the expert team which was regarded as golden standard was tested retrospectively.
Results

All the traditional Chinese medicine symptoms possibly related to spleen qi deficiency syndrome were analyzed based on the opinions of experts, and 28 symptoms were confirmed as candidate correlative factors. The occurrence of 11 symptoms between spleen qi deficiency syndrome and non-spleen-qi-deficiency syndrome showed statistical differences by means of crosstabs analysis (P<0.05). The 11 symptoms were filtered by logistic regression analysis, and tiredness, fatigue, loose stool, and poor appetite were finally determined as the symptoms relative to large intestinal cancer. These four symptoms were analyzed with conditional probability conversion and endowed with 16, 11, 4 and 8 points respectively. The diagnostic standard of spleen qi deficiency syndrome of large intestinal cancer was over 13 points. The sensitivity, specificity and accuracy of retrospective examination were all above 80%, and its positive likelihood ratio was 9.89.
Conclusion

The quantified diagnostic standard for spleen qi deficiency syndrome of large intestinal cancer is in accordance with clinical characteristics of large intestine cancer and the characteristics of TCM syndrome diagnosis.

Key words: Intestinal cancer, Spleen qi deficiency, Syndrome differentiation, Epidemiology

Feng-gang Hou , Yi Cen, Jian Guan, Ling-yun Zhu, Xiao-ling Yin. Quantified diagnositic standard for large intestinal cancer of spleen qi deficiency syndrome. Journal of Chinese Integrative Medicine, 2009, 7(9): 814-818.

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URL: http://www.jcimjournal.com/EN/10.3736/jcim20090903

http://www.jcimjournal.com/EN/Y2009/V7/I9/814

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References 12

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Xj	Xjk	Spleen qi deficiency (n=239)				Non-spleen-qi-deficiency (n=72)
Xj	Xjk	Frequency	P (%)	Absolute lijk	Frequency	P (%)	Absolute lijk	Opposite lijk of correlative factors	Points
Tiredness	0	54	22.59	3.54	66	91.67	9.62	–15.76	16
	1	185	77.41	8.89	6	8.33	–0.79
Fatigue	0	108	45.19	6.55	66	91.67	9.62	–11.25	11
	1	131	54.81	7.39	6	8.33	–0.79
Loose stool	0	166	69.46	8.42	61	84.72	9.28	–3.87	4
	1	73	30.54	4.85	11	15.28	1.84
Poor appetite	0	131	54.81	7.39	64	88.89	9.49	–8.19	8
	1	108	45.19	6.55	8	11.11	0.46

Points (threshold)	Sensitivity	1–specificity	Points (threshold)	Sensitivity	1–specificity
–1.00	1.000	1.000	21.50	0.590	0.042
2.00	0.941	0.333	23.50	0.586	0.042
6.00	0.874	0.208	25.50	0.494	0.042
9.50	0.862	0.139	27.50	0.360	0.042
11.50	0.837	0.097	29.50	0.339	0.042
13.50	0.824	0.083	33.00	0.280	0.028
15.50	0.808	0.083	37.00	0.054	0.000
17.50	0.690	0.042	40.00	0.000	0.000
19.50	0.661	0.042

Points (threshold)	Sensitivity (%)	Specificity (%)	1–specificity (%)	Points (threshold)	Sensitivity (%)	Specificity (%)	1–specificity (%)
8	87.45	79.17	20.83	13	82.43	91.67	8.33
9	86.19	86.11	13.89	14	82.43	91.67	8.33
10	86.19	86.11	13.89	15	82.43	91.67	8.33
11	86.19	86.11	13.89	16	80.75	91.67	8.33
12	83.68	90.28	9.72	17	69.04	95.79	4.21

Criteria	Differentiation criteria for expert
Criteria	Positive	Negative	Total
Quantitative criteria
Positive	197(a)	6(b)	203
Negative	42(c)	66(d)	108
Total	239	72	311

Quantified diagnositic standard for large intestinal cancer of spleen qi deficiency syndrome

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