本文選題：鼻咽癌 + 中醫(yī)��； 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:回顧分析204例鼻咽癌患者的臨床病歷資料,探討中醫(yī)治療鼻咽癌的用藥規(guī)律,放化療對(duì)中醫(yī)證型的影響,同時(shí)討論了諸如好發(fā)年齡、不同證型與EB病毒、情志的關(guān)系、好發(fā)轉(zhuǎn)移部位等問題。方法:將收集的患者病歷資料填入統(tǒng)一設(shè)計(jì)的《柳州市中醫(yī)院鼻咽癌住院病人調(diào)查表》,記錄的資料包括:(1)性別、年齡、出入院日期等一般資料;(2)鼻咽癌的中醫(yī)證型及病理類型,治療方法:包括中藥、針灸處方、放化療方案等。(3)相關(guān)實(shí)驗(yàn)室檢查;(4)對(duì)以上資料進(jìn)行綜合分析,并利用spss20統(tǒng)計(jì)軟件進(jìn)行檢驗(yàn)判定其意義。結(jié)果:(1)男性病例131例,女性病例73例,男女比例為1.79:1;(2)最小發(fā)病年齡為33歲,最大發(fā)病年齡為80歲,平均年齡為53.27+9.96歲;(3)局部放射治療對(duì)中醫(yī)證型影響主要表現(xiàn)為熱毒耗傷氣陰,有化療史以氣血兩虛證、氣陰兩虛證、肺胃熱毒證、熱毒傷陰證比例較高,平素情志抑郁病例證型以痰濕內(nèi)阻證、痰瘀氣滯證居多;(4)遠(yuǎn)處轉(zhuǎn)移以肺、肝、骨多見;低分化鱗癌遠(yuǎn)處轉(zhuǎn)移以肺常見,非角化性鱗癌則以肝、骨轉(zhuǎn)移較多,分化型非角化性癌以骨轉(zhuǎn)移常見,未分化型非角化性癌以頸部淋巴結(jié)轉(zhuǎn)移常見;(5)中藥以補(bǔ)虛類、清熱類、解表類使用頻率最高;(6)針灸常用足太陽(yáng)膀胱經(jīng)、任脈穴位。結(jié)論:經(jīng)治療后的患者中醫(yī)證型受放化療影響,一定程度上反映出放化療的熱毒性,容易耗傷人體氣血。情志抑郁病例證型以痰濕內(nèi)阻證、痰瘀氣滯證居多,符合中醫(yī)肝病傳脾及情緒抑郁導(dǎo)致肝郁氣滯的認(rèn)識(shí),總的來說鼻咽癌早期證型以實(shí)證為主,中晚期虛癥及虛實(shí)夾雜多見,其演變規(guī)律體現(xiàn)了因?qū)嵵绿?終致陰陽(yáng)俱損的特點(diǎn)。傳統(tǒng)中醫(yī)藥治療在改善患者癥狀方面具有一定優(yōu)勢(shì)。
[Abstract]:Objective: to retrospectively analyze the clinical records of 204 patients with nasopharyngeal carcinoma (NPC), explore the law of drug use and the influence of radiotherapy and chemotherapy on TCM syndromes, and discuss the relationship between Epstein-Barr virus (EBV) and different syndromes, such as predilection age, different syndromes, and emotion. Prone to metastases and other problems. Methods: the collected patient's medical records were filled in the questionnaire of inpatients with nasopharyngeal carcinoma in Liuzhou Hospital of traditional Chinese Medicine. The data recorded included sex, age, date of admission and other general data, such as TCM syndromes and pathological types of nasopharyngeal carcinoma. Treatment methods: including traditional Chinese medicine, acupuncture and moxibustion prescription, chemoradiotherapy regimen, etc.) the above data were analyzed synthetically by laboratory examination, and the significance was determined by spss20 statistical software. Results there were 131 male cases and 73 female cases. The minimum onset age was 33 years old, the maximum onset age was 80 years old, the average age was 53.279.96 years old. The influence of local radiotherapy on TCM syndromes was mainly heat toxin consumption and dampening qi and yin. The history of chemotherapy included qi and blood deficiency syndrome, qi and yin deficiency syndrome, lung and stomach heat toxin syndrome, heat toxin injury to yin syndrome ratio was higher, common mood depression syndrome type was phlegm dampness internal obstruction syndrome, phlegm and blood stasis qi stagnation syndrome was more than 4) distant metastasis was found in lung, liver and bone. Distant metastasis of poorly differentiated squamous cell carcinoma is common in lung, non-keratinized squamous cell carcinoma is liver, bone metastasis is more common, differentiated non-keratinized carcinoma is common in bone metastasis, and non-differentiated non-keratinized carcinoma is commonly seen in cervical lymph node metastasis. Acupuncture and moxibustion commonly used foot sun bladder meridian, Ren pulse acupoints. Conclusion: the TCM syndrome type after treatment is influenced by radiotherapy and chemotherapy, which reflects the thermal toxicity of radiotherapy and chemotherapy to some extent, and it is easy to consume qi and blood of human body. The main syndromes of emotional depression were phlegm dampness internal obstruction syndrome, phlegm and blood stasis qi stagnation syndrome, which was consistent with the understanding that liver disease spread spleen and emotional depression resulted in liver depression and qi stagnation in TCM. In general, the early syndromes of nasopharyngeal carcinoma were mainly positive, the middle and late stage asthenia and the mixture of deficiency and excess were more common. The law of its evolution reflects the characteristics of both yin and yang damage due to deficiency caused by reality. Traditional Chinese medicine treatment has some advantages in improving the symptoms of patients.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R273

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