甲状腺乳头状癌患者中医体质及其与颈部淋巴结转移相关性的初步研究

发布时间：2019-01-30 14:16

【摘要】：目的:通过中医体质调查,统计分析甲状腺乳头状癌患者的中医体质分布特征,探讨其人口社会学特征;从中医体质学角度探讨甲状腺乳头状癌颈部淋巴结转移的相关因素,为该病的防治研究提供临床资料及参考。方法:采用问卷调查形式获取甲状腺乳头状癌患者的中医体质分型,收集患者一般资料及颈部淋巴结转移情况资料,以EXCEL建立数据库并使用SPSS18.0统计软件包分析中医体质的分布规律,分析其与一般资料及颈部淋巴结转移情况的相关性。成果:1.119例甲状腺乳头状癌患者中体质为平和质的有23例,占19.3%,偏颇体质96例,占80.7%。与一般人群相比,差异具有统计学意义(P=0.00)。体质类型以单一体质多见,共93例,占78.2%,兼夹型体质26例,占21.8%。单一型体质中,占比重较大的前五类体质为平和质23例(19.3%)、气郁质22例(18.5%)、阳虚质10例(8.4%)、阴虚质10例(8.4%)、痰湿质8例(6.7%)。兼夹体质类中兼夹2种体质的22例,兼夹3种体质4例,未见兼夹4种及以上的兼夹体质类型。在各型单一型体质中,尚会出现倾向型体质40例,以倾向气郁质、血瘀质及痰湿质型居多。2.关于不同颈部淋巴结转移区域中,仅中央区转移组平和质7例,气虚质2例,阳虚质3例,阴虚质4例,痰湿质6例,湿热质2例,血瘀质0例,气郁质9例,特禀质0例,兼夹体质12例;转移至侧区组平和质7例,气虚质1例,阳虚质2例,阴虚质1例,痰湿质2例,湿热质2例,血瘀质3例,气郁质6例,特禀质1例,兼夹体质7例。两组差异无统计学意义(P=0.566)。3.关于淋巴结转移组与无淋巴结转移组两组,颈部淋巴结转移组平和质14例,气虚质3例,阳虚质5例,阴虚质5例,痰湿质8例,湿热质4例,血瘀质3例,气郁质15例,特禀质1例,兼夹体质19例;无颈部淋巴结转移组平和质9例,气虚质2例,阳虚质5例,阴虚质5例,痰湿质0例,湿热质3例,血瘀质3例,气郁质7例,特禀质1例,兼夹体质7例。两组差异无统计学意义(P=0.391)。结论:1.甲状腺乳头状癌患者中医体质分布与一般人群体质分布存在差异,偏颇体质比例较一般人群高,提示偏颇体质与甲状腺乳头状癌的发病具有相关性。2.甲状腺乳头状癌患者中医体质类型以偏颇体质为主,其中兼夹体质多见。偏颇体质中单一型体质较多见的为气郁质、阳虚质、阴虚质以及痰湿质。3.本研究结果提示中医体质分布与颈部淋巴结转移之间未见明显统计学差异,可能提示体质与甲状腺乳头状癌颈部淋巴结转移无明显相关性,或存在一定相关性,但由于时间有限,样本量不足导致未能出现明显统计学差异。
[Abstract]:Objective: to analyze the distribution of TCM constitution in patients with papillary thyroid carcinoma and to explore its demographic and sociological characteristics. To explore the related factors of cervical lymph node metastasis in papillary thyroid carcinoma from the perspective of TCM physique, and to provide clinical data and reference for the prevention and treatment of the disease. Methods: the TCM constitution classification of patients with papillary thyroid carcinoma was obtained by questionnaire, and the general data of patients and the status of cervical lymph node metastasis were collected. The database was established by EXCEL and the distribution law of TCM constitution was analyzed by SPSS18.0 software package. The correlation between the data and general data and cervical lymph node metastasis was analyzed. Results: among 1.119 patients with papillary thyroid carcinoma, 23 cases (19.3%) had mild constitution, 96 cases (80.7%) had partial constitution. Compared with the general population, the difference was statistically significant (P0. 00). There were 93 cases (78.2%) with single constitution and 26 cases (21.88%) with clip constitution. In the single type of constitution, 23 cases (19.3%) were mild type, 22 cases (18.5%) were qi stagnation, 10 cases (8.4%) were yang deficiency, 10 cases (8.4%) were yin deficiency. Phlegm dampness in 8 cases (6.7%). There were 22 cases of two kinds of constitution and 4 cases of 3 kinds of constitution in the category of concurrent clamping constitution, but there was no type of concurrent clamping constitution of 4 or more kinds of concurrently clamping constitution. Among the single types of physique, there were 40 cases of inclined constitution, most of which were inclined to qi stagnation, blood stasis and phlegm dampness. In different cervical lymph node metastases, there were only 7 cases of calmness, 2 cases of qi deficiency, 3 cases of yang deficiency, 4 cases of yin deficiency, 6 cases of phlegm and dampness, 2 cases of dampness and heat, 0 cases of blood stasis, 9 cases of qi stagnation and 0 cases of intrinsic substance. 12 cases were also clamped; There were 7 cases of calmness, 1 case of qi deficiency, 2 cases of yang deficiency, 1 case of yin deficiency, 2 cases of phlegm and dampness, 2 cases of dampness and heat, 3 cases of blood stasis, 6 cases of qi stagnation, 1 case of intrinsic substance and 7 cases of inclusion constitution. There was no significant difference between the two groups (P < 0. 566). There were 14 cases of cervical lymph node metastasis, 3 cases of qi deficiency, 5 cases of yang deficiency, 5 cases of yin deficiency, 8 cases of phlegm and dampness, 4 cases of dampness and heat, 3 cases of blood stasis and 15 cases of qi stagnation. 1 case was idiosyncratic, and 19 cases were clamping constitution; In the group without cervical lymph node metastasis, 9 cases were mild, 2 cases were qi deficiency, 5 cases were yang deficiency, 5 cases were yin deficiency, 0 cases were phlegm dampness, 3 cases were damp heat, 3 cases were blood stasis, 7 cases were qi stagnation, 1 case was intrinsic substance, and 7 cases were clamping constitution. There was no significant difference between the two groups (P = 0.391). Conclusion: 1. The physique distribution of traditional Chinese medicine in patients with thyroid papillary carcinoma was different from that of the general population, and the proportion of biased constitution was higher than that of the general population, suggesting that biased constitution had a correlation with the incidence of papillary thyroid carcinoma. 2. The traditional Chinese medicine constitution type of thyroid papillary carcinoma is biased constitution. Biased physique in the single type of physique is more common for Qi stagnation, Yang deficiency, Yin deficiency and phlegm dampness. 3. The results of this study suggest that there is no significant statistical difference between TCM constitution distribution and cervical lymph node metastasis, and there may be no significant correlation between constitution and cervical lymph node metastasis of papillary thyroid carcinoma, or there is a certain correlation between constitution and cervical lymph node metastasis. However, due to limited time and insufficient sample size, there was no significant statistical difference.
【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】：R736.1

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