鼻咽癌初诊患者中医证型与2008分期相关性的临床研究

发布时间：2018-07-07 17:54

本文选题：鼻咽癌 + 中医证型　；参考：《福建中医药大学》2012年硕士论文

【摘要】：目的：研究鼻咽癌初诊患者中医证型与鼻咽癌2008临床分期相关性,及EB病毒IgA抗体与EB病毒DNA对比研究,提高中西医结合防治鼻咽癌的疗效,为鼻咽癌新分期进一步提供循证医学证据,为鼻咽癌患者疗效判断提供一个更好的辅助血清学指标。方法：将初诊并经病理确诊为鼻咽癌的患者98例,在放化疗前给以辨证分型,按中医辨证分型标准分为四型(肺热型、痰凝型、瘀血阻络型及血瘀痰凝型)；同时按鼻咽癌2008分期标准给以TNM分期(Ⅰ、Ⅱ、Ⅲ及Ⅳa期)；在放化疗前及放化疗后分别抽取患者全血EB病毒DNA拷贝数与血清EB病毒IgA抗体滴度。在放化疗后2个月,复查鼻咽部MR及相应的全身检查。结果：1.四组中医证型在TNM分期中差异具有统计学意义(P=0000),说明中医证型与TNM分期具有相关性。2.血清EB病毒IgA抗体与TNM分期差异无统计学意义(P=0.189)。3.全血EB病毒DNA拷贝数与TNM分期总体上差异无统计学意义(P=0.074)。两两比较,全血EB病毒DNA拷贝数在Ⅲ期与Ⅲ期间比较,差异具有统计学意义(P=0.024)；全血EB病毒DNA拷贝数在Ⅲ期与Ⅳ期间比较,差异具有统计学意义(P=0.022)。4.放疗后,全血EB病毒DNA拷贝数转阴率高,能有效评价治疗疗效；但在提示转移或复发方面,EB病毒IgA抗体与EB病毒DNA比较二者差异无统计学意义(P=0.095)。结论：1.鼻咽癌初诊患者中医证型与临床分期具有相关性(P=0.000)。2.血清EB病毒IgA抗体与鼻咽癌临床分期无相关性(P=0.189)。3.全血EB病毒DNA拷贝数与临床分期具有相关性。4.全血EB病毒DNA拷贝数转阴率高,优于EB病毒IgA抗体,在一定程度上能有效评价治疗疗效及及监测病情变化；在提示转移及复发方面,二者差异无统计学意义,可能与病例数少有关。
[Abstract]:Objective: To study the correlation between the TCM syndrome type of nasopharyngeal carcinoma and the 2008 clinical stage of nasopharyngeal carcinoma, and the comparative study of the EB virus IgA antibody and EB virus DNA, to improve the curative effect of the combination of traditional Chinese and Western Medicine on the prevention and treatment of nasopharyngeal carcinoma, and provide evidence-based medical evidence for the new stage of nasopharyngeal carcinoma to provide a better auxiliary sera for the judgment of the curative effect of nasopharyngeal carcinoma. Study indicators.
Methods: 98 patients with nasopharyngeal carcinoma diagnosed and diagnosed by pathology were divided into four types (pulmonary heat type, phlegm coagulating type, blood stasis blocking type and blood stasis phlegm coagulation type) before and after radiotherapy and chemotherapy, and TNM staging (I, II, III and IV A) of nasopharyngeal carcinoma were given at the same time with 2008 stages of nasopharyngeal carcinoma; before and after radiotherapy and chemotherapy and after radiotherapy and chemotherapy, The number of copies of EB virus DNA and the titer of EB virus IgA antibody in the whole blood were extracted respectively. The nasopharyngeal MR and the corresponding systemic examination were re examined 2 months after radiochemotherapy.
Results: 1. the difference between the four groups of TCM Syndrome Types in TNM staging was statistically significant (P=0000), indicating the correlation between the TCM syndrome type and the TNM staging. There was no significant difference between the.2. serum EB virus IgA antibody and the TNM staging (P=0.189) the DNA copy number of EB virus in.3. whole blood and TNM staging were not statistically significant. 22 comparison, the whole blood was compared. The number of DNA copies of EB virus was compared in stage III and III (P=0.024), and the DNA copy number of whole blood EB virus was compared with stage III and IV, the difference was statistically significant (P=0.022) after.4. radiotherapy, the DNA copy number of EB virus in whole blood was high, and the therapeutic effect could be evaluated effectively, but the EB disease was suggested in the aspect of metastasis or recurrence. There was no significant difference between the two IgA antibodies and the EB virus DNA (P=0.095).
Conclusion: 1. the TCM syndrome type and clinical staging of 1. nasopharyngeal carcinoma patients have correlation (P=0.000).2. serum EB virus IgA antibody and clinical staging of nasopharyngeal carcinoma (P=0.189).3. whole blood EB virus DNA copy number and clinical stage,.4. whole blood EB virus DNA copy number conversion negative rate is high, superior to the EB virus antibody, to a certain extent. It can effectively evaluate the curative effect and monitor the change of the disease. There is no significant difference in the indication of metastasis and recurrence between the two groups, which may be related to the small number of cases.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R273;R739.63

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