食管癌中医证型分布及影响因素的研究

发布时间：2018-04-27 15:16

本文选题：食管癌 + 中医证型　；参考：《南京中医药大学》2016年硕士论文

【摘要】：研究背景：食管癌是人类最常见的恶性肿瘤之一,在我国的发病率也居高不下,江苏是食管癌的高发地区之一。食管癌的治疗主要包括外科手术、放疗和化疗,中医药治疗是食管癌综合治疗的重要组成部分,所以在江苏研究食管癌的中医证型分析以及影响因素,具有重要的指导意义。目的：通过回顾性临床研究,分析食管癌中医证型分布情况及影响因素。对象与方法：2014年6月-2015年8月江苏省中医院肿瘤科,经病理明确诊断为食管癌并进行放化疗的住院患者。根据文献研究,自行设计信息调查表,研究食管癌中医证型分布；以临床证型为对象,以相关实验室指标,瘤体生物特征及个人资料为变量,探讨食管癌中医证型的影响因素。结果：(1)食管癌患者放化疗前后比较,痰气互阻型由34.2%减少至10%,血瘀痰滞型由37.5%减少至30%,阴虚内热型由25.8%增加至40%,气虚阳微型由2.5%增加至20%,食管癌患者放化疗前后中医证型比较具有显著差异(x2=51.76,P=0.000)。(2)经多项分类Logistic回归分析结果显示,与食管癌放化疗前证型相关的因素为病理分期、KPS评分、骨髓抑制分度和原发部位；与放化疗后证型相关的因素为病理分期、KPS评分和原发部位(P0.05)。(3)经独立样本T检验,食管癌放化疗前各证型分布在白细胞计数、血红蛋白和CY211、癌胚抗原、糖类抗原199、胆碱酯酶和总蛋白这些指标上有差异性(P0.05)。结论：病例分期、KPS评分、骨髓抑制分度和原发部位是影响食管癌中医辨证分型的因素,白细胞计数、血红蛋白和CY211、癌胚抗原、糖类抗原199、胆碱酯酶和总蛋白这些指标在不同证型上存在差异,对食管癌的诊断具有一定的价值。
[Abstract]:Background: esophageal cancer is one of the most common malignant tumors in human beings, and the incidence of esophageal cancer is also high in China. Jiangsu is one of the areas with high incidence of esophageal cancer. The treatment of esophageal cancer mainly includes surgery, radiotherapy and chemotherapy, and traditional Chinese medicine is an important part of comprehensive treatment of esophageal cancer, so it is of great significance to study the TCM syndromes and influencing factors of esophageal cancer in Jiangsu Province. Objective: to analyze the distribution of TCM syndromes of esophageal carcinoma and its influencing factors. Participants and methods: from June 2014 to August 2015, Department of Oncology, Jiangsu Provincial Hospital of traditional Chinese Medicine, confirmed pathologically as esophageal carcinoma and received radiotherapy and chemotherapy. According to the literature research, we designed the information questionnaire to study the distribution of TCM syndromes of esophageal carcinoma, and discussed the influencing factors of TCM syndromes of esophageal cancer by taking clinical syndromes as the object, the related laboratory indexes, tumor biological characteristics and personal data as variables. Results (1) comparison of radiotherapy and chemotherapy before and after chemotherapy in patients with esophageal cancer, The phlegm and qi reciprocal obstruction type decreased from 34.2% to 10um, blood stasis phlegm stagnation type decreased from 37.5% to 30, Yin deficiency internal heat type increased from 25.8% to 40g, Qi deficiency Yang micro-scale increased from 2.5% to 20. There were significant differences in TCM syndromes before and after radiotherapy and chemotherapy in patients with esophageal cancer. The results of classified Logistic regression analysis showed that, The factors related to the type of esophageal cancer before radiotherapy and chemotherapy were pathological stage and KPS score, bone marrow suppression score and primary site, and the factors related to the type of syndrome after radiotherapy and chemotherapy were pathological staging and KPS score and the primary site of esophageal cancer (P0.05, P0.05. Y3) by independent sample T test, and the factors related to the syndromes type of esophageal cancer before radiotherapy and chemotherapy were KPS score, bone marrow suppression score and primary site. There were significant differences in leukocyte count, hemoglobin and CY211, carcinoembryonic antigen, carbohydrate antigen 199, cholinesterase and total protein in patients with esophageal cancer before radiotherapy and chemotherapy (P 0.05). Conclusion: KPS score, bone marrow suppression score and primary site are the factors that influence the differentiation and classification of esophageal carcinoma in TCM, including leukocyte count, hemoglobin and CY211, carcinoembryonic antigen. The indexes of carbohydrate antigen 1999,cholinesterase and total protein were different in different syndromes and had certain value in the diagnosis of esophageal carcinoma.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R273

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