本文選題：中晚期肝癌 + 證侯特點�。� 參考：《遼寧中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:將中晚期原發(fā)性肝癌患者作為研究對象,歸納總結(jié)出其癥候特點、治療特點以及療效特點,為進一步優(yōu)化中晚期肝癌治療方案提供參考意見。材料與方法:選取從2015年3月1日至2016年3月1日于遼寧中醫(yī)藥大學(xué)附屬醫(yī)院住院以肝癌為第一診斷的患者病例,嚴(yán)格按照納入標(biāo)準(zhǔn)及排除標(biāo)準(zhǔn)進行篩選,共選出符合標(biāo)準(zhǔn)的患者73人,回顧分析其一般資料,既往接受治療情況,臨床癥狀、證候特點、生存期情況及癥狀緩解情況。并用Microsoft Excel軟件進行頻次統(tǒng)計,采用spass20.0進行K-均值聚類分析。結(jié)果:1、73例中晚期肝癌患者的癥狀分析結(jié)果顯示,神疲乏力為其最主要表現(xiàn),高達82.19%,其次占20%以上的癥狀依次為腹脹、納差、失眠、脅痛、大便干結(jié)、黃疸、腹痛、口苦、口干咽燥,患者中10%-20%會出現(xiàn)惡心、下肢浮腫、形體消瘦、大便色黑、意識模糊、嘔吐、善太息、鼓脹、嘔血、氣短、大便溏泄、心煩易怒等癥狀,極少數(shù)患者會出現(xiàn)呼吸困難、發(fā)熱、厭食油膩。2、73例中晚期肝癌患者的癥狀及體征(舌脈)進行聚類分析后,共分為五種證候類型,分別是濕瘀肝膽證,肝腎陰虛證,瘀結(jié)水留證,肝郁氣滯證,脾虛濕困證。3、73例中晚期肝癌患者的中位總生存期為10.4個月,不同的證候類型中位生存期不同,五種證候的中位生存期依次為肝郁氣滯證11.8個月,瘀結(jié)水留證10.4個月,肝腎陰虛證10.2個月,脾虛濕困證9.5個月,濕瘀肝膽證6個月。濕瘀肝膽證生存期最短。4、五種證候類型經(jīng)中西醫(yī)結(jié)合治療后,證候(神傷)均有不同程度的緩解,有效率均可達50%以上,其中濕瘀肝膽證的有效率最高,高達82.61%。結(jié)論:中西醫(yī)結(jié)合療法對濕瘀肝膽證“神傷”的治療療效顯著,達到了形神的反(相對)統(tǒng)一的治療目的。由此可見中西醫(yī)結(jié)合治療中晚期肝癌的“神傷”具有優(yōu)勢,值得在臨床上推廣。
[Abstract]:Objective: To sum up the symptoms of middle and late primary hepatocellular carcinoma (HCC), summarize its symptoms, treatment characteristics and curative effect, and provide reference for further optimization of middle and late liver cancer treatment. Materials and methods: from March 1, 2015 to March 1, 2016, the hospital of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine was used for liver cancer. The first diagnosed cases were selected strictly in accordance with the inclusion criteria and exclusion criteria, and 73 patients were selected to meet the standard. The general data were reviewed and analyzed. The treatment situation, clinical symptoms, syndrome characteristics, survival time and symptom relief were analyzed. Microsoft Excel software was used for frequency statistics, and spass20.0 was used. K- mean cluster analysis. Results: the results of symptoms analysis in 1,73 patients with middle and advanced liver cancer showed that fatigue was the most important manifestation, up to 82.19%, and the next 20% of the symptoms were abdominal distention, insomnia, hypochondriac pain, stool knot, jaundice, abdominal pain, stomachache, dry mouth and throat dryness. In the patients, 10%-20% would appear nausea, swelling of the lower limbs, and body emaciation. The symptoms of dyspnea, fever, and anorexia in.2,73 patients with advanced liver cancer are divided into five types, namely, the syndrome of the liver and kidney, the liver and kidney yin deficiency, and the deficiency of the liver and kidney yin, the liver and kidney yin deficiency. Syndrome, stagnation of stagnation of water, stagnation of liver qi and syndrome of spleen deficiency and dampness syndrome, the median survival period of.3,73 patients with middle and advanced liver cancer is 10.4 months. The median survival time of different syndrome types is different. The median survival time of the five syndromes is 11.8 months of stagnation of liver Qi stagnation, 10.4 months for stagnation of stagnation of water, 10.2 months in liver kidney yin deficiency syndrome and 9.5 months for spleen deficiency syndrome. The syndrome of dampness and stasis of liver and gallbladder for 6 months. The survival period of the syndrome of dampness and stasis of liver and gallbladder is the shortest.4. After the combination of traditional Chinese and Western medicine, the five types of syndromes are relieved in different degrees, the effective rate is above 50%, of which the effective rate of the syndrome of damp and stagnant liver and gallbladder is the highest and up to 82.61%.: the therapeutic effect of the combination therapy of Chinese and Western Medicine on the "Deshen" of the damp stasis liver and Gallbladder Syndrome It can be seen that the combination of traditional Chinese and Western medicine has the advantage of "deify" in the treatment of middle and late liver cancer, and it is worth popularizing in the clinic.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R273

【參考文獻】

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