本文選題：中晚期大腸癌　切入點(diǎn)：中醫(yī)證候變化　出處：《廣州中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：探討中晚期大腸癌化療前后中醫(yī)證候變化規(guī)律,為中醫(yī)藥治療中晚期大腸癌提供理論依據(jù)。方法：病例來源：2015年5月至2015年12月在廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院接受中西醫(yī)結(jié)合治療的腸癌患者60例,男例39例,女21例,采用問卷采集技術(shù)和前瞻性研究方法,收集患者化療前后的中醫(yī)證候變化,借助excel表格建立數(shù)據(jù)庫,運(yùn)用SPSS19.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析,根據(jù)臨床癥狀及中醫(yī)辨證特點(diǎn),進(jìn)行證候分型,歸納出中晚期大腸癌化療前后的常見證型與變化,運(yùn)用配對(duì)的卡方檢驗(yàn)等統(tǒng)計(jì)方法,對(duì)化療前后的證候進(jìn)行比較,篩選出可能有統(tǒng)計(jì)學(xué)意義及臨床意義的證候變化,運(yùn)用中醫(yī)基礎(chǔ)理論、診斷學(xué)等知識(shí),探討化療方案治療腸癌前后中醫(yī)證候變化規(guī)律,配合中藥治療提高臨床療效。結(jié)果：中晚期大腸癌化療前證候較多的系疲倦乏力、面色少華、大便稀溏、腹部脹痛、腹部腫塊、惡心欲嘔、頭暈?zāi)垦�、納呆、腹部冷痛、腹脹等。舌脈象方面為舌淡暗、舌紅、舌邊齒痕、舌胖大、苔薄、苔稍厚、苔白、苔黃、苔潤、苔微膩、苔膩、脈細(xì)、脈滑等證候�；熀蟪霈F(xiàn)證候較多的依次為納呆、疲倦乏力、惡心欲嘔、面色少華、大便稀溏、肢體麻木、寐差、頭暈?zāi)垦！⒏共棵浲�、腹部腫塊等。舌象方面為舌淡暗、舌紫暗、舌邊齒痕、舌胖大、舌薄、舌稍厚、舌厚、苔白、苔微膩、苔膩、苔潤、脈細(xì)、脈滑等�；熀笞C候增加變化較大的有納呆、惡心欲嘔、疲倦乏力、肢體麻木、寐差、口干咽燥、面色少華、頭暈?zāi)垦�、腰膝酸軟、腹脹等�；熀笞C候減少的有腹部脹痛、小便色黃、大便干結(jié)、舌紅、苔薄、苔黃、苔潤等。經(jīng)卡方檢測,化療后變化具有顯著差異的系納呆、惡心欲嘔、疲倦乏力、肢體麻木、寐差、舌邊齒痕、苔薄、苔稍厚、苔潤等證候。結(jié)論：中晚期大腸癌患者的證候特點(diǎn)為虛實(shí)并見,其中,虛證方面可表現(xiàn)為氣虛、血虛、陰虛、陽虛及臟腑功能虧虛;實(shí)證方面可表現(xiàn)為痰濕、氣滯、血瘀等�；熀蟪霈F(xiàn)的納呆、惡心欲嘔、疲倦乏力等胃失和降、脾氣濕蘊(yùn)等證候,進(jìn)一步加重了原有的證候。對(duì)于化療后的患者,以化痰利濕,補(bǔ)益氣血等治法為主,兼活血化瘀,補(bǔ)而不滯。
[Abstract]:Objective: to investigate the changes of TCM syndromes before and after chemotherapy in advanced colorectal cancer. Methods: from May 2015 to December 2015, 60 cases of colorectal cancer were treated by combination of traditional Chinese and Western medicine in the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine, including 39 males and 21 females. The changes of TCM syndromes before and after chemotherapy were collected by means of questionnaire collection technique and prospective research method. The database was established with the help of excel form, and the statistical analysis was carried out by SPSS19.0 software, according to the clinical symptoms and the characteristics of TCM syndrome differentiation. The syndromes were classified, the common syndromes and changes before and after chemotherapy were summed up, and the syndromes before and after chemotherapy were compared by using paired chi-square test and other statistical methods. To screen out the changes of syndromes that may have statistical and clinical significance, using the knowledge of TCM basic theory, diagnostics and so on, to probe into the changing law of TCM syndromes before and after the treatment of colorectal cancer by chemotherapy. Results: patients with advanced colorectal cancer had more symptoms before chemotherapy, such as fatigue and fatigue, Shaohua complexion, loose stool, abdominal distended pain, abdominal mass, nausea, dizziness, anorexia, cold abdominal pain. Abdominal distension and so on. Tongue pulse is light dark, tongue red, tongue edge tooth mark, big tongue fat, thin fur, slightly thick fur, white fur, yellow fur, moist fur, slightly greasy fur, greasy fur, fine vein, smooth vein and other syndromes. Tired and tired, nausea and nausea, Shaohua, loose stool, numbness, insomnia, dizziness, abdominal distending pain, abdominal mass, etc. The tongue is pale dark, purple dark, tongue teeth mark, fat tongue, thin tongue, slightly thicker tongue, thick tongue, etc. After chemotherapy, the symptoms of the increase in symptoms are dumbass, nausea, nausea, fatigue, limb numbness, poor sleep, dry mouth, dry pharynx, Shaohua complexion, dizziness, sore waist and knee, etc. Abdominal distension and so on. After chemotherapy, the symptoms reduced include abdominal distended pain, yellow urine, dry stool knot, tongue red, thin fur, yellow fur, and so on. By chi-square test, there are significant differences in symptoms after chemotherapy, such as dysphoria, nausea, nausea, fatigue, etc. Limb numbness, poor sleep, tongue tooth marks, thin fur, slightly thicker fur, Tareun and other syndromes. Conclusion: the syndromes of patients with advanced colorectal cancer are characterized by deficiency of qi, blood deficiency, yin deficiency, and deficiency of qi, blood deficiency and yin deficiency, among which deficiency syndrome can be characterized by deficiency of qi, blood deficiency, yin deficiency, and so on. Yang deficiency and deficiency of viscera function; evidence can be shown as phlegm dampness, qi stagnation, blood stasis, etc. After chemotherapy, symptoms such as stomach disharmony, nausea and nausea, fatigue and fatigue, such as gastric disharmony, dampness of temper, etc. Further aggravated the original syndromes. For the patients after chemotherapy, phlegm and dampness, tonifying qi and blood, etc.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R273

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