消化道肿瘤癌因性疲乏临床特征分析及益气健脾补肾方干预作用观察

发布时间：2017-12-28 02:07

本文关键词：消化道肿瘤癌因性疲乏临床特征分析及益气健脾补肾方干预作用观察　出处：《北京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：研究目的癌因性疲乏在恶性肿瘤患者中十分常见,尤其是手术及放化疗之后的患者,但其发病机制尚未明确,临床缺乏疗效确切的治疗方案,严重影响着患者的生活质量,甚至使患者被迫中断治疗。本研究以消化道恶性肿瘤患者为切入点,通过统计学分析方法,研究影响消化道肿瘤患者癌因性疲乏的临床特征,探讨消化道肿瘤患者癌因性疲乏的核心病机和辨证分型特点,评价导师临床经验方益气健脾补肾方干预消化道肿瘤患者癌因性疲乏的临床疗效,为临床实践提供理论支持和客观依据。研究方法本研究共观察60例中国中医科学院广安门医院门诊消化道肿瘤癌因性疲乏患者,患者在常规支持治疗基础上予导师经验方益气健脾补肾方治疗,100mL/次,2次/日,周期为28天。分别于入组后的第1天、第28天,对患者进行疲乏情况的评价,评价内容包括欧洲癌症研究与治疗组织生命质量测定量表(European Organization for Research and Treatment Quality of life Questionnaires, EORTC QLQ-C30)、简单疲乏量表(The Brief Fatigue Inventory,BFI)、piper修订疲乏量表(The Revised Piper Fatigue, PFS-R),最后使用SPSS20.0统计软件进行数据分析。研究结果消化道肿瘤患者的癌因性疲乏程度与性别、年龄存在相关性(P0.05),女性疲乏程度高于男性,疲乏程度与年龄呈正相关；生活质量各功能领域水平由高到低依次为认知功能躯体功能情绪功能社会功能角色功能,各维度疲乏水平由高到低依次为认知、情绪情感行为、严重性感觉(P0.05)；除疲乏外,出现频率最高的症状依次为气促(76.7%)、失眠(70%)、食欲减退(65%)；辨证分型以虚证为主,占80.6%,其中脾气虚、肾虚、血虚比例最高,实证(肝郁气滞、湿邪蕴脾)占19.4%；益气健脾补肾方能够有效提高患者的躯体功能、角色功能、情绪功能及总体健康水平,显著缓解疲倦、气促、食欲减退、腹泻、便秘等症状,中重度疲乏患者疲乏程度降低,轻度及无疲乏患者增多(p0.05)。结论消化道恶性肿瘤患者的疲乏程度与性别、年龄存在相关性,女性疲乏程度高于男性,年龄越高疲乏程度越重；消化道恶性肿瘤癌因性疲乏对角色、社会、情绪功能影响最大,最易导致感觉、行为、情感维度的疲乏感；辨证分型以虚证为主,脾气虚、肾虚及血虚最常见；益气健脾补肾方能够显著提高患者生活质量,改善患者躯体、角色、情绪等功能,缓解气促、食欲减退等症状,降低疲乏程度。
[Abstract]:The purpose of the study of cancer-related fatigue in patients with malignant tumors is very common, especially after surgery and chemotherapy patients, but its pathogenesis is not clear, the lack of clinical curative treatment, seriously affecting the quality of life of patients, and even patients were forced to interrupt treatment. In this study, patients with malignant tumor of digestive tract as the breakthrough point, through the statistical analysis method, study on the effect of tumor of digestive tract cancer patients with clinical features of fatigue, cancer patients with gastrointestinal tumors by the core pathogenesis and syndrome differentiation of fatigue type characteristics, evaluate the clinical experience of my tutor Yiqi Jianpi Bushen prescription intervention in patients with gastrointestinal tumor cancer related fatigue in clinical efficacy, provide theoretical support and objective basis for clinical practice. Research methods: a total of 60 patients with gastrointestinal cancer and cancer related fatigue in Guanganmen Hospital of Chinese Academy of traditional Chinese medicine were observed in this study. On the basis of routine supportive treatment, the patients were given the experience of Yiqi Jianpi Bushen Fang, 100mL/ times, 2 times / day, the period was 28 days. On the first day and twenty-eighth days after entering the group, to evaluate the fatigue of patients, including evaluation of the quality of life instrument for the European Organization for research and treatment of cancer (European Organization for Research and Treatment Quality of life Questionnaires, EORTC QLQ-C30), a simple Fatigue Scale (The Brief Fatigue Inventory, BFI, Piper) the revised Fatigue Scale (The Revised Piper Fatigue, PFS-R), finally uses SPSS20.0 statistical software for data analysis. The results of patients with digestive tract tumor CRF correlated with gender and age (P0.05), female fatigue than men, positively correlated with age and fatigue; the quality of life of each functional area level from high to low is the cognitive function emotional function and social function of physical function role function, the dimensions of fatigue by high to low cognition, emotional behavior, severity of sensory fatigue (P0.05); in addition, the highest frequency of symptoms were dyspnea (76.7%), insomnia (70%), anorexia (65%); syndrome type of deficiency dominated, accounting for 80.6%, the proportion of kidney deficiency, blood deficiency, spleen deficiency the highest positive (Qi stagnation, dampness in the spleen) accounted for 19.4%; Yiqi Jianpi Bushen prescription can effectively improve the patient's physical function, role function, emotional function and overall health level, significantly relieve fatigue, shortness of breath, The symptoms of anorexia, diarrhea, constipation and so on, the degree of fatigue of the patients with moderate and severe fatigue decreased, and the mild and non tired patients increased (P0.05). Conclusion there exists a positive correlation between malignant tumor of digestive tract in patients with fatigue and gender, age, female fatigue than men, the higher the age fatigue severity of cancer-related fatigue; the greatest impact on the role of social and emotional function, cancer of digestive tract malignant tumors, the most easily lead to feelings, behavior, emotion exhaustion; syndrome differentiation the most common deficiency, spleen qi deficiency, kidney deficiency and blood deficiency; Yiqi Jianpi Bushen prescription can significantly improve the quality of life of patients, improve the patients physical, role, emotional function, relieve dyspnea, loss of appetite and other symptoms, reduce fatigue.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R273

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