基于舒鹏教授临床经验总结的胃癌中医证素的研究

发布时间：2018-02-22 00:14

  本文关键词： 胃癌 证素 回顾性研究　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：研究目的：本课题旨在通过对胃癌证素及其与胃癌患者常见症状、体征、舌苔脉象之间相关性的研究,对胃癌证候、证素的分布规律进行初步的探讨,为胃癌证型的规范化和标准化提供客观的参考依据,以期指导胃癌的中医临床治疗。研究方法：本课题采用回顾性研究的方法,189例病例均来自于到2012年3月-2015年3月期间,就诊于江苏省中医院、经过胃镜及病理检查确诊为胃癌的患者,符合《胃癌临床实践指南2013 V2(中文版)》诊断及分期标准,并且通过四诊资料的规范化采集,参照《中医证候诊断治疗学》及《中医虚证辨证参考标准》等文献中病性辨证及脏腑辨证的内容,结合导师经验与指导进行辨证分析。建立数据库,统计分析胃癌主要证素及症状体征、舌苔脉象的整体的分布情况；分析总结胃癌主要病位、病性证素与症状体征、舌苔脉象的之间的相关性。研究结果：根据本课题研究结果显示,胃癌患者常见的症状体征是乏力、纳差、嗳气、胃脘部隐痛、泛酸、消瘦、便溏、畏寒、胃脘部嘈杂感、腹胀；主要的舌苔脉象为：脉细、苔白、舌淡、苔薄、舌红、苔少、苔腻、舌有裂纹。Ⅰ期患者19例,主要症状体征为畏寒、乏力、纳差、嗳气、泛酸、胃脘部隐痛,Ⅱ期35例,主要症状体征为乏力、嗳气、胃脘部隐痛、泛酸、纳差,Ⅲ期63例,主要症状体征为乏力、纳差、嗳气、泛酸、便溏,Ⅳ期72例,主要症状体征为乏力、纳差、消瘦、嗳气、胃脘部隐痛。主要的病位证素为：脾、胃、大肠、肝、肾、肺；主要的病性证素为气虚、阴虚、血虚、湿、阳虚、血瘀。病性证素之间的组合方式以虚性证素和实性证素相兼组合最为常见。单一的病性证素出现频率较少,通常为2个或3个病性证素相组合。便溏、胃脘部隐痛、嗳气、舌淡、苔少、脉细是和证素“脾”相关的症状体征、舌苔脉象；嗳气、泛酸、消瘦、脉涩是和证素“胃”相关的症状体征、舌苔脉象；便溏是和证素“大肠”相关的症状体征；舌红、脉弦、脉弱是和证素“肝”相关的舌苔脉象；嗳气是与证素“肾”相关的症状体征；泛酸、乏力是和证素“肺”有关的症状体征；乏力、纳差、苔薄,脉数是与证素“气虚”有关的症状体征、舌苔脉象；泛酸、舌红、脉细是与证素“阴虚”相关的症状体征、舌苔脉象；脉弱是与证素“血虚”相关的舌苔脉象；苔腻、脉濡是与湿相关的舌苔脉象；畏寒、脉沉是与证素“阳虚”相关的症状体征、舌苔脉象；舌暗、脉涩是与证素“血瘀”相关的舌苔脉象；腹胀,苔腻是与证素“气滞”相关的症状体征、舌苔脉象；舌红、脉数是与证素“热”相关的舌苔脉象。
[Abstract]:Objective: to study the relationship between the syndromes of gastric cancer and the symptoms, signs and tongue coating of gastric cancer patients, and to explore the distribution of syndromes and syndromes of gastric cancer. To provide an objective reference for the standardization and standardization of gastric cancer syndromes, with a view to guiding the clinical treatment of gastric cancer in TCM. The patients who were diagnosed with gastric cancer by gastroscopy and pathological examination in Jiangsu traditional Chinese Medicine Hospital were in accordance with the criteria of diagnosis and staging of gastric cancer clinical practice guide 2013 V2. Referring to the contents of disease syndrome differentiation and viscera syndrome differentiation in the literature such as "TCM Syndrome diagnosis and Therapeutics" and "TCM deficiency Syndrome differentiation reference Standard", combined with the experience and guidance of the tutor, the database was established. Statistical analysis of the main syndromes and symptoms and signs of gastric cancer, the overall distribution of tongue coating pulse, analysis and summary of the main gastric cancer disease location, disease syndromes and symptoms and signs, Results: according to the results of this study, the common symptoms and signs of gastric cancer patients are fatigue, anorexia, belching, epigastric pain, pantothenic acid, wasting, loose stool, cold, stomachache, Abdominal distension; the main pulse of tongue coating is: thin vein, white tongue, light tongue, thin fur, red tongue, less fur, greasy coating, crack tongue. 19 cases of stage 鈪，

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