發(fā)布時間：2018-03-11 09:03

  本文選題：乳腺癌　切入點：疏肝法　出處：《浙江中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的對中藥組研究期間用藥進(jìn)行整理,探討柴氏逍遙散對乳腺癌術(shù)后肝郁證患者生存質(zhì)量和免疫功能的影響；探討柴可群主任中醫(yī)師在病證結(jié)合指導(dǎo)下辨治乳腺癌的學(xué)術(shù)思想及用藥經(jīng)驗,為中醫(yī)藥干預(yù)改善乳腺癌患者術(shù)后生存質(zhì)量、調(diào)節(jié)乳腺癌患者術(shù)后免疫功能提供臨床證據(jù),為優(yōu)化乳腺癌術(shù)后的診療思維、提升療效提供新的思路。方法收集符合納入標(biāo)準(zhǔn)的臨床病例49例,將其分為對照組(22例)和中藥組(27例),對照組只行標(biāo)準(zhǔn)治療,中藥組行標(biāo)準(zhǔn)治療+柴氏逍遙散。研究12周內(nèi),通過中醫(yī)癥狀量化評分、SCL-90量表、SF-36量表及淋巴細(xì)胞亞群水平的多次測定,評價柴氏逍遙散療效,觀察患者生存質(zhì)量和免疫功能改善情況；最后,探討柴師辨治乳腺癌的學(xué)術(shù)思想,運(yùn)用中醫(yī)傳承輔助系統(tǒng)軟件,收集中藥組研究期間用藥并分析規(guī)則。結(jié)果治療4周后,中藥組中醫(yī)癥狀量化評分表評分相比對照組分?jǐn)?shù)更低、總體有效率更高,存在統(tǒng)計學(xué)差異(p0.05);治療12周后,運(yùn)用SCL-90量表評價中藥組的抑郁、焦慮因子分對照對照組有明顯降低,存在統(tǒng)計學(xué)差異(p0.05),運(yùn)用SF-36量表評價中藥組在生理職能、軀體疼痛、情感職能、社會功能四個維度上的得分明顯高于對照組,存在統(tǒng)計學(xué)差異(p0.05)；對比淋巴細(xì)胞亞群各指標(biāo)水平,中藥組的T細(xì)胞和NK細(xì)胞水平高于對照組,存在統(tǒng)計學(xué)差異(p0.05)。結(jié)論 1.柴氏逍遙散能有效緩解乳腺癌術(shù)后肝郁證患者相關(guān)臨床癥狀,加快患者心理健康狀況和免疫功能的改善和恢復(fù),提高患者免疫能力和生存質(zhì)量。2.乳腺癌的發(fā)生、發(fā)展及預(yù)后和情志因素密切相關(guān),柴可群主任中醫(yī)師認(rèn)為,乳腺癌的發(fā)病主臟在肝,情志不暢、肝失疏泄是乳腺癌的主要病機(jī),存在于疾病各個階段,故辨治乳腺癌時當(dāng)著重從肝入手,臨診運(yùn)用疏肝法辨治乳腺癌術(shù)后隨訪期患者,獲得較好的效果。
[Abstract]:Objective to study the effect of Chai's Xiaoyao Powder on the quality of life and immune function of patients with liver depression after operation of breast cancer. To explore the academic thought and experience of treating breast cancer under the guidance of combination of disease and syndromes, so as to provide clinical evidence for the intervention of traditional Chinese medicine to improve the postoperative quality of life of patients with breast cancer and to regulate the postoperative immune function of patients with breast cancer. Methods 49 patients with breast cancer were collected and divided into control group (n = 22) and traditional Chinese medicine group (n = 27). The traditional Chinese medicine group was treated with the standard treatment of Chai's Xiaoyao Powder. The therapeutic effect of Chai's Xiaoyao Powder was evaluated by the quantitative score of TCM symptom and the multiple measurements of SF-36 scale and lymphocyte subgroup level of SCL-90 scale within 12 weeks. To observe the improvement of patients' quality of life and immune function; finally, to discuss the academic thought of treating breast cancer by Chai Shi, and to collect the medication and analyze the rules during the study of TCM group by using the software of traditional Chinese medicine heritage assistant system. Results after 4 weeks of treatment, Compared with the control group, the Chinese medicine group had a lower score and a higher overall effective rate. After 12 weeks of treatment, SCL-90 scale was used to evaluate the depression in the Chinese medicine group, and the anxiety factor score in the control group was significantly decreased. There was a significant difference between the four dimensions of physiological function, somatic pain, emotional function and social function in the traditional Chinese medicine group (P 0.05), and there was statistical difference between the four dimensions (P 0.05), and the level of lymphocyte subsets was compared with that of the control group, and there was no significant difference between the two groups in terms of physiological function, somatic pain, emotional function and social function. The levels of T cells and NK cells in the traditional Chinese medicine group were higher than those in the control group, and there was a statistical difference between them (P 0.05). Conclusion\\\; Speeding up the improvement and recovery of patients' mental health status and immune function, improving patients' immune ability and quality of life .2.The occurrence, development, prognosis and emotional factors of breast cancer are closely related, according to Chai Kequn, the director of TCM. The main organ of breast cancer is in the liver, the mood is not unobstructed, and the liver loss is the main pathogenesis of breast cancer, which exists in every stage of the disease. Therefore, when differentiating and treating breast cancer, we should focus on the liver and use the method of soothing the liver to treat the patients in follow-up period after operation. Good results were obtained.
【學(xué)位授予單位】：浙江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R273

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 柴可群;陳嘉斌;徐國暑;;基于病證結(jié)合論中醫(yī)辨治腫瘤四則四法[J];中醫(yī)雜志;2016年02期

2 黃蕾蕾;柴可群;陳嘉斌;江灶坤;鄒莉;王澤明;;柴可群運(yùn)用疏肝解郁法辨治乳腺癌的經(jīng)驗總結(jié)[J];黑龍江中醫(yī)藥;2015年05期

3 徐國暑;陳嘉斌;柴可群;;柴可群扶正氣祛痰毒調(diào)情志防治腫瘤經(jīng)驗擷菁[J];浙江中醫(yī)雜志;2014年10期

4 李玲;施軍平;邵喜英;;術(shù)后乳腺癌患者焦慮、抑郁及生活質(zhì)量分析[J];中國腫瘤;2014年07期

5 林霜;魏克民;;魏克民從疏肝理氣辨治乳腺癌經(jīng)驗[J];浙江中醫(yī)雜志;2014年06期

6 王征;葉新平;張浩;李偉漢;;扶正消積方維持治療對乳腺癌術(shù)后患者生命質(zhì)量和無病生存期的影響[J];中國實驗方劑學(xué)雜志;2014年11期

7 柴可群;;培本化痰解郁治法理念在惡性腫瘤臨床中的應(yīng)用探討[J];浙江中醫(yī)雜志;2013年11期

8 張希衍;李根叢;;中醫(yī)調(diào)肝健脾法聯(lián)合新輔助化療治療乳腺癌的臨床意義[J];現(xiàn)代實用醫(yī)學(xué);2013年10期

9 張明娟;左彩鳳;柴林強(qiáng);苗杰;;細(xì)胞免疫功能與腫瘤后抑郁程度的相關(guān)性研究[J];中國衛(wèi)生產(chǎn)業(yè);2013年20期

10 王學(xué)謙;張英;;林洪生教授調(diào)肝健脾治療乳腺癌經(jīng)驗初探[J];環(huán)球中醫(yī)藥;2012年09期

相關(guān)博士學(xué)位論文 前1條

1 向錚;基于代謝組學(xué)的莪術(shù)類藥材的質(zhì)量控制[D];浙江大學(xué);2012年

，

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