發(fā)布時間：2018-04-27 15:16

  本文選題：食管癌 + 中醫(yī)證型　； 參考：《南京中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：研究背景：食管癌是人類最常見的惡性腫瘤之一,在我國的發(fā)病率也居高不下,江蘇是食管癌的高發(fā)地區(qū)之一。食管癌的治療主要包括外科手術(shù)、放療和化療,中醫(yī)藥治療是食管癌綜合治療的重要組成部分,所以在江蘇研究食管癌的中醫(yī)證型分析以及影響因素,具有重要的指導(dǎo)意義。目的：通過回顧性臨床研究,分析食管癌中醫(yī)證型分布情況及影響因素。對象與方法：2014年6月-2015年8月江蘇省中醫(yī)院腫瘤科,經(jīng)病理明確診斷為食管癌并進(jìn)行放化療的住院患者。根據(jù)文獻(xiàn)研究,自行設(shè)計信息調(diào)查表,研究食管癌中醫(yī)證型分布；以臨床證型為對象,以相關(guān)實驗室指標(biāo),瘤體生物特征及個人資料為變量,探討食管癌中醫(yī)證型的影響因素。結(jié)果：(1)食管癌患者放化療前后比較,痰氣互阻型由34.2%減少至10%,血瘀痰滯型由37.5%減少至30%,陰虛內(nèi)熱型由25.8%增加至40%,氣虛陽微型由2.5%增加至20%,食管癌患者放化療前后中醫(yī)證型比較具有顯著差異(x2=51.76,P=0.000)。(2)經(jīng)多項分類Logistic回歸分析結(jié)果顯示,與食管癌放化療前證型相關(guān)的因素為病理分期、KPS評分、骨髓抑制分度和原發(fā)部位；與放化療后證型相關(guān)的因素為病理分期、KPS評分和原發(fā)部位(P0.05)。(3)經(jīng)獨立樣本T檢驗,食管癌放化療前各證型分布在白細(xì)胞計數(shù)、血紅蛋白和CY211、癌胚抗原、糖類抗原199、膽堿酯酶和總蛋白這些指標(biāo)上有差異性(P0.05)。結(jié)論：病例分期、KPS評分、骨髓抑制分度和原發(fā)部位是影響食管癌中醫(yī)辨證分型的因素,白細(xì)胞計數(shù)、血紅蛋白和CY211、癌胚抗原、糖類抗原199、膽堿酯酶和總蛋白這些指標(biāo)在不同證型上存在差異,對食管癌的診斷具有一定的價值。
[Abstract]:Background: esophageal cancer is one of the most common malignant tumors in human beings, and the incidence of esophageal cancer is also high in China. Jiangsu is one of the areas with high incidence of esophageal cancer. The treatment of esophageal cancer mainly includes surgery, radiotherapy and chemotherapy, and traditional Chinese medicine is an important part of comprehensive treatment of esophageal cancer, so it is of great significance to study the TCM syndromes and influencing factors of esophageal cancer in Jiangsu Province. Objective: to analyze the distribution of TCM syndromes of esophageal carcinoma and its influencing factors. Participants and methods: from June 2014 to August 2015, Department of Oncology, Jiangsu Provincial Hospital of traditional Chinese Medicine, confirmed pathologically as esophageal carcinoma and received radiotherapy and chemotherapy. According to the literature research, we designed the information questionnaire to study the distribution of TCM syndromes of esophageal carcinoma, and discussed the influencing factors of TCM syndromes of esophageal cancer by taking clinical syndromes as the object, the related laboratory indexes, tumor biological characteristics and personal data as variables. Results (1) comparison of radiotherapy and chemotherapy before and after chemotherapy in patients with esophageal cancer, The phlegm and qi reciprocal obstruction type decreased from 34.2% to 10um, blood stasis phlegm stagnation type decreased from 37.5% to 30, Yin deficiency internal heat type increased from 25.8% to 40g, Qi deficiency Yang micro-scale increased from 2.5% to 20. There were significant differences in TCM syndromes before and after radiotherapy and chemotherapy in patients with esophageal cancer. The results of classified Logistic regression analysis showed that, The factors related to the type of esophageal cancer before radiotherapy and chemotherapy were pathological stage and KPS score, bone marrow suppression score and primary site, and the factors related to the type of syndrome after radiotherapy and chemotherapy were pathological staging and KPS score and the primary site of esophageal cancer (P0.05, P0.05. Y3) by independent sample T test, and the factors related to the syndromes type of esophageal cancer before radiotherapy and chemotherapy were KPS score, bone marrow suppression score and primary site. There were significant differences in leukocyte count, hemoglobin and CY211, carcinoembryonic antigen, carbohydrate antigen 199, cholinesterase and total protein in patients with esophageal cancer before radiotherapy and chemotherapy (P 0.05). Conclusion: KPS score, bone marrow suppression score and primary site are the factors that influence the differentiation and classification of esophageal carcinoma in TCM, including leukocyte count, hemoglobin and CY211, carcinoembryonic antigen. The indexes of carbohydrate antigen 1999,cholinesterase and total protein were different in different syndromes and had certain value in the diagnosis of esophageal carcinoma.
【學(xué)位授予單位】：南京中醫(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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