本文選題：疏肝補(bǔ)腎法 + 乳腺癌　； 參考：《廣州中醫(yī)藥大學(xué)》2017年博士論文

【摘要】：目的:1.觀察兩組乳腺癌類圍絕經(jīng)期綜合征患者治療前后血清性激素水平、T細(xì)胞亞群、血脂以及Kupperman積分、生活質(zhì)量(KPS)變化及證候積分變化,探討疏肝補(bǔ)腎作用的中藥組方(歸苓調(diào)經(jīng)湯)對乳腺癌類圍絕經(jīng)期綜合征發(fā)病過程中某些有代表性細(xì)胞因子的影響,揭示性激素水平與T細(xì)胞亞群失衡在乳腺癌類圍絕經(jīng)期綜合征的致病機(jī)理和相關(guān)調(diào)節(jié)作用,綜合客觀評價(jià)兩組方案對乳腺癌類圍絕經(jīng)期綜合征的影響與療效。2.揭示具有疏肝補(bǔ)腎作用的中藥組方(歸苓調(diào)經(jīng)湯)在治療乳腺癌類圍絕經(jīng)期綜合征過程中可能通過調(diào)控相關(guān)因子改善患者相關(guān)癥狀,以及歸苓調(diào)經(jīng)湯組方的安全性和有效性,為進(jìn)一步用于乳腺癌類圍絕經(jīng)期綜合征的預(yù)測及靶點(diǎn)治療提供理論及數(shù)據(jù)上的依據(jù),從古方基礎(chǔ)上多方位、多靶點(diǎn)和整體調(diào)節(jié)角度探索乳腺癌類圍絕經(jīng)期綜合征的治療新思路,為臨床診斷、治療提供新的視角。方法:選擇鄭州市腫瘤醫(yī)院腫瘤科住院部2015年12月～2016年12月符合收治入組條件的中醫(yī)辨證為肝郁腎虛型乳腺癌類圍絕經(jīng)期綜合征患者80人,按隨機(jī)數(shù)字法將患者隨機(jī)分為兩組,分別為治療組40例,對照組40例,對照組的患者給予常規(guī)谷維素、維生素B1對癥處理;治療組在對照組治療基礎(chǔ)上加服自擬歸苓調(diào)經(jīng)湯,對比觀察患者治療前后性激素水平、T細(xì)胞亞群、血脂、Kupperman積分、生活質(zhì)量(KPS)變化及證候積分、血常規(guī)及肝腎功能變化,以綜合評估歸苓調(diào)經(jīng)湯治療肝郁腎虛型乳腺癌類圍絕經(jīng)期綜合征的臨床療效和安全性,并揭示歸苓調(diào)經(jīng)湯干預(yù)、調(diào)節(jié)相關(guān)因子的作用機(jī)制,為進(jìn)一步中西醫(yī)研究提供科研理論依據(jù)。結(jié)果:觀察兩組治療前、后組內(nèi)與組間性激素水平、T細(xì)胞亞群、血脂、Kupperman積分、生活質(zhì)量(KPS)變化及證候積分情況,發(fā)現(xiàn)均有不同程度的變化;分別將兩組治療前、后性激素水平、T細(xì)胞亞群、血脂、Kupperman積分、生活質(zhì)量(KPS)變化及證候積分變化,進(jìn)行組內(nèi)比較,得出組內(nèi)治療前、后變化水平差值有統(tǒng)計(jì)學(xué)意義(P0.01)。比較治療后兩組組間性激素水平、T細(xì)胞亞群、血脂、Kupperman積分、生活質(zhì)量(KPS)變化及證候積分變化,發(fā)現(xiàn)治療組治療后性激素水平、T細(xì)胞亞群、血脂、Kupperman積分、生活質(zhì)量(KPS)變化及證候積分變化顯著高于對照組。將兩組治療前、后的差值分別經(jīng)獨(dú)立樣本t檢驗(yàn),得出P0.01,說明兩組間治療前后性激素水平、T細(xì)胞亞群、血脂、Kupperman積分、生活質(zhì)量(KPS)變化及證候積分變化差值比較有統(tǒng)計(jì)學(xué)意義。結(jié)論:1.兩組治療后均可使性激素水平、T細(xì)胞亞群、Kupperman積分、生活質(zhì)量(KPS)評分、證候積分、血脂不同程度改變,相關(guān)癥狀改善;組間比較變化、改善程度存在顯著差異,比較有統(tǒng)計(jì)學(xué)意義。2.歸苓調(diào)經(jīng)湯對肝郁腎虛型乳腺癌類圍絕經(jīng)期綜合征患者不僅可調(diào)節(jié)性激素水平/T細(xì)胞亞群失衡狀態(tài),促進(jìn)患者激素水平調(diào)節(jié)、增強(qiáng)機(jī)體免疫力、減輕藥物的毒副性、改善患者臨床癥狀和提高患者生活質(zhì)量。特別是在緩解潮熱盜汗、失眠、倦怠乏力、焦慮等方面顯著高于對照組。
[Abstract]:Objective: 1. to observe the serum sex hormone level, T cell subgroup, blood lipid and Kupperman score, the change of quality of life (KPS) and the change of syndrome score before and after treatment of the two groups of perimenopausal syndrome of breast cancer, and discuss some of the Chinese medicine groups (GUI Ling tonifying soup) for the liver and tonifying the kidney (GUI Ling tonifying soup) in the course of the pathogenesis of perimenopausal syndrome of breast cancer The effect of sex hormone level and T cell subgroup imbalance on the pathogenesis and regulation of perimenopausal syndrome of breast cancer, the effect of the two groups on the perimenopausal syndrome of breast cancer and the effect of.2. were evaluated. In the course of the treatment of perimenopausal syndrome of breast cancer, it is possible to improve the related symptoms by regulating the related factors, and the safety and effectiveness of the prescription of GUI Ling Jing Jing decoction, and provide the theoretical and data basis for the further use of the prediction and target treatment of the perimenopausal syndrome of breast cancer, and the multi-target and multi target on the basis of the ancient recipe. In order to provide a new perspective for the clinical diagnosis and treatment of perimenopausal syndrome of breast cancer, a new perspective on the treatment of perimenopausal syndrome of breast cancer is provided by the point and the overall adjustment angle. Method: the Chinese traditional medicine of the inpatient department of the oncology department of Zhengzhou city from December 2015 to December 2016 was based on the syndrome of the liver depression and kidney deficiency type of perimenopause syndrome of 8 patients. 0 people were randomly divided into two groups according to the random number method, which were 40 cases in the treatment group and 40 in the control group. The patients in the control group were given conventional orovidin and vitamin B1 treatment, and the treatment group was treated with the self-made GUI Ling regulating Decoction on the basis of the control group, and the level of sex hormone, the T cell subgroup, the blood lipid, and the Kupperman product before and after treatment were compared. The changes of quality of life (KPS), syndrome score, blood routine and liver and kidney function change, in order to comprehensively evaluate the clinical efficacy and safety of GUI Ling Jing Jing Decoction on the treatment of perimenopausal syndrome of breast cancer with liver depression and kidney deficiency, and reveal the mechanism of regulating the related factors to provide scientific research theory for further Chinese and Western medicine research. Results: before the treatment of the two groups, the levels of sex hormone, T cell subgroup, blood lipid, Kupperman score, quality of life (KPS) and syndrome integral were observed in the posterior group, and the levels of sex hormone, T subgroup, blood lipid, Kupperman score, quality of life (KPS), and syndrome product before the treatment of the two groups were observed. The difference between the two groups was statistically significant (P0.01). The levels of sex hormone, T cell subgroup, blood lipid, Kupperman score, quality of life (KPS) and syndrome scores were compared between the two groups after treatment, and the level of sex hormone, T cell subgroup, blood lipid, and Kupperman score after treatment were found. The change of quality of life (KPS) and the change of syndrome score were significantly higher than that of the control group. The difference between the two groups before and after the treatment was tested by independent sample t, and P0.01 was obtained. The difference between the levels of sex hormone, T cell subgroup, blood lipid, Kupperman score, quality of life (KPS) and the difference of syndrome integral changes before and after treatment were statistically significant. 1. the two groups can make the level of sex hormone, T cell subgroup, Kupperman integral, quality of life (KPS) score, syndrome score, different degree of blood lipid, and the improvement of the related symptoms; there is a significant difference in the degree of improvement between the groups, and the comparison is statistically significant to the comprehensive perimenopausal period synthesis of the liver qi stagnation and kidney deficiency type of.2. The patients can not only regulate the imbalance of the /T cell subgroup of sex hormone level, promote the regulation of hormone level, enhance the immunity of the body, reduce the side effects of the drug, improve the clinical symptoms and improve the quality of life of the patients, especially in alleviating hot flashes, sweating, insomnia, tired tired, anxiety and so on.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2017
【分類號】：R273

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