舌微循環(huán)變化與肺癌的相關(guān)性研究
[Abstract]:Objective: To explore the changes of tongue microcirculation in patients with primary bronchogenic carcinoma, and further analyze the characteristics of tongue microcirculation in lung cancer patients with Qi deficiency and phlegm dampness, Yin deficiency and toxic heat, Qi and blood stasis and deficiency of both qi and yin.
Methods: Referring to the diagnostic criteria of lung cancer in the 7th edition of Internal Medicine, 140 patients with primary bronchogenic carcinoma hospitalized in the Department of Respiratory Medicine in the Fourth Hospital of Hebei Medical University (Hebei Cancer Hospital) from September 2011 to October 2012 were enquired about according to the unified observation table. The diagnostic criteria of TCM syndromes of lung cancer were divided into four syndromes: deficiency of Qi and phlegm-dampness, deficiency of yin and toxin-heat, stagnation of Qi and blood, deficiency of both qi and yin. Number of vessel, diameter of input branch, diameter of output branch; 2 papillary state: 1 epithelial layer thickness, diameter of bacterial papilla; 3 loop shape: 1 loop clarity, 2 loop abnormality; 4 blood flow state: 1 dashed line, 2 broken line; 5 microvascular state: 1 hemorrhage, 2 exudation, and explore the changing characteristics of four syndrome types.
Result:
There were significant differences in the number of microvessels, epithelial layer thickness, loop clarity, abnormal periloop, blood flow status, and microvascular status between lung cancer patients and normal control group (P 0.01). The main manifestations were the decrease of the number of microvessels, the thinning of epithelial layer, and the loops clarity. The percentage of periloop abnormalities was 34.29% and 22.86% respectively; the blood flow was mainly dotted line and broken line, accounting for 45.0% and 45.71% respectively; the microvasculature was mainly hemorrhage and exudation, accounting for 42.14% and 38.57% respectively.
The changes of microcirculation of tongue in lung cancer patients with different syndromes were different. In Qi-deficiency and phlegm-dampness group, the diameter of papillae was enlarged, the thickness of epithelium was thickened, the spasm around the loop was increased, accounting for 60.0%, the microvascular exudation was increased, accounting for 73.33%, and there was significant difference compared with other three groups (P 0.05). The diameter of the outgoing branch was enlarged, and the blood flow was mainly intermittent, accounting for 90.0%, which was significantly different from the other three groups (P 0.05); in the Qi-blood stasis group, the loops and periloops were blurred, and the microvascular bleeding was characterized by 96.87%, 78.13% and 75.0% of the other three groups, respectively. Sex difference (P 0.05); Qi-Yin deficiency group had the least number of microvessels, input branches, output branches and the shortest diameter of bacterial papilla, the thinnest thickness of epithelial layer, the most obvious blood flow state was dotted line, accounting for 86.84%, compared with the other three groups had significant differences (P 0.05).
Conclusion:
1. There are obvious microcirculation disorders in lung cancer patients, which may be caused by respiratory dysfunction, dysfunction of propagating and lowering, dysfunction of regulating channels, dereliction of transfusion and distribution of fluid, and unstable external defense functions, leading to peripheral microcirculation disorders. There were more spasms and blurs, the blood flow was mainly dotted line and broken line, and the microvasculature was mainly bleeding and exudation.
The changes of tongue microcirculation in lung cancer patients with different syndromes were different.Qi deficiency and phlegm-dampness group had weak promotion of Qi deficiency,and the movement of Qi-blood and fluid was not smooth,which led to blood stasis in the tongue and the accumulation of body fluid.Qi deficiency could not control the blood and make it overflow the pulse. The changes of layer cells were slowed down; phlegm obstructed the channels and collaterals, and the channels were constrained, so the diameter of bacterial papillae was enlarged, the thickness of epithelial layer was increased, the spasm around the loop and the microvascular exudation was most obvious. In the Qi-blood stasis group, Qi-qi was blocked, the movement was not smooth, the blood transfusion was abnormal, and blood stasis was blocked, the blood flow was not smooth, and the tongue was dystrophic; "blood stasis did not go away, new blood did not grow; blood stasis did not go away, blood did not return to the meridian," blood stasis internal obstruction, blood stasis did not follow the normal path, overflow veins. The deficiency of both Qi and Yin group can not stimulate blood flow, blood flow rate is slowed down; deficiency of both Qi and Yin, tongue dystrophy, dysplasia of the nipple, so the input branch, output branch and the smallest diameter of bacterial papilla, epithelial layer thickness is the thinnest. The most obvious flow pattern is dotted line, which can help us to understand the nature of lung cancer and provide a reference for the study of microcosmic syndrome differentiation of tongue diagnosis.
【學(xué)位授予單位】:河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2013
【分類號(hào)】:R241.25;R273
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