本文選題：胃息肉 + 中醫(yī)證型　； 參考：《廣州中醫(yī)藥大學》2016年碩士論文

【摘要】：研究目的：探討胃息肉中醫(yī)證型與其病理類型及血清學指標胸苷激酶(TK1)、CEA之間的相互關系,探尋中醫(yī)“證”與現(xiàn)代醫(yī)學病理、血清學指標之間的內在聯(lián)系。研究方法：1.通過文獻調研和專家咨詢,制定胃息肉臨床信息調查表(見附錄)。2.收集病例資料：對符合納入標準并同意參與本次調查的胃息肉患者,收集一般信息,如實填寫調查表中的各項內容,四診合參,根據(jù)《中醫(yī)常見證診斷標準》,進行中醫(yī)辨證分型,所有患者均抽血送我院檢驗科行TK1和CEA檢測,息肉切除前簽署胃息肉切除知情同意書,胃息肉切除后一律行病理檢測,記錄其病理類型結果。3.分析134例胃息肉中醫(yī)證型、病理類型的分布特點。4.探討134例胃息肉中醫(yī)證型與活檢病理類型之間的關系。5.探討胃息肉中醫(yī)證型、病理類型與TK1和CEA水平之間的關系。研究結果：1.胃息肉發(fā)病以中老年多見,平均年齡54.35±11.73歲,男性發(fā)病率高于女性,男女比例為1.16：1。2.134例胃息肉患者中脾胃虛寒證10例(7%),脾虛濕蘊證7例(5%),脾胃濕熱證41例(31%),肝郁氣滯證25例(19%),脾虛濕瘀證41例(31%),氣滯血瘀證4例(3%),氣滯痰阻證6例(4%)。女性多以肝郁氣滯為主,男性多以脾胃濕熱為主,中青年患者多見脾胃濕熱證及肝郁氣滯證,而老年患者則以脾虛濕瘀證為主。3.134例胃息肉患者中炎性息肉59例(44%,男36例,女23例),增生性息肉21例(15%,男7例,女14例),腺瘤性息肉24例(18%,男18例,女6例),腺息肉5例(4%,男2例,女3例),混合性息肉21例(16%,男6例,女15例),組織學陰性息肉4例(3%,男3例,女1例),其中男性以炎性息肉和腺瘤性息肉為主,女性則以炎性息肉、增生性息肉及混合性息肉為主,不同病理類型的息肉在各年齡段的分布無差異。4.胃息肉中醫(yī)證型與病理類型之間存在相關性,炎性息肉和腺瘤性息肉均以脾虛濕瘀及脾胃濕熱為主,表明濕瘀、濕熱與其病理環(huán)境的形成有關,增生性息肉以肝郁氣滯、脾胃濕熱為主,表明氣滯、濕熱是其主要的病理因素。5.中醫(yī)證型、病理類型與TKl和CEA水平的關系：不同中醫(yī)證型和TK1、CEA水平的關系比較中,均無顯著性差異,7種胃息肉病理類型中,腺瘤性息肉的TK1和CEA含量最高,與組織學陰性息肉比較,不同病理類型的TK1水平具有顯著統(tǒng)計學差異(P0.05),不同病理類型(除腺息肉外)的CEA水平也具有顯著統(tǒng)計學差異(P0.05)。研究結論：1.胃息肉發(fā)病以中老年多見,男性發(fā)病率高于女性。2.中醫(yī)證型分布規(guī)律：脾胃濕熱證脾虛濕瘀證肝郁氣滯證脾胃虛寒證脾虛濕蘊證氣滯痰阻證氣滯血瘀證,女性多以肝郁氣滯為主,男性多以脾胃濕熱為主,中青年患者多見脾胃濕熱證及肝郁氣滯證,而老年患者則以脾虛濕瘀證為主。3.病理類型分布特點：炎性息肉最多,其后依次是腺瘤性、混合性息肉、增生性息肉、腺息肉、組織學陰性息肉,其中男性以炎性息肉和腺瘤性息肉為主,女性則以炎性息肉、增生性息肉及混合性息肉為主,不同病理類型的息肉在各年齡段的分布無差異。4.胃息肉中醫(yī)證型與病理類型之間存在相關性,炎性息肉和腺瘤性息肉均以脾虛濕瘀及脾胃濕熱為主,表明濕瘀、濕熱與其病理環(huán)境的形成有關,增生性息肉以肝郁氣滯、脾胃濕熱為主,表明氣滯、濕熱是其主要的病理因素。5.中醫(yī)證型與TK1和CEA水平的關系：不同中醫(yī)證型和TK1、CEA水平的關系比較中,均無顯著性差異。6.病理類型與TK1和CEA水平的關系：與組織學陰性息肉比較,不同病理類型的TKl水平具有顯著統(tǒng)計學差異(P0.05),不同病理類型(除腺息肉外)的CEA水平也具有顯著統(tǒng)計學差異(P0.05)。7種胃息肉病理類型中,腺瘤性息肉的TK1和CEA含量最高,認為TK1和CEA可作為檢測胃息肉癌變的指標。增生性息肉的TK1和CEA水平僅次于腺瘤性息肉,提示增生性息肉也有癌變可能。
[Abstract]:Objective: To explore the relationship between the TCM syndrome type of gastric polyp and its pathological type and the serological index of thymidine kinase (TK1) and CEA, and to explore the internal relationship between the TCM syndrome and the modern medical pathology and the serological index. 1. through literature investigation and expert consultation, the clinical information questionnaire of gastric polyps was formulated (see Appendix). .2. collection of case data: collect general information for patients with gastric polyps conforming to the inclusion criteria and agree to participate in this investigation, fill out all the contents in the questionnaire, complete the four diagnostics, according to the standard of TCM syndrome diagnosis, carry out the syndrome differentiation of traditional Chinese medicine, all patients take blood to our hospital for TK1 and CEA examination, before the resection of polyps An informed consent book was signed for the resection of gastric polyps. After the resection of the gastric polyps, a pathological examination was performed, and the pathological type results were recorded..3. analysis of 134 cases of gastric polyps, the distribution of pathological types, the relationship between the TCM syndrome types of 134 cases of gastric polyps and the pathological types of biopsy.5. was used to explore the TCM syndrome type of gastric polyps, the pathological type and the TK1 and CEA water. The relationship between the 1. gastric polyps was seen in the middle and old age, the average age was 54.35 + 11.73 years old, the incidence of male was higher than that of the female. The proportion of men and women was 10 cases (7%) of spleen and stomach deficiency cold syndrome in 1.16:1.2.134 patients with gastric polyps, 7 cases of spleen deficiency syndrome (5%), 41 cases of spleen and stomach damp heat syndrome (31%), 25 cases (19%) of stagnation of liver qi stagnation, 41 cases of spleen deficiency and damp stasis syndrome (3). 1%) 4 cases of qi stagnation and blood stasis syndrome (3%), stagnation of qi stagnation syndrome in 6 cases (4%). Most women were mainly with stagnation of liver qi and qi stagnation, male mostly with spleen and stomach damp heat. The middle-aged and young patients saw spleen and stomach damp heat syndrome and stagnation of liver qi stagnation, while the elderly patients with spleen deficiency and damp stasis syndrome were mainly.3.134 cases with inflammatory polyps in 59 cases (44%, 36 men, 23 cases), and 21 cases of proliferative polyp. (15%, 7 men, 14 women), 24 cases of adenomatous polyps (18%, 18 men, 6 women), 5 adenomatous polyps (4%, 2 men, 3 cases), 21 cases of mixed polyps (16%, males, females), male with inflammatory polyps and adenomatous polyps, and women with inflammatory polyps, proliferative polyps and mixed polyps There was no difference in the distribution of different pathological types of polyps in all ages. There was a correlation between the TCM syndrome type and pathological type of.4. gastric polyps. Inflammatory polyps and adenomatous polyps were dominated by spleen deficiency dampness stasis and spleen and stomach damp heat. It showed that wet heat and damp heat were related to the formation of pathological environment. Hyperplastic polyps were stagnation of liver qi and stagnation of liver and spleen and stomach. The main pathological factors, such as qi stagnation and damp heat, are the main pathological factors of.5. TCM syndrome type, pathological type and TKl and CEA level. There are no significant differences in the relationship between different TCM Syndrome Types and TK1 and CEA levels. Among the 7 types of gastric polyps, the content of TK1 and CEA in adenomatous polyps is the highest, compared with histological negative polyps, different pathological types. The level of the type of TK1 has significant statistical difference (P0.05), and the CEA level of different pathological types (except for adeno polyps) also has significant statistical difference (P0.05). Research conclusion: 1. the incidence of gastric polyps is more common in the middle and old age, the incidence of male is higher than that of the female.2. TCM syndrome type distribution rules: spleen stomach damp heat syndrome liver depression stagnation of spleen qi stagnation syndrome, spleen and stomach deficiency The spleen deficiency syndrome of cold syndrome shows qi stagnation and stagnation of qi stagnation and blood stasis syndrome with stagnation of qi stagnation and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of spleen and stomach. The majority of the male and young patients are mainly spleen and stomach damp heat syndrome and stagnation of liver qi stagnation, while the elderly patients with spleen deficiency and damp stasis are mainly.3. pathological types: inflammatory polyps are the most, followed by adenomatous and mixed interest. Meat, hyperplastic polyps, adeno polyps, histologic negative polyps, among which men are mainly inflammatory polyps and adenomatous polyps, women are mainly inflammatory polyps, proliferative polyps and mixed polyps. There is no difference in the distribution of different pathological types of polyps in all ages. There is a correlation between the TCM syndrome type and the pathological type of.4. gastric polyps. Meat and adenomatous polyps are mainly spleen deficiency dampness stasis and spleen and stomach damp heat, indicating that wet heat and damp heat are related to the formation of pathological environment. Hyperplastic polyps are mainly stagnation of liver qi, spleen and stomach damp heat, which indicate that qi stagnation and damp heat are the main pathological factors of.5. syndrome type and TK1 and CEA level: the relationship between different TCM Syndrome Types and TK1, CEA level In comparison, there was no significant difference in the relationship between the.6. pathological type and the level of TK1 and CEA: compared with the histologic negative polyps, the TKl levels of different pathological types were significantly different (P0.05), and the CEA levels of different pathological types (except for adeno polyps) also had significant statistical differences (P0.05) in the pathological type of the.7 species of gastric polyps, adenomatous and interest. The content of TK1 and CEA in meat is the highest. It is considered that TK1 and CEA can be used as an indicator of canceration of gastric polyps. The TK1 and CEA levels of proliferative polyps are second only to adenomatous polyps, suggesting that hyperplastic polyps may also be cancerous.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R259

【參考文獻】

相關期刊論文 前10條

1 朱江;彭寬嘉;何津春;;癌胚抗原在腫瘤中應用研究進展[J];國際檢驗醫(yī)學雜志;2015年21期

2 楊振;吳戰(zhàn)軍;;不同病理類型胃息肉患者Hp感染情況及胃、結直腸息肉之間的相關性[J];山東醫(yī)藥;2015年37期

3 王平;魏睦新;;魏睦新教授采用化痰消瘀法治療胃息肉經驗介紹[J];中國中西醫(yī)結合消化雜志;2014年12期

4 趙琳;曹夢晗;王民憲;;血清TK1監(jiān)測對胰腺癌診斷的臨床意義[J];中國實驗診斷學;2014年11期

5 李衛(wèi)軍;;健脾祛瘀合劑聯(lián)合胃鏡下電凝電切術治療老年胃息肉[J];吉林中醫(yī)藥;2014年10期

6 方輝;李學良;任一鳴;施瑞華;;血清胸苷激酶1在胃息肉惡性進展中的變化及臨床價值[J];胃腸病學和肝病學雜志;2014年08期

7 朱碧媛;鄧麗娥;何少初;;何世東老中醫(yī)治療胃息肉經驗介紹[J];新中醫(yī);2013年10期

8 馮智;米娜娃兒·阿布都;古麗巴哈爾·司馬義;;胃息肉的臨床病理特征分析460例[J];世界華人消化雜志;2013年25期

9 鄭恩典;翁雪健;鄭亮;王英;余穎聰;陳艷;鄭秀華;柯建利;;1352例胃息肉臨床特點分析[J];浙江實用醫(yī)學;2013年03期

10 劉婉薇;馬娟;余蓮英;沙衛(wèi)紅;王啟儀;;上消化道息肉臨床特征分析2376例[J];世界華人消化雜志;2013年08期

相關重要報紙文章 前1條

1 李子云;;胃息肉治驗[N];民族醫(yī)藥報;2002年

相關碩士學位論文 前2條

1 王海龍;血清TK1、TSGF、CEA、CA125及CA19-9聯(lián)合檢測在胃癌診斷中的臨床意義[D];福建醫(yī)科大學;2014年

2 孫啟強;TK1、Ki-67在胃良惡性病變中的表達及其臨床意義[D];福建醫(yī)科大學;2012年

，

本文編號：2038917