本文關(guān)鍵詞： 耳針 逍遙散 乳腺癌 生存質(zhì)量 肝郁氣滯　出處：《成都中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：乳腺癌的發(fā)生、發(fā)展、轉(zhuǎn)歸及預(yù)后與生存質(zhì)量有密切關(guān)系,由于醫(yī)學(xué)診療技術(shù)的發(fā)展,乳腺癌患者的生存期明顯延長,康復(fù)期乳腺癌患者日益成為一個龐大的特殊群體。了解康復(fù)期乳腺癌患者的心理特點(diǎn),進(jìn)行有效的干預(yù)以消除她們的情緒障礙,對患者身心健康恢復(fù)以及提高生活質(zhì)量意義重大。本臨床觀察是依據(jù)中醫(yī)基礎(chǔ)理論、現(xiàn)代藥理研究及經(jīng)絡(luò)穴位學(xué)說,結(jié)合李世杰教授多年臨床經(jīng)驗(yàn),采用問卷調(diào)查的形式,對康復(fù)期乳腺癌患者進(jìn)行生存質(zhì)量測評表(FACT-B 4.0版)調(diào)查,分析耳針聯(lián)合逍遙散組和逍遙散組的評分結(jié)果,觀察耳針對患者生活質(zhì)量的影響,以期尋求乳腺癌康復(fù)的中醫(yī)耳穴應(yīng)用治療途徑。方法：采用隨機(jī)對照的臨床研究方法,設(shè)立樣本診斷標(biāo)準(zhǔn)、納入標(biāo)準(zhǔn)、排除及終止臨床試驗(yàn)標(biāo)準(zhǔn)。在征得患者同意簽署知情同意書后,由研究者記錄其一般資料、精神狀況檢查及中醫(yī)辨證分型。收集2015年3月-2015年10月成都中醫(yī)藥大學(xué)第一附屬醫(yī)院腫瘤科門診就診的康復(fù)期肝郁氣滯型乳腺癌患者80例,隨機(jī)分為治療組和對照組,各40例,入組時均填寫FACT-B表。兩組基礎(chǔ)治療：據(jù)激素受體狀況規(guī)范予以內(nèi)分泌治療+逍遙散加減中藥口服,治療組聯(lián)合耳針,耳針每日自行按壓3次,每次留針3-5天(即每周2次),3周后兩組患者填寫FACT-B測量表；觀察記錄患者治療前后生理情況、社會家庭狀況、情感狀況、功能狀況和乳腺癌的附加關(guān)注部分評分,用SPSS19.0統(tǒng)計(jì)軟件建立數(shù)據(jù)庫,對兩組治療前后生活質(zhì)量表各子項(xiàng)目評分采用獨(dú)立樣本t檢驗(yàn),治療組和對照組前后用配對t檢驗(yàn)或者秩和檢驗(yàn),分析評價兩組經(jīng)過三周期治療后的生活質(zhì)量改善情況。結(jié)果：1、治療組相對于對照組明顯提高康復(fù)期肝郁氣滯型乳腺癌的生存質(zhì)量,兩組組間獨(dú)立樣本t檢驗(yàn),P0.05,具有明顯統(tǒng)計(jì)學(xué)差異。2、治療組前后經(jīng)過配對t檢驗(yàn)和秩和檢驗(yàn),各子項(xiàng)目P0.05,提示治療組經(jīng)耳針聯(lián)合逍遙散中藥治療前后生存質(zhì)量明顯改善。3、對照組前后經(jīng)過配對t檢驗(yàn)和秩和檢驗(yàn),生理狀況及量表總分P0.05,有統(tǒng)計(jì)學(xué)意義,其它條目P0.05,提示治療前后無差異。結(jié)論：耳針聯(lián)合逍遙散加減治療組可明顯提高康復(fù)期肝郁氣滯型乳腺癌患者的生存質(zhì)量。耳針聯(lián)合疏肝解郁中藥相對于單純中藥治療臨床療效好,耳針在乳腺癌康復(fù)治療中有應(yīng)用前景。
[Abstract]:Objective: the occurrence, development, prognosis and prognosis of breast cancer are closely related to the quality of life. Because of the development of medical diagnosis and treatment, the survival time of breast cancer patients is obviously prolonged. Convalescent breast cancer patients have increasingly become a large special group. Understand the psychological characteristics of patients with recovered breast cancer and carry out effective intervention to eliminate their emotional disorders. This clinical observation is based on the basic theory of traditional Chinese medicine, modern pharmacology research and meridian acupoint theory, combined with Professor Li Shijie's many years clinical experience. To investigate the quality of life (FACT-B 4.0 version) of breast cancer patients in convalescent stage, and analyze the score of auricular acupuncture combined with Xiaoyao powder and Xiaoyao powder group. Objective: to observe the effect of ear acupuncture on the quality of life of patients with breast cancer. Methods: the clinical study method of random control was used to establish the standard of sample diagnosis and the standard of inclusion. The criteria for excluding and terminating clinical trials. After obtaining the consent of the patient to sign an informed consent, the general information is recorded by the researcher. From March 2015 to October 2015, 80 cases of breast cancer with liver stagnation and Qi stagnation were collected from the oncology department of the first affiliated Hospital of Chengdu University of traditional Chinese Medicine (Chengdu University of traditional Chinese Medicine). Two groups were randomly divided into treatment group and control group, 40 cases in each group, when they entered the group, they all filled out the FACT-B form. The two groups were treated with basic therapy: according to the standard of hormone receptor status, oral administration of Xiaoyao Powder was given according to the standard of hormone receptor status. The treatment group combined with auricular acupuncture, auricular acupuncture was pressed 3 times a day, each time the needle was kept for 3 to 5 days (that is, 2 times a week for 3 weeks), the two groups of patients filled out the FACT-B scale; To observe and record the physiological status, social and family status, emotional status, functional status and the additional concern score of breast cancer before and after treatment, and to establish the database with SPSS19.0 statistical software. The quality of life (QOL) scores of the two groups were evaluated by independent sample t test before and after treatment, and by paired t test or rank sum test before and after treatment and control group. Results: compared with the control group, the quality of life of the treatment group was significantly improved compared with the control group. Independent samples between the two groups P0.05, with a significant statistical difference. 2, before and after the treatment group after the paired t test and rank test, each sub-item P0.05. The results showed that the quality of life of the treatment group was significantly improved before and after the treatment of auricular acupuncture combined with Xiaoyao powder, and the control group was treated with paired t test and rank sum test, physiological status and total score of the scale P0.05, with statistical significance. Other items P0.05. Conclusion:. The treatment group of auricular acupuncture combined with Xiaoyao powder can obviously improve the quality of life of breast cancer patients with liver stagnation and qi stagnation in convalescent period. The clinical effect of auricular acupuncture combined with soothing liver and relieving stagnation Chinese medicine is better than that of traditional Chinese medicine alone. Auricular acupuncture is promising in rehabilitation treatment of breast cancer.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R273

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