原发性支气管肺癌中医实性证候特点的研究

发布时间：2018-05-13 09:13

本文选题：肺癌 + 辨证分型　；参考：《北京中医药大学》2017年硕士论文

【摘要】：研究目的1、探讨我院2015年12月至2016年12月在广安门医院肿瘤科门诊纳入的135例原发性支气管肺癌患者中医辨证分型中实证的特点。2、研究原发性支气管肺癌各实证证候的比例,与性别、组织病理类型、卡氏评分及临床分期的关系,各实证证候间的相互关系。研究方法选取国家标准、行业标准及相关中医书籍中关于实证的诊断条目,依据临床上原发性支气管肺癌的发病特点、临床症状,以证素为核心,采用多层级诊断的方法为基础,结合张培彤教授的临床经验初步拟定各肺癌实性证候的诊断标准,制作相应的观察表,根据纳入标准和排除标准筛选患者,使用EPIdata软件录入135例肺癌患者症状。使用Excel、SPSS19软件统一辨证,进行统计学分析,运用卡方检验分析各实证证候与性别、组织病理类型、卡氏评分及临床分期的关系。多证组合与临床分期的关系,以及各实证相互间的关系。研究结果1、各实证证候的比例气滞证患者132例,占97.78%,气逆证患者132例,占97.78%,痰凝证患者97例,占71.85%,血瘀证患者71例,占52.59%,实热证患者28例,占20.74%,饮停证患者20例,占14.81%,湿阻证患者16例,占11.85%,血热证患者14例,占10.37%,血寒证患者8例,占5.93%,实寒证患者8例,占5.930%,水停证患者5例,占3.70%,气闭证患者0例,占0%。2、各实证证候与性别、组织病理类型、卡氏评分及临床分期的关系气滞证与非气滞证患者在性别、组织病理类型、KPS评分、及临床分期上没有显著的统计学意义上的差异;气逆证与非气逆证患者在性别及KPS评分上没有显著的统计学意义上的差异,在组织病理分型及临床分期上有显著的统计学意义上的差异;血瘀证与非血瘀证患者在性别、KPS评分及临床分期上没有显著的统计学意义上的差异,在组织病理分型上有显著的统计学意义上的差异;血寒证与非血寒证患者在性别、KPS评分、组织病理分型及临床分期上没有显著的统计学意义上的差异;血热证与非血热证患者在性别、KPS评分、组织病理类型、及临床分期上没有显著的统计学意义上的差异;痰凝证与非痰凝证患者在性别、KPS评分、组织病理类型、及临床分期上没有显著的统计学意义上的差异;饮停证与非饮停证患者在性别、KPS评分、组织病理类型、及临床分期上没有显著的统计学意义上的差异;湿阻证与非湿阻证患者在性别、KPS评分、组织病理类型、及临床分期上没有显著的统计学意义上的差异;水停证与非水停证患者在性别、组织病理类型、及临床分期上没有显著的统计学意义上的差异,在KPS评分上有显著的统计学意义上的差异;实热证与非实热证患者在性别、KPS评分及临床分期上没有显著的统计学意义上的差异,在组织病理类型上有显著的统计学意义上的差异;实寒证与非实寒证患者在性别、KPS评分、组织病理类型、及临床分期上没有显著的统计学意义上的差异。3、多证组合及实证证候相互关系本研究共纳入135例病例,研究其中实证证候的组合,在135例肺癌患者中,(1)单证出现2例,占1.48%,其中气滞证2例,占100%。(2)二证组合:共12例,占8.89%。其中气滞证+气逆证11例,占91.67%;气滞证+血瘀证1例,占8.33%。(3)三证组合:共33例,占24.44%。其中气滞证+气逆证+痰凝证19例,占57.58%;气滞证+气逆证+血瘀证6例,占18.18;气滞证+气逆证+实热证2例,占6.06%;气滞证+气逆证+血寒证2例,占6.06%;气滞证+气逆证+饮停证1例,占3.03%;气逆证+血瘀证+痰凝证1例,占3.03%;气逆证+痰凝证+湿阻证1例,占3.03%;气逆证+痰凝证+实寒证1例,占3.03%。(4)四证组合:共48例,占35.56%。其中气滞证+气逆证+血瘀证+痰凝证23例,占47.92%;气滞证+气逆证+血瘀证+实热证8例,占16.67%;气滞证+气逆证+痰凝证+实寒证5例,占10.42%;气滞证+气逆证+血瘀证+血热证2例,占4.17%;气滞证+气逆证+血瘀证+湿阻证2例,占4.17%;气滞证+气逆证+痰凝证+饮停证2例,占4.17%;气滞证+气逆证+痰凝证+实热证2例,占4.17%;气滞证+气逆证+血瘀证+血寒证1例,占2.08%;气滞证+气逆证+痰凝证+血热证1例,占2.08%;气滞证+气逆证+痰凝证+湿阻证1例,占2.08%;气滞证+气逆证+痰凝证+水停证1例,占2.08%。(5)五证组合:共30例,占22.22%。其中气滞证+气逆证+血瘀证+痰凝证+血热证5例,占16.67%;气滞证+气逆证+血瘀证+痰凝证+实热证5例,占16.67%;气滞证+气逆证+血瘀证+痰凝证+饮停证4例,占13.33%;气滞证+气逆证+血瘀证+痰凝证+湿阻证3例,占10%;气滞证+气逆证+痰凝证+饮停证+实热证3例,占10%;气滞证+气逆证+血瘀证+痰凝证+水停证2例,占6.67%;气滞证+气逆证+痰凝证+饮停证+湿阻证2例,占6.67%;气滞证+气逆证+血瘀证+痰凝证+血寒证1例,占3.33%;气滞证+气逆证+血热证+痰凝证+实热证1例,占3.33%;气滞证+气逆证+血热证+痰凝证+湿阻证1例,占3.33%;气滞证+气逆证+痰凝证+饮停证+实寒证1例,占3.33%;气滞证+气逆证+痰凝证+湿阻证+实热证1例,占3.33%;气滞证+气逆证+痰凝证+湿阻证+实寒证1例,占3.33%。(6)六证组合:共6例,占4.44%。其中气滞证+气逆证+血瘀证+痰凝证+饮停证+实热证2例,占33.33%;气滞证+气逆证+血寒证+血热证+痰凝证+实热证1例,占16.67%;气滞证+气逆证+血瘀证+血寒证+痰凝证+饮停证1例,占16.67%;气滞证+气逆证+血瘀证+血寒证+痰凝证+湿阻证1例,占16.67%;气滞证+气逆证+血瘀证+痰凝证+湿阻证+实热证1例,占16.67%。(7)七证组合:共4例,占2.96%。其中气滞证+气逆证+血瘀证+血热证+痰凝证+饮停证+实热证1例,占25.00%;气滞证+气逆证+血寒证+血热证+痰凝证+饮停证+湿阻证1例,占25.00%;气滞证+气逆证+血瘀证+血热证+痰凝证+饮停证+水停证1例,占25.00%;气滞证+气逆证+痰凝证+饮停证+湿阻证+水停证+实热证1例,占25.00%。其中单一证候Ⅳ期0例,占0.00%;二证组合Ⅳ期5例,占41.67%;三证组合Ⅳ期13例,占39.39%;四证组合IV期20例,占41.67%;五证组合Ⅳ期13例,占43.33%;六证组合IV期5例,占83.33%;七证组合Ⅳ期2例,占20%。当出现气滞证的时候,气逆证伴随出现的概率最高,为97.73%,其次是痰凝证71.21%、血瘀证53.03%、实热证21.21%、饮停证15.15%、湿阻证11.36%、血热证10.61%。伴随出现概率较低的有血寒证6.06%、实寒证5.30%、水停证3.79%。当出现气逆证的时候,气滞证伴随出现的概率最高,为97.73%,其次是痰凝证73.48%、血瘀证53.03%、实热证21.21%、饮停证15.15%、湿阻证12.12%、血热证10.61%。伴随出现概率较低的有血寒证6.06%、实寒证6.06%、水停证3.79%。当出现血瘀证的时候,气滞证与气逆证伴随出现的概率最高,为98.59%,其次是痰凝证71.83%、实热证23.94%、血热证12.68%、饮停证12 68%。伴随出现概率较低的有湿阻证9.86%、血寒证5.63%、水停证4.23%。在本研究中,当血瘀证出现时,实寒证出现的病例数为0。当出现血寒证的时候,气逆证和气滞证伴随出现概率的最高,为100.00%,其次是痰凝证62.50%、血瘀证50.00%、血热证25.00%、饮停证25.00%、湿阻证25.00%、实热证12.500%。在本研究中,当血寒证出现时,水停证和实寒证出现的病例数为0。当出现血热证的时候,气逆证和气滞证伴随出现的概率最高,为100.00%,其次是痰凝证85.71%、血瘀证64.29%、饮停证21.43%、实热证21.43%、血寒证14.29%、湿阻证14.29%,伴随出现概率较低的有水停证7.14%。在本研究中,当出现血热证时,实寒证出现的病例数为0。当出现痰凝证的时候,气逆证和气滞证伴随出现的概率最高,分别为100.00%、96.91%,其次是血瘀证52.58%、实热证18.56%、湿阻证14.43%、血热证12.37%。伴随出现概率较低的有实寒证8.25%、血寒证5.15%、水停证5.15%。当出现饮停证的时候,气逆证和气滞证伴随出现的概率最高,为100.00%,其次是痰凝证95.00%、血瘀证45.00%、实热证35.00%、湿阻证20.00%、血热证15.00%、血寒证10.00%、水停证10.00%。伴随出现概率较低的是实寒证5.00%。当出现湿阻证的时候,气逆证和气滞证伴随出现的概率最高,分别为100.00%、93.75%,其次是痰凝证87.500%、血瘀证43.75%、饮停证25.00%、实热证18.75%、血寒证12.50%、血热证12.50%。伴随出现概率较低的是水停证和实寒证,占6.25%。当出现水停证的时候,气逆证、气滞证及痰凝伴随出现的概率最高,为100.00%,其次是血瘀证60.00%、饮停证40.00%、血热证20.00%、湿阻证20.00%、实热证20.00%。本研究中出现水停证时,出现血寒证和实寒证的病例数为0。当出现实寒证的时候,气逆证和痰凝证伴随出现的概率最高,为100.00%,其次是气滞证87.50%、饮停证12.50%、湿阻证12.50%。本研究中出现实寒证时,出现血瘀证、血寒证、血热证、水停证、实热证的病例数为0。当出现实热证的时候,气逆证和气滞证伴随出现的概率最高,为100.00%,其次是痰凝证64.29%、血瘀证60.71%、饮停证25.00%、血热证10.71%、湿阻证10.71%。伴随出现概率较低的有血寒证3.57%、水停证3.57%。本研究中出现实热证时,出现实寒证的病例数为0。当将实证证候两两分组统计一同出现的频数时,其中出现频数较高的依次是:气滞证+气逆证129例,占95.56%;气逆证+痰凝证97例,占71.85%;气滞证+痰凝证94例,占69.63%;气滞证+血瘀证70例,占51.85%;气逆证+血瘀证70例,占51.85%;血瘀证+痰凝证51例,占37.78%。结论通过对纳入本研究的135例原发性支气管肺癌患者的临床调查发现:1、在各实证证候中,出现频率由高到低分别为:气滞证、气逆证、痰凝证、血瘀证、实热证、饮停证、湿阻证、血热证、血寒证、实寒证、水停证。2、气逆证患者与非气逆证患者在组织病理分型及临床分期上有统计学意义上的差异;血瘀证患者与非血瘀证患者在组织病理分型上有统计学意义上的差异;水停证患者与非水停证患者在KPS评分上有统计学意义上的差异;实热证患者与非实热证患者在组织病理分型上有统计学意义上的差异;余实证证候与患者的性别、KPS评分、组织病理分型及临床分期无显著统计学意义上的差异。3、多证同时出现的几率较单证为多见,四证组合出现的几率最高,多证组合多见于晚期肺癌患者。各实证证候与气滞证、气逆证的关系最为密切,其次是痰凝证和血瘀证。其中气滞证+气逆证、气逆证+痰凝证、气滞证+痰凝证、气滞证+血瘀证、气逆证+血瘀证、血瘀证+痰凝证易并见。
[Abstract]:The purpose of this study was to investigate the characteristics of 135 cases of primary bronchogenic cancer patients in our hospital from December 2015 to December 2016 in the oncology clinic of Guanganmen hospital,.2, to study the proportion of the syndromes of primary bronchogenic carcinoma, the relationship with sex, histopathological type, Cartesian score and clinical staging. The relationship between syndromes and syndromes. The research methods selected national standards, industry standards and related diagnostic items in traditional Chinese medicine books, based on the characteristics of clinical primary bronchogenic lung cancer, clinical symptoms, syndrome elements as the core, the multi-layer diagnosis method as the basis, combined with Professor Zhang Peitong's clinical experience preliminarily drawn up. The diagnostic criteria for the syndrome of lung cancer were made, and the corresponding observation table was made. According to the inclusion criteria and exclusion criteria, 135 cases of lung cancer patients were recorded by EPIdata software. Excel, SPSS19 software was used for statistical analysis, and statistical analysis was carried out, and chi square test was used to analyze the syndrome and sex, histopathological type, and KASH score. The relationship between the clinical staging and clinical staging, the relationship between the clinical stages and the clinical staging. Results 1, 132 cases of qi stagnation syndrome, 132 cases of Qi inverse syndrome, 97 cases of phlegm coagulation syndrome, 71.85%, 71 cases of blood stasis syndrome, 52.59% of blood stasis syndrome, 28 cases of real heat syndrome, 20.74%, drinking and stopping. There were 20 cases, 14.81%, 16 cases of damp resistance syndrome, 11.85%, 14 cases of blood heat syndrome, 10.37%, 8 cases of blood cold syndrome, 5.93%, 8 cases of real cold syndrome, 5.930%, 5 cases of water stop syndrome, 3.70%, 0%.2, the relationship between syndrome and pathological type, Chi's score and clinical stages There was no significant difference in sex, histopathological type, KPS score, and clinical staging of patients with qi stagnation; there was no significant difference in gender and KPS score in the patients with Qi inverse syndrome and non gas inverse syndrome, and there were significant differences in the histopathological classification and clinical stages; blood stasis. There was no significant difference in sex, KPS score and clinical staging of the patients with syndrome and non blood stasis syndrome, and there were significant differences in histopathological classification. There was no significant difference in gender, KPS score, histopathological classification and clinical staging of the blood cold syndrome and non blood cold syndrome. There was no significant difference in sex, KPS score, histopathological type, and clinical staging of patients with blood heat syndrome and non blood heat syndrome. There was no significant difference in gender, KPS score, histopathological type, and clinical staging of patients with phlegm and non phlegm coagulating syndrome. There was no significant difference in KPS score, histopathological type, and clinical staging; there was no significant difference in gender, KPS score, histopathological type, and clinical staging of patients with dampness syndrome and non dampness syndrome, and the sex, histopathological type, and clinical staging of patients with water stop and non water stop syndrome. There is no significant statistical difference, there is significant difference in statistical significance on KPS score; there is no significant statistical difference between the patients with real heat syndrome and non real heat syndrome in sex, KPS score and clinical stage, and there are significant differences in the sense of unification on the histopathological types; the real cold syndrome and the non real cold syndrome have a significant difference. There was no significant difference in sex, KPS score, histopathological type, and clinical staging of.3, the multiple syndrome combination and the correlation of empirical syndrome were included in 135 cases, and the combination of empirical syndromes was studied. Among 135 patients with lung cancer, (1) 2 cases, accounting for 1.48%, 2 cases of qi stagnation, accounting for 100%. (2) two. Syndrome combination: a total of 12 cases, accounting for 11 cases of qi stagnation syndrome + Qi inverse syndrome in 8.89%., 1 cases of qi stagnation and blood stasis syndrome, accounting for 33 cases (3), accounting for 57.58%, qi stagnation syndrome + Qi inverse syndrome + blood stasis syndrome in 57.58%, qi stagnation + Qi reverse syndrome + blood stasis in 6 cases, 18.18, qi stagnation + Qi inverse syndrome + solid heat syndrome 2, 6.06%; Qi Stagnation Syndrome + Qi inverse syndrome + blood, and qi stagnation syndrome + Qi inverse syndrome + blood 2 cases of cold syndrome, accounting for 6.06%, qi stagnation syndrome + Qi inverse syndrome + drinking stop syndrome in 1 cases, accounting for 3.03%, Qi inverse syndrome + blood stasis syndrome + coagulation syndrome 1 cases, 3.03%; Qi inverse syndrome + phlegm coagulation + damp resistance syndrome 1 cases, 3.03%; Qi inverse syndrome + phlegm coagulating syndrome + 1 cases, accounting for 3.03%. (4) four syndrome, altogether 48 cases, accounting for qi stagnation syndrome + Qi reverse syndrome + phlegm coagulating syndrome 23 cases, accounting for 47.92%; Qi Stagnation Syndrome + +; Qi Stagnation Syndrome + + Qi Stagnation Syndrome + blood stasis syndrome + solid heat syndrome, accounting for 16.67%, qi stagnation + Qi inverse syndrome + phlegm coagulation + solid cold syndrome 5 cases, accounting for 10.42%, qi stagnation + Qi inverse syndrome + blood stasis syndrome + blood heat syndrome 2 cases, 4.17%; Qi stagnation + Qi reverse syndrome + blood stasis syndrome + damp resistance syndrome 2 cases, 4.17%; Qi stagnation + Qi reverse syndrome + phlegm coagulating syndrome + stopping syndrome 2 cases, 4.17%; Qi stagnation + Qi reverse syndrome + phlegm coagulation + phlegm coagulating syndrome + solid heat syndrome 2 4.17% cases, 1 cases of qi stagnation syndrome + Qi inverse syndrome + blood stasis syndrome + blood cold syndrome, accounting for 2.08%, qi stagnation + Qi inverse syndrome + phlegm coagulation + blood heat syndrome in 1 cases, accounting for 2.08%, qi stagnation + Qi reverse syndrome + phlegm coagulation syndrome + damp syndrome 1 cases, 2.08%, qi stagnation + Qi reverse syndrome + phlegm coagulation syndrome + 1 cases, accounting for 2.08%. (5) five syndrome combination: 30 cases, accounting for qi stagnation syndrome + Qi inverse syndrome + blood stasis syndrome + phlegm in the case of qi stagnation syndrome + Qi reverse syndrome + blood stasis syndrome + blood stasis syndrome. 5 cases of coagulant syndrome + blood heat syndrome, accounting for 16.67%, qi stagnation + Qi inverse syndrome + blood stasis syndrome + solid heat syndrome + 5 cases, accounting for 16.67%, qi stagnation + Qi reverse syndrome + blood stasis syndrome + stagnation of phlegm + stop syndrome 4 cases, 13.33%; Qi stagnation + Qi reverse syndrome + blood stasis syndrome + phlegm syndrome + damp resistance syndrome 3 cases, 10%; Qi stagnation + Qi reverse syndrome + phlegm coagulating syndrome + solid heat syndrome + 3 cases, 10%; Qi Stagnation Syndrome + Qi inverse Syndrome + blood stasis syndrome + phlegm coagulation syndrome + water stop syndrome, accounting for 6.67%, qi stagnation + Qi reverse syndrome + phlegm coagulating syndrome + damp resistance syndrome (6.67%), accounting for 6.67%, qi stagnation + Qi reverse syndrome + blood stasis syndrome + blood cold syndrome 1 cases, accounting for 3.33%; Qi stagnation + Qi reverse syndrome + blood heat syndrome + phlegm coagulation + solid heat syndrome 1 cases, accounting for 3.33%; Qi stagnation + Qi reverse syndrome + blood heat syndrome + phlegm coagulation syndrome + damp resistance syndrome 1 cases, accounting for 3.33%; Qi Stagnation Syndrome + Qi inverse syndrome + phlegm coagulating syndrome + drinking stop syndrome + solid cold syndrome 1 cases, accounting for 3.33%; Qi Stagnation Syndrome + Qi inverse syndrome + phlegm coagulating syndrome + solid heat syndrome 1 cases, accounting for 3.33%; Qi Stagnation Syndrome + Qi reverse syndrome + phlegm coagulating syndrome + solid cold 1 cases, accounting for 6) six combination: 6 cases, accounting for qi stagnation + Qi reverse syndrome + blood stasis syndrome + phlegm coagulation + drink stop syndrome + solid heat syndrome, 2 cases, accounting for 33.3 3%, 1 cases of qi stagnation + Qi inverse syndrome + blood cold syndrome + blood heat syndrome + phlegm coagulation + solid heat syndrome, accounting for 16.67%, 1 cases of qi stagnation syndrome + Qi reverse syndrome + blood stasis syndrome + phlegm coagulation + drink stop syndrome, accounting for 16.67%, 1 cases of qi stagnation syndrome + Qi inverse syndrome + blood stasis syndrome + blood cold syndrome + phlegm coagulation + damp resistance syndrome, 16.67%, qi stagnation syndrome + Qi reverse syndrome + blood stasis syndrome + phlegm coagulation + damp resistance syndrome + solid heat syndrome 1 cases, accounting for 16.67%. (7) seven syndromes: a total of 4 cases, accounting for 4 cases of qi stagnation syndrome + Qi inverse syndrome + blood stasis syndrome + blood heat syndrome + phlegm coagulating syndrome + solid heat syndrome 1 cases, accounting for 25%; Qi stagnation + Qi inverse syndrome + blood cold syndrome + blood heat syndrome + phlegm coagulating syndrome + damp resistance 1 cases, accounting for 25%; Qi stagnation + Qi reverse syndrome + blood stasis syndrome + blood heat syndrome + phlegm coagulation + water stop syndrome 1 cases, accounting for 25%; Qi stagnation; Qi stagnation. Syndrome + gas inverse syndrome + phlegm coagulating syndrome + drink stop syndrome + water stop + water stop + solid heat syndrome, accounting for 1 cases of 25.00%., which accounted for 0 cases of single syndrome IV, accounting for 0%, two syndrome group IV 5 cases, 41.67%, 13 cases in 13 cases, 39.39%; four syndrome group IV 20 cases, 41.67%; five syndrome IV period 13 cases, occupy 43.33%; six syndrome combination IV phase IV cases Period 2 cases, accounting for 20%. when the syndrome of qi stagnation, gas inverse syndrome with the highest probability of 97.73%, followed by phlegm coagulation 71.21%, blood stasis syndrome 53.03%, solid heat syndrome 21.21%, drink stop 15.15%, dampness syndrome 11.36%, blood fever syndrome 10.61%. accompanied by low probability of blood cold 6.06%, the real cold syndrome 5.30%, water stop 3.79%. when the gas inverse syndrome, when the water stop syndrome occurs, when the Qi inverse syndrome appears, the water stop license 3.79%. appears Qi inverse syndrome, when water stop license appears Qi Qi syndrome, The incidence of qi stagnation syndrome was 97.73%, followed by phlegm coagulation 73.48%, blood stasis syndrome 53.03%, solid heat syndrome 21.21%, drinking stop syndrome 15.15%, damp resistance 12.12%, blood heat syndrome 10.61%. accompanied by low probability of cold syndrome 6.06%, real cold syndrome 6.06%, and water stop syndrome when blood stasis syndrome appeared, qi stagnation syndrome and Qi inverse syndrome accompanied with the probability of occurrence. The highest was 98.59%, followed by phlegm coagulation 71.83%, solid heat syndrome 23.94%, blood heat syndrome 12.68%, drinking stop syndrome 12 68%. accompanied by low probability of damp resistance 9.86%, blood cold 5.63%, water stop syndrome 4.23%. in this study, when blood stasis syndrome appeared, the number of cases of real cold syndrome was 0. when the blood cold syndrome appeared, Qi inverse syndrome and qi stagnation syndrome accompanied the appearance of almost all the occurrence of almost all the appearance of the occurrence of the syndrome of qi stagnation and qi stagnation. The highest rate was 100%, followed by phlegm coagulation 62.50%, blood stasis syndrome 50%, blood heat syndrome 25%, drink stop syndrome 25%, damp resistance syndrome 25%, 12.500%. in this study, when the blood cold syndrome appeared, the number of cases of water stop and real cold syndrome was 0. when there was blood heat syndrome, and the highest probability of occurrence of Qi reverse syndrome and qi stagnation syndrome was 100%. The second is phlegm coagulating syndrome 85.71%, blood stasis syndrome 64.29%, drinking stop syndrome 21.43%, solid heat syndrome 21.43%, blood cold syndrome 14.29%, damp resistance syndrome 14.29%, accompanied with low probability of water stop syndrome in this study, when the occurrence of blood heat syndrome 7.14%., when there is a syndrome of blood heat, the number of cases of real cold syndrome is 0. when there is phlegm coagulating syndrome, the probability of occurrence of Qi inverse syndrome and qi stagnation syndrome is the highest, 100%, 96.91%, followed by blood stasis syndrome 52.58%, solid heat syndrome 18.56%, dampness syndrome 14.43%, blood heat syndrome 12.37%. with low incidence of cold syndrome 8.25%, blood cold 5.15%, water stop syndrome 5.15%. when drinking and stopping syndrome, gas inverse syndrome and Qi Stagnation with the highest probability of 100%, followed by phlegm 95%, blood stasis 45 %, 35% of real heat syndrome, 20% of damp resistance syndrome, 15% of blood heat syndrome, 10% of blood heat syndrome, 10% of blood cold syndrome, the lower probability of 10.00%. in water stop syndrome is the highest probability of occurrence of qi stagnation syndrome and qi stagnation syndrome, 100%, 93.75%, respectively, 87.500% of phlegm coagulation, 43.75% of blood stasis, 25% of blood stasis, 25% of stagnation of blood, and 18.7 heat syndrome. 18.7 5%, blood cold syndrome 12.50%, the incidence of blood heat syndrome 12.50%. with lower incidence of water stop syndrome and real cold syndrome, accounting for 6.25%. when the emergence of water withdrawal syndrome, gas inverse syndrome, qi stagnation syndrome and phlegm coagulation accompanied by the highest probability of 100%, followed by blood stasis syndrome 60%, drink stop 40%, blood heat syndrome 20%, damp resistance 20%, real heat syndrome in the 20.00%. study appeared in this study When the water was stopped, the number of cases of blood cold and real cold syndrome was 0.. When the real cold syndrome appeared, the highest probability of occurrence of Qi reverse syndrome and phlegm coagulation syndrome was 100%, followed by qi stagnation syndrome (87.50%), drinking stop syndrome (12.50%), and cold syndrome (12.50%.) in the study of damp syndrome, blood stasis syndrome, blood cold syndrome, blood heat syndrome, water stop syndrome and real heat syndrome cases were found. When the number was 0., when there was a solid heat syndrome, the incidence of qi stagnation syndrome and qi stagnation syndrome was the highest, 100%, followed by phlegm coagulation 64.29%, blood stasis syndrome 60.71%, drinking stop syndrome 25%, blood heat syndrome 10.71%, damp syndrome 10.71%. accompanied by low probability of blood cold 3.57%, water stop syndrome in 3.57%. this study appeared real cold syndrome. The number of cases was 0. when the number of 22 groups of empirical syndromes appeared together. The higher frequency was: Qi Stagnation Syndrome + Qi inverse syndrome in 129 cases, accounting for 95.56%, 97 cases of qi stagnation and phlegm coagulation syndrome, 71.85%; Qi Stagnation Syndrome + coagulation syndrome 94 cases, 69.63%; Qi stagnation + blood stasis 70 cases, 51.85%; Qi inverse syndrome + blood stasis syndrome 70, 51.85%; blood stasis syndrome + sputum. 51 cases of coagulant evidence, accounting for 37.78%. conclusion, were found through the clinical investigation of 135 cases of primary bronchogenic carcinoma in this study: 1, in each case, the frequency from high to low were as follows: Qi stagnation, Qi reverse syndrome, phlegm coagulating syndrome, blood stasis syndrome, solid heat syndrome, drinking stop syndrome, damp resistance syndrome, blood heat syndrome, blood cold syndrome, cold syndrome, water stop.2, Qi inverse syndrome There were statistically significant differences in histopathological classification and clinical staging of patients with non gas inverse syndrome. There were statistical differences between the patients with blood stasis syndrome and non blood stasis syndrome in the histopathological classification; there were statistical differences between the patients with water stop and the non water stop syndrome in the KPS score; the patients with real heat syndrome and non solid heat syndrome had a significant difference. There were statistically significant differences in histopathological typing, excess sex syndrome, sex, KPS score, histopathological classification and clinical stage.

【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R273

【参考文献】