【摘要】：目的:通過回顧性研究,總結(jié)大腸癌臨床特點分布情況,探索大腸癌中醫(yī)證候分布規(guī)律,并進(jìn)一步探討大腸癌與相關(guān)因素的相關(guān)性,加強對大腸癌的認(rèn)識,為大腸癌辨證論治提供理論依據(jù),指導(dǎo)臨床治療。方法:首先設(shè)計大腸癌臨床信息采集表,收集符合納入標(biāo)準(zhǔn)的334例大腸癌患者的臨床資料,對其進(jìn)行中醫(yī)辨證,整理信息采集表,建立數(shù)據(jù)庫,運用統(tǒng)計學(xué)方法描述大腸癌臨床資料的分布情況,總結(jié)大腸癌中醫(yī)證候的分布規(guī)律,探索大腸癌與個人一般情況、臨床特點、腫瘤生物特性、治療情況等資料之間的關(guān)系。結(jié)果:1、在334例病例中,平均年齡為62.46±12.740,50歲以上84.4%;男女比例為1.32:1;廣西籍79.6%;漢族58.7%,壯族29.6%,其他少數(shù)民族11.7%;中學(xué)文化程度近50%;離退休及無業(yè)合計超過50%;飲酒者超過50%,吸煙者達(dá)到40%。2、腫瘤病灶位于直腸者占45.2%;管狀腺癌占80.8%,中分化有62.6%;Ⅲ期與Ⅳ期總患病率和Ⅰ期與Ⅱ期總患病率有統(tǒng)計學(xué)差異(P0.05);腫瘤轉(zhuǎn)移者占60.2%,遠(yuǎn)處轉(zhuǎn)移中,肝轉(zhuǎn)移者53.6%。3、從治療情況來看,接受化療者占34.1%,接受手術(shù)者占50%。4、從臨床特點來看,最短病程為1天,最長病程達(dá)17年,中位病程為6個月。入院主訴中腹痛、便血、大便習(xí)性改變共占60.8%,體征中腹部疤痕、腹部包塊、腹部壓痛均占50%以上。有177例患者合并他病,其中胃腸息肉占43.0%。5、從證型分布情況看,6種證型構(gòu)成比依次是濕熱蘊結(jié)證(26.6%)脾腎陽虛證(16.8%)瘀毒內(nèi)阻證(16.6%)脾胃虛弱證(14.7%)氣血虧虛證(14.1%)肝腎陰虛證(11.4%),經(jīng)統(tǒng)計學(xué)分析,濕熱蘊結(jié)證是臨床最常見的證型(P0.05)。其余5種證型分布無顯著性差異(P0.05)。6、大腸癌證型與性別、年齡、婚姻、文化程度、職業(yè)、合并他病、腫瘤部位、病理類型、分化程度無明顯相關(guān)性(P0.05),與病理分期、腫瘤轉(zhuǎn)移、手術(shù)、化療、病例來源、病程存在相關(guān)性(P0.05)。結(jié)論:1、大腸癌發(fā)病以老年患者為主,男性多于女性;籍貫以廣西籍為主,民族以漢族多見,其次是壯族;文化程度集中在中學(xué);職業(yè)以離退休為主;吸煙者與飲酒者均占較大比例。2、腫瘤發(fā)病部位以直腸最常見;管狀腺癌在病理類型中最多見,其分化程度集中在中分化;就病理分期、腫瘤轉(zhuǎn)移情況而言,我院收治患者以中晚期為主。3、手術(shù)仍是大腸癌最主要的治療方式。4、腹痛、便血、大便習(xí)慣改變、腹內(nèi)包塊是大腸癌的主要辨病依據(jù)。合并疾病中胃腸息肉最多見。5、最常見的證型是濕熱蘊結(jié)證,脾腎陽虛證也占較高比例。6、大腸癌患者的性別、年齡、婚姻、文化程度、職業(yè)、合并他病、腫瘤部位、病理類型、分化程度不會影響大腸癌證型的分布,病理分期、腫瘤轉(zhuǎn)移、手術(shù)、化療、病例來源、病程等會影響大腸癌證型的分布。
[Abstract]:Objective: to summarize the distribution of clinical characteristics of colorectal cancer, explore the distribution of TCM syndromes of colorectal cancer, and further explore the correlation between colorectal cancer and related factors, and strengthen the understanding of colorectal cancer. To provide a theoretical basis for the treatment of colorectal cancer based on syndrome differentiation, guiding clinical treatment. Methods: first of all, we designed the clinical information collection table of colorectal cancer, collected the clinical data of 334 patients with colorectal cancer according to the inclusion criteria, differentiated the symptoms and signs of TCM, sorted out the information collection table, and established a database. The distribution of clinical data of colorectal cancer was described by statistical method. The distribution of TCM syndromes of colorectal cancer was summarized, and the relationship between colorectal cancer and individual general situation, clinical characteristics, tumor biological characteristics and treatment was explored. Results: (1) in 334 cases, the average age was 62.46 鹵12.740 ~ 50 years old, the ratio of male to female was 1.32: 1, the nationality of Guangxi was 79.66.The Han nationality was 58.7%, the Zhuang nationality was 29.6 and the other minorities were 11.775. The total number of alcohol drinkers was more than 50, the smokers reached 40.2, the tumors were located in the rectum 45.2, the tubular adenocarcinoma was 80.8, the middle differentiation was 62.6; The total prevalence of stage 鈪，

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