柳州市中医院近10年鼻咽癌的回顾性临床研究

发布时间：2018-04-20 15:09

本文选题：鼻咽癌 + 中医　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:回顾分析204例鼻咽癌患者的临床病历资料,探讨中医治疗鼻咽癌的用药规律,放化疗对中医证型的影响,同时讨论了诸如好发年龄、不同证型与EB病毒、情志的关系、好发转移部位等问题。方法:将收集的患者病历资料填入统一设计的《柳州市中医院鼻咽癌住院病人调查表》,记录的资料包括:(1)性别、年龄、出入院日期等一般资料;(2)鼻咽癌的中医证型及病理类型,治疗方法:包括中药、针灸处方、放化疗方案等。(3)相关实验室检查;(4)对以上资料进行综合分析,并利用spss20统计软件进行检验判定其意义。结果:(1)男性病例131例,女性病例73例,男女比例为1.79:1;(2)最小发病年龄为33岁,最大发病年龄为80岁,平均年龄为53.27+9.96岁;(3)局部放射治疗对中医证型影响主要表现为热毒耗伤气阴,有化疗史以气血两虚证、气阴两虚证、肺胃热毒证、热毒伤阴证比例较高,平素情志抑郁病例证型以痰湿内阻证、痰瘀气滞证居多;(4)远处转移以肺、肝、骨多见;低分化鳞癌远处转移以肺常见,非角化性鳞癌则以肝、骨转移较多,分化型非角化性癌以骨转移常见,未分化型非角化性癌以颈部淋巴结转移常见;(5)中药以补虚类、清热类、解表类使用频率最高;(6)针灸常用足太阳膀胱经、任脉穴位。结论:经治疗后的患者中医证型受放化疗影响,一定程度上反映出放化疗的热毒性,容易耗伤人体气血。情志抑郁病例证型以痰湿内阻证、痰瘀气滞证居多,符合中医肝病传脾及情绪抑郁导致肝郁气滞的认识,总的来说鼻咽癌早期证型以实证为主,中晚期虚症及虚实夹杂多见,其演变规律体现了因实致虚,终致阴阳俱损的特点。传统中医药治疗在改善患者症状方面具有一定优势。
[Abstract]:Objective: to retrospectively analyze the clinical records of 204 patients with nasopharyngeal carcinoma (NPC), explore the law of drug use and the influence of radiotherapy and chemotherapy on TCM syndromes, and discuss the relationship between Epstein-Barr virus (EBV) and different syndromes, such as predilection age, different syndromes, and emotion. Prone to metastases and other problems. Methods: the collected patient's medical records were filled in the questionnaire of inpatients with nasopharyngeal carcinoma in Liuzhou Hospital of traditional Chinese Medicine. The data recorded included sex, age, date of admission and other general data, such as TCM syndromes and pathological types of nasopharyngeal carcinoma. Treatment methods: including traditional Chinese medicine, acupuncture and moxibustion prescription, chemoradiotherapy regimen, etc.) the above data were analyzed synthetically by laboratory examination, and the significance was determined by spss20 statistical software. Results there were 131 male cases and 73 female cases. The minimum onset age was 33 years old, the maximum onset age was 80 years old, the average age was 53.279.96 years old. The influence of local radiotherapy on TCM syndromes was mainly heat toxin consumption and dampening qi and yin. The history of chemotherapy included qi and blood deficiency syndrome, qi and yin deficiency syndrome, lung and stomach heat toxin syndrome, heat toxin injury to yin syndrome ratio was higher, common mood depression syndrome type was phlegm dampness internal obstruction syndrome, phlegm and blood stasis qi stagnation syndrome was more than 4) distant metastasis was found in lung, liver and bone. Distant metastasis of poorly differentiated squamous cell carcinoma is common in lung, non-keratinized squamous cell carcinoma is liver, bone metastasis is more common, differentiated non-keratinized carcinoma is common in bone metastasis, and non-differentiated non-keratinized carcinoma is commonly seen in cervical lymph node metastasis. Acupuncture and moxibustion commonly used foot sun bladder meridian, Ren pulse acupoints. Conclusion: the TCM syndrome type after treatment is influenced by radiotherapy and chemotherapy, which reflects the thermal toxicity of radiotherapy and chemotherapy to some extent, and it is easy to consume qi and blood of human body. The main syndromes of emotional depression were phlegm dampness internal obstruction syndrome, phlegm and blood stasis qi stagnation syndrome, which was consistent with the understanding that liver disease spread spleen and emotional depression resulted in liver depression and qi stagnation in TCM. In general, the early syndromes of nasopharyngeal carcinoma were mainly positive, the middle and late stage asthenia and the mixture of deficiency and excess were more common. The law of its evolution reflects the characteristics of both yin and yang damage due to deficiency caused by reality. Traditional Chinese medicine treatment has some advantages in improving the symptoms of patients.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R273

【参考文献】