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ObjectiveTo explore the distribution and characteristics of traditional Chinese medicine （TCM） syndromes in patients with endometriosis （EMS）. MethodA cross-sectional survey was conducted to analyze the characteristics of TCM syndromes in 1 895 cases of EMS in hospitals of 19 provinces， autonomous regions， and municipalities. ResultAmong the 1 895 patients， Qistagnation and blood stasis syndrome accounted for the highest proportion， followed by Qi deficiency and blood stasis syndrome， cold coagulation and blood stasis syndrome， and kidney deficiency and blood stasis syndrome. The distribution of TCM syndrome types of patients with EMS in different regions， different treatment stages， and different disease types and with different therapeutic goals was different， and the differences were statistically significant. However， under different conditions， the Qi stagnation and blood stasis syndrome accounted for the highest proportion. Under the stratification of different regions， the cold coagulation and blood stasis syndrome in north China was relatively high， the kidney deficiency and blood stasis syndrome in south China was relatively high， and the combined phlegm and stasis syndrome was relatively high in southwest China. Different diagnosis and treatment goals corresponded to different clinical syndromes. With pelvic pain as the main manifestation， the proportion of cold coagulation and blood stasis syndrome was higher. The proportion of kidney deficiency and blood stasis syndrome was higher in married patients with infertility. Patients with the main diagnosis and treatment goals of controlling mass and inhibiting recurrence had a higher proportion of Qi deficiency and blood stasis syndrome. In different treatment stages， the proportion of Qi deficiency and blood stasis syndrome in postoperative patients and those with recurrent EMS was higher. Among different disease types， the Qi deficiency and blood stasis syndrome accounted for a higher proportion in patients with ovarian endometriosis （OEM）. The cold coagulation and blood stasis syndrome accounted for a higher proportion in patients with deep invasive endometriosis （DIE）. The kidney deficiency and blood stasis syndrome accounted for a higher proportion in patients with peritoneal EMS. There were significant differences in age， body mass index （BMI）， and course of disease among patients with different syndromes. Patients with Qi deficiency and blood stasis syndrome was relatively older， and their course of the disease was relatively long. Patients with combined phlegm and stasis syndrome had relatively high BMI. There was no significant difference in CA125 and CA199 levels among all syndrome types. ConclusionThe distribution of TCM syndromes of EMS has a certain regularity， and there are differences in regional distribution， therapeutic goals， treatment stages， and disease types（P<0.05）. However， the Qi stagnation and blood stasis syndrome accounts for a large proportion under different conditions， suggesting that Qi stagnation is the key link of EMS. In the early stage， the team took relieving depression and activating blood as the primary treatment， and created Huoxue Xiaoyi prescription， which was the core prescription for the treatment of EMS with Qi stagnation and blood stasis syndrome， achieving good clinical effect. At the same time， it is emphasized that EMS treatment should be integrated into the concept of chronic disease management and combined with health management. Through psychological counseling， cognitive behavior intervention， popular science lectures， and other methods， it is advised to adjust the emotion of patients with EMS， thereby increasing the curative effect. This study is expected to provide references for the clinical treatment of EMS.
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Background:At present,domestic guidelines and consensus recommend the use of nutritional risk screening 2002(NRS 2002)and patient-generated subjective global assessment(PG-SGA)for nutritional risk screening and assessment of patients with gastrointestinal cancer during the perioperative period.However,PG-SGA has higher professional requirements,complex content and time-consuming.In the current busy situation of medical staff,NRS 2002 is more used for screening alone.Aims:To explore the consistency of NRS 2002 and PG-SGA in the assessment of nutritional status and clinical outcomes in patients with gastrointestinal malignancies,and to explore the accuracy of screening using NRS 2002 alone,so as to provide guidance for the establishment of clinical nutritional screening and assessment standards.Methods:A retrospective analysis was conducted on 157 patients with gastrointestinal malignancies who underwent radical operation in the Department of Gastrointestinal Surgery of Xiangya Hospital,Central South University from January 2020 to October 2022.Nutritional screening and evaluation were performed by NRS 2002 and PG-SGA scales and demographic data and nutrition-related laboratory indicators were collected to observe short-term postoperative clinical outcomes.Results:Patients with nutritional risk or malnutrition had lower body mass index(BMI),lymphocytes and prealbumin(P<0.05).The correlation and consistency of NRS 2002 and PG-SGA scales were good(r=0.728,κ=0.46)and the areas under the curve(AUC)for predicting postoperative complications were 0.691 and 0.702,respectively.In addition,nutritional risk and postoperative complications were significantly increased in patients with malnutrition(P<0.05).Conclusions:Therefore,gastrointestinal surgeons can only use NRS2002 to perform nutritional screening of patients and make corresponding nutritional treatment according to the screening results in the case of busy clinical work.
