运用柴氏逍遥散改善乳腺癌患者术后生存质量和免疫功能的临床研究

发布时间：2018-03-11 09:03

本文选题：乳腺癌　切入点：疏肝法　出处：《浙江中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的对中药组研究期间用药进行整理,探讨柴氏逍遥散对乳腺癌术后肝郁证患者生存质量和免疫功能的影响；探讨柴可群主任中医师在病证结合指导下辨治乳腺癌的学术思想及用药经验,为中医药干预改善乳腺癌患者术后生存质量、调节乳腺癌患者术后免疫功能提供临床证据,为优化乳腺癌术后的诊疗思维、提升疗效提供新的思路。方法收集符合纳入标准的临床病例49例,将其分为对照组(22例)和中药组(27例),对照组只行标准治疗,中药组行标准治疗+柴氏逍遥散。研究12周内,通过中医症状量化评分、SCL-90量表、SF-36量表及淋巴细胞亚群水平的多次测定,评价柴氏逍遥散疗效,观察患者生存质量和免疫功能改善情况；最后,探讨柴师辨治乳腺癌的学术思想,运用中医传承辅助系统软件,收集中药组研究期间用药并分析规则。结果治疗4周后,中药组中医症状量化评分表评分相比对照组分数更低、总体有效率更高,存在统计学差异(p0.05);治疗12周后,运用SCL-90量表评价中药组的抑郁、焦虑因子分对照对照组有明显降低,存在统计学差异(p0.05),运用SF-36量表评价中药组在生理职能、躯体疼痛、情感职能、社会功能四个维度上的得分明显高于对照组,存在统计学差异(p0.05)；对比淋巴细胞亚群各指标水平,中药组的T细胞和NK细胞水平高于对照组,存在统计学差异(p0.05)。结论 1.柴氏逍遥散能有效缓解乳腺癌术后肝郁证患者相关临床症状,加快患者心理健康状况和免疫功能的改善和恢复,提高患者免疫能力和生存质量。2.乳腺癌的发生、发展及预后和情志因素密切相关,柴可群主任中医师认为,乳腺癌的发病主脏在肝,情志不畅、肝失疏泄是乳腺癌的主要病机,存在于疾病各个阶段,故辨治乳腺癌时当着重从肝入手,临诊运用疏肝法辨治乳腺癌术后随访期患者,获得较好的效果。
[Abstract]:Objective to study the effect of Chai's Xiaoyao Powder on the quality of life and immune function of patients with liver depression after operation of breast cancer. To explore the academic thought and experience of treating breast cancer under the guidance of combination of disease and syndromes, so as to provide clinical evidence for the intervention of traditional Chinese medicine to improve the postoperative quality of life of patients with breast cancer and to regulate the postoperative immune function of patients with breast cancer. Methods 49 patients with breast cancer were collected and divided into control group (n = 22) and traditional Chinese medicine group (n = 27). The traditional Chinese medicine group was treated with the standard treatment of Chai's Xiaoyao Powder. The therapeutic effect of Chai's Xiaoyao Powder was evaluated by the quantitative score of TCM symptom and the multiple measurements of SF-36 scale and lymphocyte subgroup level of SCL-90 scale within 12 weeks. To observe the improvement of patients' quality of life and immune function; finally, to discuss the academic thought of treating breast cancer by Chai Shi, and to collect the medication and analyze the rules during the study of TCM group by using the software of traditional Chinese medicine heritage assistant system. Results after 4 weeks of treatment, Compared with the control group, the Chinese medicine group had a lower score and a higher overall effective rate. After 12 weeks of treatment, SCL-90 scale was used to evaluate the depression in the Chinese medicine group, and the anxiety factor score in the control group was significantly decreased. There was a significant difference between the four dimensions of physiological function, somatic pain, emotional function and social function in the traditional Chinese medicine group (P 0.05), and there was statistical difference between the four dimensions (P 0.05), and the level of lymphocyte subsets was compared with that of the control group, and there was no significant difference between the two groups in terms of physiological function, somatic pain, emotional function and social function. The levels of T cells and NK cells in the traditional Chinese medicine group were higher than those in the control group, and there was a statistical difference between them (P 0.05). Conclusion\\\; Speeding up the improvement and recovery of patients' mental health status and immune function, improving patients' immune ability and quality of life .2.The occurrence, development, prognosis and emotional factors of breast cancer are closely related, according to Chai Kequn, the director of TCM. The main organ of breast cancer is in the liver, the mood is not unobstructed, and the liver loss is the main pathogenesis of breast cancer, which exists in every stage of the disease. Therefore, when differentiating and treating breast cancer, we should focus on the liver and use the method of soothing the liver to treat the patients in follow-up period after operation. Good results were obtained.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R273

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