耳针联合逍遥散治疗康复期肝郁气滞型乳腺癌患者生存质量的临床观察

发布时间：2018-01-29 22:15

本文关键词： 耳针逍遥散乳腺癌生存质量肝郁气滞　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：乳腺癌的发生、发展、转归及预后与生存质量有密切关系,由于医学诊疗技术的发展,乳腺癌患者的生存期明显延长,康复期乳腺癌患者日益成为一个庞大的特殊群体。了解康复期乳腺癌患者的心理特点,进行有效的干预以消除她们的情绪障碍,对患者身心健康恢复以及提高生活质量意义重大。本临床观察是依据中医基础理论、现代药理研究及经络穴位学说,结合李世杰教授多年临床经验,采用问卷调查的形式,对康复期乳腺癌患者进行生存质量测评表(FACT-B 4.0版)调查,分析耳针联合逍遥散组和逍遥散组的评分结果,观察耳针对患者生活质量的影响,以期寻求乳腺癌康复的中医耳穴应用治疗途径。方法：采用随机对照的临床研究方法,设立样本诊断标准、纳入标准、排除及终止临床试验标准。在征得患者同意签署知情同意书后,由研究者记录其一般资料、精神状况检查及中医辨证分型。收集2015年3月-2015年10月成都中医药大学第一附属医院肿瘤科门诊就诊的康复期肝郁气滞型乳腺癌患者80例,随机分为治疗组和对照组,各40例,入组时均填写FACT-B表。两组基础治疗：据激素受体状况规范予以内分泌治疗+逍遥散加减中药口服,治疗组联合耳针,耳针每日自行按压3次,每次留针3-5天(即每周2次),3周后两组患者填写FACT-B测量表；观察记录患者治疗前后生理情况、社会家庭状况、情感状况、功能状况和乳腺癌的附加关注部分评分,用SPSS19.0统计软件建立数据库,对两组治疗前后生活质量表各子项目评分采用独立样本t检验,治疗组和对照组前后用配对t检验或者秩和检验,分析评价两组经过三周期治疗后的生活质量改善情况。结果：1、治疗组相对于对照组明显提高康复期肝郁气滞型乳腺癌的生存质量,两组组间独立样本t检验,P0.05,具有明显统计学差异。2、治疗组前后经过配对t检验和秩和检验,各子项目P0.05,提示治疗组经耳针联合逍遥散中药治疗前后生存质量明显改善。3、对照组前后经过配对t检验和秩和检验,生理状况及量表总分P0.05,有统计学意义,其它条目P0.05,提示治疗前后无差异。结论：耳针联合逍遥散加减治疗组可明显提高康复期肝郁气滞型乳腺癌患者的生存质量。耳针联合疏肝解郁中药相对于单纯中药治疗临床疗效好,耳针在乳腺癌康复治疗中有应用前景。
[Abstract]:Objective: the occurrence, development, prognosis and prognosis of breast cancer are closely related to the quality of life. Because of the development of medical diagnosis and treatment, the survival time of breast cancer patients is obviously prolonged. Convalescent breast cancer patients have increasingly become a large special group. Understand the psychological characteristics of patients with recovered breast cancer and carry out effective intervention to eliminate their emotional disorders. This clinical observation is based on the basic theory of traditional Chinese medicine, modern pharmacology research and meridian acupoint theory, combined with Professor Li Shijie's many years clinical experience. To investigate the quality of life (FACT-B 4.0 version) of breast cancer patients in convalescent stage, and analyze the score of auricular acupuncture combined with Xiaoyao powder and Xiaoyao powder group. Objective: to observe the effect of ear acupuncture on the quality of life of patients with breast cancer. Methods: the clinical study method of random control was used to establish the standard of sample diagnosis and the standard of inclusion. The criteria for excluding and terminating clinical trials. After obtaining the consent of the patient to sign an informed consent, the general information is recorded by the researcher. From March 2015 to October 2015, 80 cases of breast cancer with liver stagnation and Qi stagnation were collected from the oncology department of the first affiliated Hospital of Chengdu University of traditional Chinese Medicine (Chengdu University of traditional Chinese Medicine). Two groups were randomly divided into treatment group and control group, 40 cases in each group, when they entered the group, they all filled out the FACT-B form. The two groups were treated with basic therapy: according to the standard of hormone receptor status, oral administration of Xiaoyao Powder was given according to the standard of hormone receptor status. The treatment group combined with auricular acupuncture, auricular acupuncture was pressed 3 times a day, each time the needle was kept for 3 to 5 days (that is, 2 times a week for 3 weeks), the two groups of patients filled out the FACT-B scale; To observe and record the physiological status, social and family status, emotional status, functional status and the additional concern score of breast cancer before and after treatment, and to establish the database with SPSS19.0 statistical software. The quality of life (QOL) scores of the two groups were evaluated by independent sample t test before and after treatment, and by paired t test or rank sum test before and after treatment and control group. Results: compared with the control group, the quality of life of the treatment group was significantly improved compared with the control group. Independent samples between the two groups P0.05, with a significant statistical difference. 2, before and after the treatment group after the paired t test and rank test, each sub-item P0.05. The results showed that the quality of life of the treatment group was significantly improved before and after the treatment of auricular acupuncture combined with Xiaoyao powder, and the control group was treated with paired t test and rank sum test, physiological status and total score of the scale P0.05, with statistical significance. Other items P0.05. Conclusion:. The treatment group of auricular acupuncture combined with Xiaoyao powder can obviously improve the quality of life of breast cancer patients with liver stagnation and qi stagnation in convalescent period. The clinical effect of auricular acupuncture combined with soothing liver and relieving stagnation Chinese medicine is better than that of traditional Chinese medicine alone. Auricular acupuncture is promising in rehabilitation treatment of breast cancer.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R273

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