本文選題：胃癌 + 食管癌　； 參考：《遼寧中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:探討胃癌、食管癌術(shù)后患者中醫(yī)辨證分型及與中醫(yī)體質(zhì)的關(guān)系。方法:選取2014年4月-2015年8月就診于本院門診及住院處并符合本次研究標(biāo)準(zhǔn)的135例胃癌、食管癌術(shù)后患者,應(yīng)用聚類分析(K-均值聚類)方法及填寫《中醫(yī)體質(zhì)測(cè)評(píng)量表》,對(duì)其進(jìn)行中醫(yī)證型的聚類分析及中醫(yī)體質(zhì)的調(diào)查,并分析主要中醫(yī)體質(zhì)與中醫(yī)證型的關(guān)系。結(jié)果:1.胃癌、食道癌兩組患者乏力、睡眠欠佳、納差等癥狀均較突出,達(dá)40%以上;兩組相比,胃癌組腹痛、腹脹、便溏、怕冷、消瘦所占比例更高,在31-43%之間,食管癌組進(jìn)食哽噎、嘔吐痰涎、便秘等癥狀所占比例較胃癌組更為明顯,在37-48%之間。2.四診信息經(jīng)聚類分析后胃癌分脾胃虛寒型(26例),脾虛痰濕型(21例),胃陰不足型(17例),肝氣犯胃型(13例),氣血兩虛型(12例)5型;食管癌分為痰氣交阻型(19例),氣陰兩虛型(16例),肝胃不和型(11例)3型。3.135例患者中醫(yī)體質(zhì)的總體分布平和質(zhì)占8.89%,8種偏頗體質(zhì)占91.11%。其中,8種偏頗體質(zhì)中以陽(yáng)虛質(zhì)、氣虛質(zhì)、氣郁質(zhì)為主,這三種體質(zhì)占全部調(diào)查體質(zhì)類型的65.18%,其余的體質(zhì)占比在3-9%之間,而血瘀質(zhì)和濕熱質(zhì)最少,此次調(diào)查無(wú)特稟質(zhì)。4.胃癌中氣虛質(zhì)與氣血兩虛型、脾虛痰濕型顯著相關(guān)(P0.05);胃癌陽(yáng)虛質(zhì)與脾胃虛寒型(不論術(shù)后無(wú)癌及有癌)顯著正相關(guān)(P0.01),但與脾虛痰濕型顯著負(fù)相關(guān)(P0.05);術(shù)后復(fù)發(fā)或轉(zhuǎn)移的胃癌肝氣犯胃型(P〈0.01)和食管癌肝胃不和型(P〈0.05)均與氣郁質(zhì)顯著相關(guān)。結(jié)論:1.135例胃癌、食管癌術(shù)后患者的中醫(yī)證型分別聚類為5類、3類比較符合臨床實(shí)際。2.135例胃癌、食管癌術(shù)后患者的偏頗體質(zhì)以陽(yáng)虛質(zhì)、氣虛質(zhì)、氣郁質(zhì)多見。3.胃癌患者出現(xiàn)的陽(yáng)虛質(zhì)與其本來(lái)體質(zhì)相關(guān),胃癌、食管癌患者的氣郁質(zhì)與疾病的修飾有關(guān),氣虛質(zhì)可能是胃癌患者的主要病機(jī)基礎(chǔ)。
[Abstract]:Objective: to explore the relationship between TCM syndrome differentiation and TCM constitution in patients with gastric cancer and esophageal carcinoma. Methods: 135 patients with gastric cancer and esophageal cancer were selected from April 2014 to August 2015, who were treated in outpatient and inpatient department of our hospital and met the criteria of this study. By using the cluster analysis method and filling out the TCM physique Evaluation scale, the cluster analysis of TCM syndromes and the investigation of TCM physique were carried out, and the relationship between TCM constitution and TCM syndrome type was analyzed. The result is 1: 1. The symptoms of fatigue, poor sleep and anorexia in gastric cancer and esophageal cancer groups were more than 40%, and the proportion of stomach pain, abdominal distension, loose stools, fear of cold and weight loss in gastric cancer group was higher than that in stomach cancer group, and between 31 and 43%, esophageal cancer group ate and choked. Vomiting, sputum, salivation, constipation and other symptoms were more obvious than gastric cancer group, between 37-48%. According to cluster analysis, 26 cases of gastric cancer were divided into two types: deficiency of spleen and stomach of cold type (n = 26), spleen deficiency of phlegm and dampness type (n = 21), deficiency of stomach yin type (n = 17), invasion of liver qi by stomach type (n = 13), deficiency of both qi and blood in 12 cases (n = 12). Esophageal carcinoma was divided into phlegm and qi stagnation type (n = 19), Qi and yin deficiency type (n = 16) and liver-stomach disharmony type (n = 11). Among the 8 kinds of partial physiques, Yang deficiency and Qi stagnation are the main ones. These three kinds of physiques account for 65.18 of the total types of physique investigated, while the remaining ones are between 3 and 9%, while blood stasis and dampness and heat are the least. This investigation has no special quality. 4. Deficiency of Qi and Blood in gastric carcinoma, There was a significant positive correlation between yang deficiency of gastric cancer and deficiency of spleen and stomach cold type (no cancer or cancer after operation), but a negative correlation with spleen deficiency phlegm dampness type (P < 0.01), and a significant negative correlation with spleen deficiency phlegm dampness type (P < 0.01), and a negative correlation with spleen deficiency phlegm dampness type (P < 0.01). There was a significant correlation between liver and stomach disharmony (P < 0.05) and qi stagnation in esophageal carcinoma. Conclusion 1.135 cases of gastric cancer were divided into 5 types and 3 types of TCM syndromes respectively. The results showed that 2.135 cases of gastric cancer were in accordance with clinical practice. The partial physique of patients with esophageal cancer after operation was yang deficiency and Qi stagnation was more than .3.Conclusion: 1. 135 cases of gastric cancer were divided into 5 types and 3 types of TCM syndromes, respectively. The deficiency of yang in patients with gastric cancer is related to their original constitution, and the qi stagnation in patients with esophageal cancer is related to the modification of disease. The deficiency of qi may be the main pathogenesis of gastric cancer.
【學(xué)位授予單位】：遼寧中醫(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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本文編號(hào)：2047812