本文選題：鼻咽癌 + 中醫(yī)證型�。� 參考：《福建中醫(yī)藥大學(xué)》2012年碩士論文

【摘要】：目的：研究鼻咽癌初診患者中醫(yī)證型與鼻咽癌2008臨床分期相關(guān)性,及EB病毒IgA抗體與EB病毒DNA對(duì)比研究,提高中西醫(yī)結(jié)合防治鼻咽癌的療效,為鼻咽癌新分期進(jìn)一步提供循證醫(yī)學(xué)證據(jù),為鼻咽癌患者療效判斷提供一個(gè)更好的輔助血清學(xué)指標(biāo)。 方法：將初診并經(jīng)病理確診為鼻咽癌的患者98例,在放化療前給以辨證分型,按中醫(yī)辨證分型標(biāo)準(zhǔn)分為四型(肺熱型、痰凝型、瘀血阻絡(luò)型及血瘀痰凝型)；同時(shí)按鼻咽癌2008分期標(biāo)準(zhǔn)給以TNM分期(Ⅰ、Ⅱ、Ⅲ及Ⅳa期)；在放化療前及放化療后分別抽取患者全血EB病毒DNA拷貝數(shù)與血清EB病毒IgA抗體滴度。在放化療后2個(gè)月,復(fù)查鼻咽部MR及相應(yīng)的全身檢查。 結(jié)果：1.四組中醫(yī)證型在TNM分期中差異具有統(tǒng)計(jì)學(xué)意義(P=0000),說(shuō)明中醫(yī)證型與TNM分期具有相關(guān)性。2.血清EB病毒IgA抗體與TNM分期差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.189)。3.全血EB病毒DNA拷貝數(shù)與TNM分期總體上差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.074)。兩兩比較,全血EB病毒DNA拷貝數(shù)在Ⅲ期與Ⅲ期間比較,差異具有統(tǒng)計(jì)學(xué)意義(P=0.024)；全血EB病毒DNA拷貝數(shù)在Ⅲ期與Ⅳ期間比較,差異具有統(tǒng)計(jì)學(xué)意義(P=0.022)。4.放療后,全血EB病毒DNA拷貝數(shù)轉(zhuǎn)陰率高,能有效評(píng)價(jià)治療療效；但在提示轉(zhuǎn)移或復(fù)發(fā)方面,EB病毒IgA抗體與EB病毒DNA比較二者差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.095)。 結(jié)論：1.鼻咽癌初診患者中醫(yī)證型與臨床分期具有相關(guān)性(P=0.000)。2.血清EB病毒IgA抗體與鼻咽癌臨床分期無(wú)相關(guān)性(P=0.189)。3.全血EB病毒DNA拷貝數(shù)與臨床分期具有相關(guān)性。4.全血EB病毒DNA拷貝數(shù)轉(zhuǎn)陰率高,優(yōu)于EB病毒IgA抗體,在一定程度上能有效評(píng)價(jià)治療療效及及監(jiān)測(cè)病情變化；在提示轉(zhuǎn)移及復(fù)發(fā)方面,二者差異無(wú)統(tǒng)計(jì)學(xué)意義,可能與病例數(shù)少有關(guān)。
[Abstract]:Objective: To study the correlation between the TCM syndrome type of nasopharyngeal carcinoma and the 2008 clinical stage of nasopharyngeal carcinoma, and the comparative study of the EB virus IgA antibody and EB virus DNA, to improve the curative effect of the combination of traditional Chinese and Western Medicine on the prevention and treatment of nasopharyngeal carcinoma, and provide evidence-based medical evidence for the new stage of nasopharyngeal carcinoma to provide a better auxiliary sera for the judgment of the curative effect of nasopharyngeal carcinoma. Study indicators.
Methods: 98 patients with nasopharyngeal carcinoma diagnosed and diagnosed by pathology were divided into four types (pulmonary heat type, phlegm coagulating type, blood stasis blocking type and blood stasis phlegm coagulation type) before and after radiotherapy and chemotherapy, and TNM staging (I, II, III and IV A) of nasopharyngeal carcinoma were given at the same time with 2008 stages of nasopharyngeal carcinoma; before and after radiotherapy and chemotherapy and after radiotherapy and chemotherapy, The number of copies of EB virus DNA and the titer of EB virus IgA antibody in the whole blood were extracted respectively. The nasopharyngeal MR and the corresponding systemic examination were re examined 2 months after radiochemotherapy.
Results: 1. the difference between the four groups of TCM Syndrome Types in TNM staging was statistically significant (P=0000), indicating the correlation between the TCM syndrome type and the TNM staging. There was no significant difference between the.2. serum EB virus IgA antibody and the TNM staging (P=0.189) the DNA copy number of EB virus in.3. whole blood and TNM staging were not statistically significant. 22 comparison, the whole blood was compared. The number of DNA copies of EB virus was compared in stage III and III (P=0.024), and the DNA copy number of whole blood EB virus was compared with stage III and IV, the difference was statistically significant (P=0.022) after.4. radiotherapy, the DNA copy number of EB virus in whole blood was high, and the therapeutic effect could be evaluated effectively, but the EB disease was suggested in the aspect of metastasis or recurrence. There was no significant difference between the two IgA antibodies and the EB virus DNA (P=0.095).
Conclusion: 1. the TCM syndrome type and clinical staging of 1. nasopharyngeal carcinoma patients have correlation (P=0.000).2. serum EB virus IgA antibody and clinical staging of nasopharyngeal carcinoma (P=0.189).3. whole blood EB virus DNA copy number and clinical stage,.4. whole blood EB virus DNA copy number conversion negative rate is high, superior to the EB virus antibody, to a certain extent. It can effectively evaluate the curative effect and monitor the change of the disease. There is no significant difference in the indication of metastasis and recurrence between the two groups, which may be related to the small number of cases.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R273;R739.63

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 羅耀凌;歐國(guó)萍;池沛冬;梁永能;劉宇輝;黃馬燕;;聯(lián)合檢測(cè)EB病毒相關(guān)抗體和抗原對(duì)診斷鼻咽癌的價(jià)值[J];癌癥;2009年01期

2 譚毅菁;蘇錫康;崔金環(huán);區(qū)文華;薛雄燕;;鼻咽癌患者血清中VCA-IgA、EA-IgA、EBV-DNA評(píng)價(jià)的比較[J];重慶醫(yī)學(xué);2010年06期

3 蔡永林;鄭裕明;成積儒;王偉;張旖旎;王衛(wèi)華;吳英松;楊淑君;鐘偉銘;李軍;莫永坤;;EB病毒Rta/IgG、EBNA1/IgA、VCA/IgA及EA/IgA抗體與鼻咽癌分期的關(guān)系[J];南方醫(yī)科大學(xué)學(xué)報(bào);2010年03期

4 劉宇龍;袁芳;徐凱;曾普華;于雪梅;;鼻咽癌中醫(yī)證型與病灶分布及頸淋巴結(jié)轉(zhuǎn)移的相關(guān)性研究[J];廣東醫(yī)學(xué);2006年02期

5 成積儒;蔡永林;鄭裕明;李軍;莫永坤;鐘青燕;;EB病毒EBNA1/IgA與鼻咽癌分期的關(guān)系[J];華夏醫(yī)學(xué);2009年05期

6 李亞軍;趙春妮;;鼻咽癌中醫(yī)辨證分型研究進(jìn)展[J];國(guó)醫(yī)論壇;2006年04期

7 胡艷慧;趙春妮;;鼻咽癌的中醫(yī)辨證分型與西醫(yī)客觀性指標(biāo)的相關(guān)性研究進(jìn)展[J];國(guó)醫(yī)論壇;2008年05期

8 高萍;辨證治療鼻咽癌放療不良反應(yīng)126例[J];貴陽(yáng)醫(yī)學(xué)院學(xué)報(bào);2005年01期

9 張紅;曾師;;鼻咽癌初診患者的中醫(yī)辨證分型與TNM分期相關(guān)性的臨床觀察[J];中醫(yī)藥導(dǎo)報(bào);2011年07期

10 陳孟溪;張紅;蘇志新;毛丹;;鼻咽癌中醫(yī)主癥、證型及常用中藥的文獻(xiàn)研究[J];湖南中醫(yī)藥大學(xué)學(xué)報(bào);2010年01期

，

本文編號(hào)：2105770