本文關(guān)鍵詞： 益氣養(yǎng)陰 涼血散瘀 放療 食管癌 毒副反應(yīng)　出處：《南京中醫(yī)藥大學(xué)》2016年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的：本課題基于周仲瑛教授“瘀熱”理論指導(dǎo)和導(dǎo)師吳勉華教授的臨床經(jīng)驗(yàn)基礎(chǔ),運(yùn)用益氣養(yǎng)陰、涼血散瘀的治法,擬定食管癌放療期間常用中藥處方加減,聯(lián)合放療治療食管癌,客觀評(píng)價(jià)中醫(yī)藥在干預(yù)食管癌放療期間毒副反應(yīng)的臨床療效。方法：將符合納入標(biāo)準(zhǔn)的60例患者,按隨機(jī)對(duì)照的研究方法分為治療組和對(duì)照組各30例,最終收集病例數(shù)為兩組各29例。對(duì)照組給予單純放療方案治療,治療組在放療基礎(chǔ)上口服以“益氣養(yǎng)陰、涼血散瘀”法擬定的中藥處方,每日1劑,早晚2次分服。觀察從放療開(kāi)始日起,至放療結(jié)束1周止。比較兩組在中醫(yī)癥狀、放射性食管炎、骨髓抑制、KPS體力狀況以及體重之間的差別。全部數(shù)據(jù)采用SPSS19.0進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果：①中醫(yī)癥候改善比較：治療組患者進(jìn)食梗阻,吞咽疼痛,倦怠乏力,大便干結(jié)治療前后較對(duì)照組相比,有統(tǒng)計(jì)學(xué)意義(P0.05),而口干欲飲,自覺(jué)發(fā)熱治療前后較對(duì)照組相比無(wú)明顯差異,無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；②放射性食管炎比較：兩組患者均不同程度地出現(xiàn)了放射性食管炎,兩組患者放射性食管炎的發(fā)生率治療組為85.2%,對(duì)照組為100%。兩組患者放射性食管炎分級(jí)比較方面,治療組發(fā)生2級(jí)及以上食管炎的發(fā)生率為38%,對(duì)照組為73%,兩組比較差異具有顯著統(tǒng)計(jì)學(xué)意義(P0.05)；③骨髓抑制比較：治療組出現(xiàn)骨髓抑制0度14例,Ⅰ度8例,Ⅱ度6例,Ⅲ度1例,總發(fā)生率為52%,對(duì)照組出現(xiàn)骨髓移植0度4例,Ⅰ度12例,Ⅱ度11例,Ⅲ度2例總發(fā)生率為86%,兩組經(jīng)統(tǒng)計(jì)學(xué)處理卡方檢驗(yàn)(P0.05),有統(tǒng)計(jì)學(xué)意義；④KPS體力狀況比較：治療組放療前后體力增強(qiáng)和穩(wěn)定的共有25例(86.2%),而對(duì)照組為16例(55.2%),治療組放療后體力狀況下降的有4例(13.8%),而對(duì)照組為13例(44.8%),兩組比較經(jīng)卡方檢驗(yàn),X2=6.685,P=0.04(P0.05),兩組比較差異有統(tǒng)計(jì)學(xué)意義;⑤體重比較：治療組放療前后體重改變共有23例(79.3%),而對(duì)照組為18例(62%),治療組放療后體重改變下降的有7例(24.1%),而對(duì)照組為11例(37.9%)兩組比較經(jīng)卡方檢驗(yàn),X2=2.219,P=0.364(P0.05),兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論：益氣養(yǎng)陰、涼血散瘀法能改善食管癌患者放療期間中醫(yī)癥候,尤其在改善進(jìn)食梗阻、吞咽疼痛、大便干結(jié)、倦怠乏力方面。減輕放射性食管炎、骨髓抑制發(fā)生率及嚴(yán)重程度,提高患者生存質(zhì)量,但在體重變化方面兩者沒(méi)有顯著差異。
[Abstract]:Objective: based on the theoretical guidance of Professor Zhou Zhongying's "blood stasis heat" and the clinical experience of professor Wu Menghua, and using the methods of supplementing qi and nourishing yin, cooling blood and dissipating blood stasis, the author worked out the addition and subtraction of traditional Chinese medicine for esophageal cancer during radiotherapy. To evaluate objectively the clinical efficacy of traditional Chinese medicine (TCM) in the treatment of esophageal carcinoma during radiotherapy. Methods: 60 patients who met the criteria were divided into two groups according to the randomized control study: 30 cases in the treatment group and 30 cases in the control group. The final number of cases was 29 cases in each group. The control group was treated with radiotherapy alone, while the treatment group was treated with traditional Chinese medicine prescription of "replenishing Qi and nourishing Yin, cooling blood and dissipating stasis" on the basis of radiotherapy, 1 dose per day. Take it twice in the morning and evening. Observe from the beginning of radiotherapy to the end of 1 week of radiotherapy. Compare the two groups in TCM symptoms, radiation esophagitis, All data were analyzed statistically by SPSS19.0. Results the improvement of TCM symptoms in the treatment group: eating obstruction, dysphagia pain, burnout and fatigue. Compared with the control group before and after treatment, there was no significant difference between the control group and the control group before and after treatment, but there was no significant difference between the control group and the control group before and after treatment, while there was no significant difference between the two groups before and after the treatment. Comparison of radiation esophagitis between the two groups: the incidence of radiation esophagitis was 85.2in the treatment group and 100 in the control group. The incidence of grade 2 and above esophagitis in the treatment group was 38 and that in the control group was 73. The difference between the two groups was statistically significant (P 0.05). There were 14 cases of bone marrow depression of 0 degree, 8 cases of grade 鈪，

本文編號(hào)：1529345