D期前列腺癌中醫(yī)辨證分型方式及中西醫(yī)結(jié)合治療初探
發(fā)布時(shí)間：2018-12-13 08:08
【摘要】：前列腺癌是男性最常見的惡性腫瘤之一,其發(fā)病率和死亡率都很高。在美國(guó)其發(fā)病率占男性腫瘤第1位,病死率占第2位。在我國(guó)其發(fā)病率也已躍居男性泌尿、生殖系統(tǒng)惡性腫瘤第三位。中醫(yī)古籍并無前列腺癌之病名,即使有有關(guān)記載與描述也散見于“淋證、癃閉、痛證、血證”等范疇;明確提出用中醫(yī)藥治療前列腺癌,主要是近十年的事。目前中醫(yī)藥治療前列腺癌的方法主要是辯證論治,但卻至今沒有公認(rèn)的前列腺癌辨證分型模式可供臨床醫(yī)生參考,也沒有權(quán)威的論治規(guī)范可供中醫(yī)臨床醫(yī)生遵循,各醫(yī)家對(duì)前列腺癌的證候命名繁多而不規(guī)范,離中華人民共和國(guó)國(guó)家標(biāo)準(zhǔn)《中醫(yī)臨床診療術(shù)語(yǔ)·證候部分》相去甚遠(yuǎn)。 本課題以解決這些問題為目的,進(jìn)行了創(chuàng)建一種較好的D期前列腺癌中醫(yī)辨證分型方式的探討。首先用循證醫(yī)學(xué)的研究方法,從文獻(xiàn)調(diào)研入手,梳理了近10年各地醫(yī)家對(duì)前列腺癌的辨證分型觀點(diǎn),得出了腎氣虛、腎陰虛、脾氣虛、腎陽(yáng)虛、氣血兩虛、氣陰兩虛、血瘀、熱毒蘊(yùn)結(jié)、下焦?jié)駸帷駸崽N(yùn)結(jié)、痰瘀互結(jié)10種證型為文獻(xiàn)記錄的前列腺癌常見證候的結(jié)論。 其次用病例回顧性研究方法,對(duì)近3年廣東省中醫(yī)院已確診為D期前列腺癌的103例住院病例進(jìn)行回顧性研究,將這些病例的辨證證型及臨床癥狀、體征進(jìn)行頻數(shù)、構(gòu)成比統(tǒng)計(jì)。結(jié)果103名患者分屬44個(gè)不同的證候名,且大多數(shù)為復(fù)合證型,以腎虛血瘀、濕熱瘀阻、肝腎陰虛、腎虛不固、脾氣虛、脾腎陽(yáng)虛、氣血兩虛、血瘀、痰瘀互結(jié)9種證型出現(xiàn)頻率較高,為我院D期前列腺癌病歷記錄中的常見證型;有30種證候名稱分別只出現(xiàn)過一次,為病歷記錄中的少見證型。103名患者入院時(shí)共有69個(gè)不同癥狀體征及29種舌象、脈象。分屬形神、頭面、寒熱、消化、呼吸與循環(huán)、泌尿與生殖、骨骼、舌象、脈象等9個(gè)維度,其中以神疲乏力、少氣懶言、形體消瘦、寐差失眠、面白無華、面色萎黃、面色晦暗、兩顴潮紅、口唇色暗、口唇色淡、畏寒、肢冷、顏面烘熱、尿線細(xì)、尿頻尿急、夜尿頻多、尿滴瀝無力、尿短澀、尿黃、血尿、尿灼熱、排尿費(fèi)力、癃閉、尿失禁、尿痛、咽干口燥、惡心、腹脹、少腹墜痛、便溏不爽、大便秘結(jié)、痛骨不移、腰膝酸痛等出現(xiàn)頻率最高,為D期前列腺癌辨證分型的常見癥狀、體征指標(biāo)。 接著在文獻(xiàn)調(diào)研及病歷回顧性研究的基礎(chǔ)上設(shè)計(jì)D期前列腺癌辨證癥、征指標(biāo)調(diào)查表。使用制成的“D期前列腺癌證候調(diào)查表”對(duì)已確診為D期前列腺癌的160例患者進(jìn)行調(diào)查,采集這些患者的癥狀、體征信息。將這些信息審查合格后錄入電子計(jì)算機(jī),建立D期前列腺癌癥狀、體征信息數(shù)據(jù)庫(kù)。先是把臨床證候癥、征指標(biāo)作為變量,應(yīng)用SPSS11.0統(tǒng)計(jì)軟件包對(duì)變量進(jìn)行聚類分析。然后運(yùn)用專業(yè)知識(shí)對(duì)聚類結(jié)果進(jìn)行比較,得出聚類分型越少?gòu)?fù)合證、兼夾證越多,證候越復(fù)雜,越不好掌握,把D期前
[Abstract]:Prostate cancer is one of the most common malignant tumors in men, with high morbidity and mortality. In the United States, the incidence of cancer is the first in men, and the mortality is the second. In China, the incidence rate has also leapt to the male urinary tract, reproductive system malignant tumors in the third place. The ancient books of Chinese medicine do not have the name of prostate cancer, even though there are relevant records and descriptions, they are scattered in the category of "Lymphoma, dysphagia, pain syndrome, blood syndrome" and so on. It is clearly proposed that the treatment of prostate cancer with traditional Chinese medicine is mainly in the past ten years. At present, Chinese medicine is mainly used to treat prostate cancer by dialectical treatment. However, there is no generally accepted pattern of differentiation and classification of prostate cancer for clinicians to refer to, and there is no authoritative standard for clinicians to follow. The names of the symptoms of prostate cancer are various and not standardized, which is far from the National Standard of the people's Republic of China, the TCM Clinical diagnosis and treatment terminology Syndrome part, which is far from the National Standard of the people's Republic of China. In order to solve these problems, this paper discusses how to establish a better way of differentiation and classification of D stage prostate cancer. Firstly, by using the research method of evidence-based medicine, starting with the literature investigation, this paper combs the views of doctors in nearly 10 years on the differentiation and classification of prostate cancer, and concludes the deficiency of kidney qi, the deficiency of kidney yin, the deficiency of spleen qi, the deficiency of kidney yang, the deficiency of both qi and blood, the deficiency of qi and yin, and the blood stasis. Ten syndromes of heat toxin accumulation, lower pyrolysis damp-heat, damp-heat accumulation and phlegm and blood stasis were the common syndromes of prostate cancer recorded in the literature. Secondly, 103 cases of stage D prostate cancer diagnosed in Guangdong traditional Chinese Medicine Hospital in recent 3 years were studied retrospectively by retrospective study. The frequency of syndrome differentiation and clinical symptoms and signs of these cases were analyzed. Results 103 patients belonged to 44 different syndromes, and most of them were complex syndromes, including kidney deficiency and blood stasis, damp-heat stasis, liver and kidney yin deficiency, kidney deficiency, spleen qi deficiency, spleen and kidney yang deficiency, qi and blood deficiency, and blood stasis. Nine syndromes of phlegm and blood stasis were common in the records of stage D prostate cancer in our hospital. There were 30 syndromes that appeared only once, which was the type of less witness in the medical record. There were 69 different symptoms and signs and 29 tongue signs and pulses at the time of admission. They belong to nine dimensions: form and spirit, head, cold and heat, digestion, respiration and circulation, urology and reproduction, bone, tongue, pulse, etc. Dark complexion, dark lips, pale lips, cold limbs, hot face, thin line of urine, frequent urination, weak urine droplets, short urine, yellow urine, hematuria, hot urine, laborious urination, dysphagia, urinary incontinence, dysphoria, dysuria, dysphagia, urinary incontinence. Urinary pain, dry pharynx, nausea, abdominal distension, less abdominal pain, loose stools, constipation, bone pain, pain of waist and knee are the most frequent symptoms and signs of D stage prostate cancer. On the basis of literature investigation and retrospective study of medical records, we designed D-stage prostate cancer syndrome differentiation and sign index questionnaire. The symptom questionnaire of stage D prostate cancer was used to investigate 160 patients who had been diagnosed with stage D prostate cancer. The information of symptoms and signs of these patients was collected. The information was checked and entered into the computer, and the D prostate cancer symptom and sign information database was established. First, the clinical syndrome, sign index as a variable, using SPSS11.0 statistical software package to cluster analysis of variables. Then using professional knowledge to compare the clustering results, it is concluded that the less the cluster classification, the more complex the syndrome, the more complex the syndromes, the more difficult to master.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2006
【分類號(hào)】：R277.52
本文編號(hào)：2376211
[Abstract]:Prostate cancer is one of the most common malignant tumors in men, with high morbidity and mortality. In the United States, the incidence of cancer is the first in men, and the mortality is the second. In China, the incidence rate has also leapt to the male urinary tract, reproductive system malignant tumors in the third place. The ancient books of Chinese medicine do not have the name of prostate cancer, even though there are relevant records and descriptions, they are scattered in the category of "Lymphoma, dysphagia, pain syndrome, blood syndrome" and so on. It is clearly proposed that the treatment of prostate cancer with traditional Chinese medicine is mainly in the past ten years. At present, Chinese medicine is mainly used to treat prostate cancer by dialectical treatment. However, there is no generally accepted pattern of differentiation and classification of prostate cancer for clinicians to refer to, and there is no authoritative standard for clinicians to follow. The names of the symptoms of prostate cancer are various and not standardized, which is far from the National Standard of the people's Republic of China, the TCM Clinical diagnosis and treatment terminology Syndrome part, which is far from the National Standard of the people's Republic of China. In order to solve these problems, this paper discusses how to establish a better way of differentiation and classification of D stage prostate cancer. Firstly, by using the research method of evidence-based medicine, starting with the literature investigation, this paper combs the views of doctors in nearly 10 years on the differentiation and classification of prostate cancer, and concludes the deficiency of kidney qi, the deficiency of kidney yin, the deficiency of spleen qi, the deficiency of kidney yang, the deficiency of both qi and blood, the deficiency of qi and yin, and the blood stasis. Ten syndromes of heat toxin accumulation, lower pyrolysis damp-heat, damp-heat accumulation and phlegm and blood stasis were the common syndromes of prostate cancer recorded in the literature. Secondly, 103 cases of stage D prostate cancer diagnosed in Guangdong traditional Chinese Medicine Hospital in recent 3 years were studied retrospectively by retrospective study. The frequency of syndrome differentiation and clinical symptoms and signs of these cases were analyzed. Results 103 patients belonged to 44 different syndromes, and most of them were complex syndromes, including kidney deficiency and blood stasis, damp-heat stasis, liver and kidney yin deficiency, kidney deficiency, spleen qi deficiency, spleen and kidney yang deficiency, qi and blood deficiency, and blood stasis. Nine syndromes of phlegm and blood stasis were common in the records of stage D prostate cancer in our hospital. There were 30 syndromes that appeared only once, which was the type of less witness in the medical record. There were 69 different symptoms and signs and 29 tongue signs and pulses at the time of admission. They belong to nine dimensions: form and spirit, head, cold and heat, digestion, respiration and circulation, urology and reproduction, bone, tongue, pulse, etc. Dark complexion, dark lips, pale lips, cold limbs, hot face, thin line of urine, frequent urination, weak urine droplets, short urine, yellow urine, hematuria, hot urine, laborious urination, dysphagia, urinary incontinence, dysphoria, dysuria, dysphagia, urinary incontinence. Urinary pain, dry pharynx, nausea, abdominal distension, less abdominal pain, loose stools, constipation, bone pain, pain of waist and knee are the most frequent symptoms and signs of D stage prostate cancer. On the basis of literature investigation and retrospective study of medical records, we designed D-stage prostate cancer syndrome differentiation and sign index questionnaire. The symptom questionnaire of stage D prostate cancer was used to investigate 160 patients who had been diagnosed with stage D prostate cancer. The information of symptoms and signs of these patients was collected. The information was checked and entered into the computer, and the D prostate cancer symptom and sign information database was established. First, the clinical syndrome, sign index as a variable, using SPSS11.0 statistical software package to cluster analysis of variables. Then using professional knowledge to compare the clustering results, it is concluded that the less the cluster classification, the more complex the syndrome, the more complex the syndromes, the more difficult to master.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2006
【分類號(hào)】：R277.52
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 王濤,江澤飛;多西紫杉醇治療激素非依賴性前列腺癌臨床研究新進(jìn)展[J];癌癥進(jìn)展;2005年02期
2 梁曉焱;中藥治療前列腺癌1例[J];長(zhǎng)春中醫(yī)學(xué)院學(xué)報(bào);2004年02期
3 王濤;前列腺癌的中醫(yī)藥治療[J];光明中醫(yī);2004年02期
4 李可,吳鐵球;PSA及相關(guān)指標(biāo)在前列腺癌診斷中的應(yīng)用及進(jìn)展[J];國(guó)外醫(yī)學(xué).泌尿系統(tǒng)分冊(cè);2003年05期
5 賀偉,姜寧 ,江魚;前列腺特異抗原臨床應(yīng)用研究進(jìn)展[J];國(guó)外醫(yī)學(xué).泌尿系統(tǒng)分冊(cè);2005年02期
6 周道紅,徐學(xué)義,袁金聲;學(xué)習(xí)李昌源教授病證合參治療前列腺癌的心得[J];貴陽(yáng)中醫(yī)學(xué)院學(xué)報(bào);1996年01期
7 楚延春,張同斌;前列腺癌的病因病機(jī)淺探[J];河南中醫(yī)藥學(xué)刊;1997年04期
8 譚新華 ,張作明 ,李德宏 ,何清湖;前列腺癌[J];湖南中醫(yī)雜志;1995年02期
9 曾小菊;前列腺癌治驗(yàn)[J];湖南中醫(yī)雜志;1996年03期
10 李承功;周智恒治療前列腺疾病經(jīng)驗(yàn)[J];江西中醫(yī)藥;2002年02期
，本文編號(hào)：2376211
本文鏈接：http://sikaile.net/yixuelunwen/zhxiyjh/2376211.html
最近更新
教材專著
