73例中晚期肝癌患者的证候规律及疗效特点的临床研究

发布时间：2018-05-28 06:54

本文选题：中晚期肝癌 + 证侯特点　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：目的:将中晚期原发性肝癌患者作为研究对象,归纳总结出其症候特点、治疗特点以及疗效特点,为进一步优化中晚期肝癌治疗方案提供参考意见。材料与方法:选取从2015年3月1日至2016年3月1日于辽宁中医药大学附属医院住院以肝癌为第一诊断的患者病例,严格按照纳入标准及排除标准进行筛选,共选出符合标准的患者73人,回顾分析其一般资料,既往接受治疗情况,临床症状、证候特点、生存期情况及症状缓解情况。并用Microsoft Excel软件进行频次统计,采用spass20.0进行K-均值聚类分析。结果:1、73例中晚期肝癌患者的症状分析结果显示,神疲乏力为其最主要表现,高达82.19%,其次占20%以上的症状依次为腹胀、纳差、失眠、胁痛、大便干结、黄疸、腹痛、口苦、口干咽燥,患者中10%-20%会出现恶心、下肢浮肿、形体消瘦、大便色黑、意识模糊、呕吐、善太息、鼓胀、呕血、气短、大便溏泄、心烦易怒等症状,极少数患者会出现呼吸困难、发热、厌食油腻。2、73例中晚期肝癌患者的症状及体征(舌脉)进行聚类分析后,共分为五种证候类型,分别是湿瘀肝胆证,肝肾阴虚证,瘀结水留证,肝郁气滞证,脾虚湿困证。3、73例中晚期肝癌患者的中位总生存期为10.4个月,不同的证候类型中位生存期不同,五种证候的中位生存期依次为肝郁气滞证11.8个月,瘀结水留证10.4个月,肝肾阴虚证10.2个月,脾虚湿困证9.5个月,湿瘀肝胆证6个月。湿瘀肝胆证生存期最短。4、五种证候类型经中西医结合治疗后,证候(神伤)均有不同程度的缓解,有效率均可达50%以上,其中湿瘀肝胆证的有效率最高,高达82.61%。结论:中西医结合疗法对湿瘀肝胆证“神伤”的治疗疗效显著,达到了形神的反(相对)统一的治疗目的。由此可见中西医结合治疗中晚期肝癌的“神伤”具有优势,值得在临床上推广。
[Abstract]:Objective: To sum up the symptoms of middle and late primary hepatocellular carcinoma (HCC), summarize its symptoms, treatment characteristics and curative effect, and provide reference for further optimization of middle and late liver cancer treatment. Materials and methods: from March 1, 2015 to March 1, 2016, the hospital of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine was used for liver cancer. The first diagnosed cases were selected strictly in accordance with the inclusion criteria and exclusion criteria, and 73 patients were selected to meet the standard. The general data were reviewed and analyzed. The treatment situation, clinical symptoms, syndrome characteristics, survival time and symptom relief were analyzed. Microsoft Excel software was used for frequency statistics, and spass20.0 was used. K- mean cluster analysis. Results: the results of symptoms analysis in 1,73 patients with middle and advanced liver cancer showed that fatigue was the most important manifestation, up to 82.19%, and the next 20% of the symptoms were abdominal distention, insomnia, hypochondriac pain, stool knot, jaundice, abdominal pain, stomachache, dry mouth and throat dryness. In the patients, 10%-20% would appear nausea, swelling of the lower limbs, and body emaciation. The symptoms of dyspnea, fever, and anorexia in.2,73 patients with advanced liver cancer are divided into five types, namely, the syndrome of the liver and kidney, the liver and kidney yin deficiency, and the deficiency of the liver and kidney yin, the liver and kidney yin deficiency. Syndrome, stagnation of stagnation of water, stagnation of liver qi and syndrome of spleen deficiency and dampness syndrome, the median survival period of.3,73 patients with middle and advanced liver cancer is 10.4 months. The median survival time of different syndrome types is different. The median survival time of the five syndromes is 11.8 months of stagnation of liver Qi stagnation, 10.4 months for stagnation of stagnation of water, 10.2 months in liver kidney yin deficiency syndrome and 9.5 months for spleen deficiency syndrome. The syndrome of dampness and stasis of liver and gallbladder for 6 months. The survival period of the syndrome of dampness and stasis of liver and gallbladder is the shortest.4. After the combination of traditional Chinese and Western medicine, the five types of syndromes are relieved in different degrees, the effective rate is above 50%, of which the effective rate of the syndrome of damp and stagnant liver and gallbladder is the highest and up to 82.61%.: the therapeutic effect of the combination therapy of Chinese and Western Medicine on the "Deshen" of the damp stasis liver and Gallbladder Syndrome It can be seen that the combination of traditional Chinese and Western medicine has the advantage of "deify" in the treatment of middle and late liver cancer, and it is worth popularizing in the clinic.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R273

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