本文選題：啟膈散 + 電子胃鏡�。� 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:本研究旨在:運用啟膈散聯(lián)合食管支架置入術(shù)治療晚期食管癌并食管狹窄。通過本臨床研究,對該方式治療食管癌并食管狹窄的臨床療效做出評估,為今后中西醫(yī)結(jié)合治療食管癌并狹窄的研究提供更多的臨床依據(jù)。方法:采用隨機數(shù)字表分組方法,將符合入組標(biāo)準(zhǔn)病例65例分為兩組,其中治療組32例,對照組33例。經(jīng)統(tǒng)計學(xué)檢驗,兩組治療前在年齡、性別、疾病分期、飲食情況上無統(tǒng)計學(xué)差異(P0.05)。兩組均在電子胃鏡下行食管支架置入術(shù),術(shù)后予常規(guī)抗感染、抑酸、營養(yǎng)支持等1-3天。其中治療組在支架置入術(shù)后第7天起予口服啟膈散,藥物組成主要由沙參、丹參、茯苓、砂仁殼等組成;日服2次,每次100ml,30天為1療程,共6個療程;對照組予單純食管支架置入術(shù)治療。療程結(jié)束后,通過分別臨床隨訪觀察每位入組患者,對比兩種治療方式下患者在中醫(yī)證候、生存質(zhì)量、飲食、體重、并發(fā)癥的差異,以探討其改進的方法。結(jié)果:通過統(tǒng)計軟件分析治療結(jié)果表明:(1)在中醫(yī)證候療效方面:治療組治療后總有效率為87.09%,對照組為62.5%,經(jīng)統(tǒng)計學(xué)檢驗后,差異具有統(tǒng)計學(xué)意義(P0.05);(2)治療前后KPS評分的比較:兩組治療前KPS積分,經(jīng)統(tǒng)計學(xué)檢驗,差異無統(tǒng)計學(xué)意義(P0.05),治療后治療組KPS積分與對照組相比較,差異有統(tǒng)計學(xué)意義(P0.05);(3)治療組與對照組在飲食變化上的比較,差異具有統(tǒng)計學(xué)意義(P0.05);(4)治療組可增加患者體重,治療前后有統(tǒng)計學(xué)差異(P0.05);(5)并發(fā)癥方面:兩組治療后在反流性食管炎、再狹窄方面的比較,差異有統(tǒng)計學(xué)意義(P0.05);兩組在治療后的并發(fā)癥:疼痛、移位方面的比較,差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:啟膈散加減聯(lián)合支架置入術(shù)治療食管癌并食管狹窄,近期療效確切,可改善臨床癥狀,減少術(shù)后并發(fā)癥,改善進食狀況,提高生活質(zhì)量,從而改善預(yù)后,發(fā)揮了中醫(yī)藥優(yōu)勢,為中西醫(yī)結(jié)合治療食管癌并食管狹窄提供了一定的依據(jù)。
[Abstract]:Objective: to treat advanced esophageal carcinoma with esophageal stricture by Qige Powder combined with esophageal stent implantation. Through this clinical study, to evaluate the clinical effect of the treatment of esophageal cancer with esophageal stenosis, and to provide more clinical basis for the treatment of esophageal cancer with stricture by the combination of traditional Chinese and western medicine. Methods: 65 cases were divided into two groups, 32 cases in the treatment group and 33 cases in the control group. After statistical test, the two groups before treatment in age, sex, disease stages, diet no statistical difference (P0.05). The two groups were treated with esophageal stents under electronic gastroscopy for 1-3 days, including routine anti-infection, acid suppression and nutritional support. In the treatment group, Qigi powder was given orally on the 7th day after stent implantation, and the drug composition was mainly composed of Salvia miltiorrhiza, Salvia miltiorrhiza, Poria cocos, Amomum kernel shell, etc. The control group was treated with simple esophageal stent implantation. After the course of treatment, each patient was followed up and compared the difference of TCM syndrome, quality of life, diet, body weight and complications. Results: the results showed that: (1) the total effective rate after treatment was 87.09 in the treatment group and 62.5 in the control group. The difference was statistically significant (P0.05) before and after treatment. Before and after treatment, there was no significant difference between the two groups before and after treatment (P0.05). After treatment, the KPS score of the treatment group was higher than that of the control group. The difference was statistically significant (P0.05); (3) the difference between the treatment group and the control group in diet changes was statistically significant (P0.05); (4) the treatment group could increase the weight of the patients before and after treatment (P0.05); (5) complications: the two groups after treatment in reflux esophagitis, Restenosis comparison, the difference was statistically significant (P0.05); the two groups in the treatment of complications: pain, displacement comparison, the difference was not statistically significant (P0.05). Conclusion: Qige Powder plus or minus plus stent implantation is effective in the treatment of esophageal carcinoma with esophageal stricture. It can improve clinical symptoms, reduce postoperative complications, improve food intake, improve quality of life, and improve prognosis. The advantages of traditional Chinese medicine are brought into play, which provides a basis for the treatment of esophageal cancer with esophageal stricture by combining traditional Chinese and western medicine.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.1

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