基于“六经辨证”理论探讨乳腺癌化疗所致消化道反应辨证规律

发布时间：2018-03-25 16:02

本文选题：乳腺癌　切入点：化疗　出处：《广州中医药大学》2017年硕士论文

【摘要】：目的:通过调查经广东省中医院病理诊断为乳腺癌并接受第1周期EC、TEC、FEC及TC化疗方案后出现消化道反应的患者的一般情况,观察其消化道反应的相关症状及舌脉象,进行六经辨证,探讨乳腺癌化疗所致消化道反应的一般年龄分布情况及六经辨证分型规律,为进一步通过中医药来改善围化疗期患者的消化道反应,及化疗后消化道反应的治疗思路提供一定的临床依据。方法:本研究选择广东省中医院乳腺科2016年9月至2017年1月的接受初次化疗后出现消化道反应的121例乳腺癌患者进行研究,全部为女性,按照严格的纳排标准挑选其中符合消化道反应诊断标准并可获取完整相关信息的100例患者,使用一般资料收集表和症状观察收集表进行相关资料收集,包括通过调查收集患者的一般情况及四诊收集消化道反应的相关症状和舌象脉象等,统一由专家根据六经辨证进行辨证分型,将数据汇总,用Excle录入,用频数分析法和计数资料卡方检验进一步分析和对比。结果:1.乳腺癌患者出现消化道反应的年龄多处于40-60岁之间。2.乳腺癌消化道反应的六经辩证具有特定的规律。在3种不同类型的消化道反应中,六经辨证分型规律大体基本一致。太阴病为主要证型,依次为少阴病、厥阴病、少阳病、阳明病、其他病。3.在化疗方案与消化道反应关系方面,恶心呕吐与EC方案关系最为密切,其次是FEC、TC、TEC方案;腹泻患者中则FEC方案患者则占大多数,其余由多到少依次为TC,TEC,EC;便秘则与TEC方案关联紧密,剩余则依次为TC,EC,FEC。结论:1.本研究中,乳腺癌患者消化道反应的发病年龄与中国乳腺癌患病年龄分布特点一致,并与主要证型太阴病无明显的相关性。2.六经辨证分型多以阴证为主,其中以太阴病和少阴病占大多数,其中太阴病为主要证型。3.在乳腺癌化疗方案中,EC、FEC、TEC三种方案分别与消化道反应中的恶心呕吐、腹泻和便秘关系紧密。
[Abstract]:Objective: to investigate the general situation of patients with digestive tract reaction after the first cycle chemotherapy regimen ECTECTECFEC and TC, and to observe the symptoms and tongue pulse of digestive tract reaction in Guangdong Provincial Hospital of traditional Chinese Medicine (TCM). To discuss the general age distribution of digestive tract reaction induced by chemotherapy of breast cancer and the pattern of syndrome differentiation of six meridians, in order to further improve the digestive tract reaction of patients with perichemotherapy by Chinese medicine. Methods: 121 cases of digestive tract reaction after first chemotherapy from September 2016 to January 2017 were selected from mammary gland department of Guangdong traditional Chinese medicine hospital. Cancer patients were studied, 100 patients who met the diagnostic criteria of digestive tract reaction and were able to obtain complete relevant information were selected according to strict nano row criteria. The data were collected using general data collection table and symptom observation collection table. Including collecting the general situation of the patients through investigation and collecting the symptoms and tongue signs and pulses of the digestive tract reaction at the fourth diagnosis, and unifying the experts according to the syndrome differentiation of the six meridians to classify the symptoms and signs, collect the data and input them with Excle. The frequency analysis and counting data chi-square test were used to further analyze and compare. Results: 1. The age of digestive tract reaction in breast cancer patients was between 40 and 60 years old. 2. The six meridians dialectical of digestive tract reaction of breast cancer has a special law. In three different types of digestive tract reactions, The main syndromes were Taiyin disease, followed by Shaoyin disease, Jueyin disease, Shaoyang disease, Yangming disease, and other diseases. 3. In terms of the relationship between chemotherapy regimen and digestive tract reaction, Nausea and vomiting were the most closely related to the EC regimen, followed by the FEC regimen, the majority of the patients with diarrhea, and the rest from more to less. Constipation was closely associated with the TEC regimen, and the rest was TCEC-TEC-FEC.Conclusion in this study, The age of onset of digestive tract reaction in breast cancer patients was consistent with the age distribution of breast cancer in China, and there was no obvious correlation with the main syndromes of Taiyin disease. Among them, Taiyin disease is the main syndrome type. In the chemotherapy regimen of breast cancer, the three regimens of EC-FEC-TEC are closely related to nausea and vomiting, diarrhea and constipation in digestive tract reaction, respectively.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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