中晚期大肠癌化疗后中医证候变化规律探讨

发布时间：2018-03-29 22:02

本文选题：中晚期大肠癌　切入点：中医证候变化　出处：《广州中医药大学》2016年硕士论文

【摘要】：目的：探讨中晚期大肠癌化疗前后中医证候变化规律,为中医药治疗中晚期大肠癌提供理论依据。方法：病例来源：2015年5月至2015年12月在广州中医药大学第一附属医院接受中西医结合治疗的肠癌患者60例,男例39例,女21例,采用问卷采集技术和前瞻性研究方法,收集患者化疗前后的中医证候变化,借助excel表格建立数据库,运用SPSS19.0软件进行统计学分析,根据临床症状及中医辨证特点,进行证候分型,归纳出中晚期大肠癌化疗前后的常见证型与变化,运用配对的卡方检验等统计方法,对化疗前后的证候进行比较,筛选出可能有统计学意义及临床意义的证候变化,运用中医基础理论、诊断学等知识,探讨化疗方案治疗肠癌前后中医证候变化规律,配合中药治疗提高临床疗效。结果：中晚期大肠癌化疗前证候较多的系疲倦乏力、面色少华、大便稀溏、腹部胀痛、腹部肿块、恶心欲呕、头晕目眩、纳呆、腹部冷痛、腹胀等。舌脉象方面为舌淡暗、舌红、舌边齿痕、舌胖大、苔薄、苔稍厚、苔白、苔黄、苔润、苔微腻、苔腻、脉细、脉滑等证候。化疗后出现证候较多的依次为纳呆、疲倦乏力、恶心欲呕、面色少华、大便稀溏、肢体麻木、寐差、头晕目眩、腹部胀痛、腹部肿块等。舌象方面为舌淡暗、舌紫暗、舌边齿痕、舌胖大、舌薄、舌稍厚、舌厚、苔白、苔微腻、苔腻、苔润、脉细、脉滑等。化疗后证候增加变化较大的有纳呆、恶心欲呕、疲倦乏力、肢体麻木、寐差、口干咽燥、面色少华、头晕目眩、腰膝酸软、腹胀等。化疗后证候减少的有腹部胀痛、小便色黄、大便干结、舌红、苔薄、苔黄、苔润等。经卡方检测,化疗后变化具有显著差异的系纳呆、恶心欲呕、疲倦乏力、肢体麻木、寐差、舌边齿痕、苔薄、苔稍厚、苔润等证候。结论：中晚期大肠癌患者的证候特点为虚实并见,其中,虚证方面可表现为气虚、血虚、阴虚、阳虚及脏腑功能亏虚;实证方面可表现为痰湿、气滞、血瘀等。化疗后出现的纳呆、恶心欲呕、疲倦乏力等胃失和降、脾气湿蕴等证候,进一步加重了原有的证候。对于化疗后的患者,以化痰利湿,补益气血等治法为主,兼活血化瘀,补而不滞。
[Abstract]:Objective: to investigate the changes of TCM syndromes before and after chemotherapy in advanced colorectal cancer. Methods: from May 2015 to December 2015, 60 cases of colorectal cancer were treated by combination of traditional Chinese and Western medicine in the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine, including 39 males and 21 females. The changes of TCM syndromes before and after chemotherapy were collected by means of questionnaire collection technique and prospective research method. The database was established with the help of excel form, and the statistical analysis was carried out by SPSS19.0 software, according to the clinical symptoms and the characteristics of TCM syndrome differentiation. The syndromes were classified, the common syndromes and changes before and after chemotherapy were summed up, and the syndromes before and after chemotherapy were compared by using paired chi-square test and other statistical methods. To screen out the changes of syndromes that may have statistical and clinical significance, using the knowledge of TCM basic theory, diagnostics and so on, to probe into the changing law of TCM syndromes before and after the treatment of colorectal cancer by chemotherapy. Results: patients with advanced colorectal cancer had more symptoms before chemotherapy, such as fatigue and fatigue, Shaohua complexion, loose stool, abdominal distended pain, abdominal mass, nausea, dizziness, anorexia, cold abdominal pain. Abdominal distension and so on. Tongue pulse is light dark, tongue red, tongue edge tooth mark, big tongue fat, thin fur, slightly thick fur, white fur, yellow fur, moist fur, slightly greasy fur, greasy fur, fine vein, smooth vein and other syndromes. Tired and tired, nausea and nausea, Shaohua, loose stool, numbness, insomnia, dizziness, abdominal distending pain, abdominal mass, etc. The tongue is pale dark, purple dark, tongue teeth mark, fat tongue, thin tongue, slightly thicker tongue, thick tongue, etc. After chemotherapy, the symptoms of the increase in symptoms are dumbass, nausea, nausea, fatigue, limb numbness, poor sleep, dry mouth, dry pharynx, Shaohua complexion, dizziness, sore waist and knee, etc. Abdominal distension and so on. After chemotherapy, the symptoms reduced include abdominal distended pain, yellow urine, dry stool knot, tongue red, thin fur, yellow fur, and so on. By chi-square test, there are significant differences in symptoms after chemotherapy, such as dysphoria, nausea, nausea, fatigue, etc. Limb numbness, poor sleep, tongue tooth marks, thin fur, slightly thicker fur, Tareun and other syndromes. Conclusion: the syndromes of patients with advanced colorectal cancer are characterized by deficiency of qi, blood deficiency, yin deficiency, and deficiency of qi, blood deficiency and yin deficiency, among which deficiency syndrome can be characterized by deficiency of qi, blood deficiency, yin deficiency, and so on. Yang deficiency and deficiency of viscera function; evidence can be shown as phlegm dampness, qi stagnation, blood stasis, etc. After chemotherapy, symptoms such as stomach disharmony, nausea and nausea, fatigue and fatigue, such as gastric disharmony, dampness of temper, etc. Further aggravated the original syndromes. For the patients after chemotherapy, phlegm and dampness, tonifying qi and blood, etc.
【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】：2016
【分类号】：R273

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