胃息肉中医证型与病理类型及血清学指标TK1、CEA的相关性研究

发布时间：2018-06-19 06:32

本文选题：胃息肉 + 中医证型　；参考：《广州中医药大学》2016年硕士论文

【摘要】：研究目的：探讨胃息肉中医证型与其病理类型及血清学指标胸苷激酶(TK1)、CEA之间的相互关系,探寻中医“证”与现代医学病理、血清学指标之间的内在联系。研究方法：1.通过文献调研和专家咨询,制定胃息肉临床信息调查表(见附录)。2.收集病例资料：对符合纳入标准并同意参与本次调查的胃息肉患者,收集一般信息,如实填写调查表中的各项内容,四诊合参,根据《中医常见证诊断标准》,进行中医辨证分型,所有患者均抽血送我院检验科行TK1和CEA检测,息肉切除前签署胃息肉切除知情同意书,胃息肉切除后一律行病理检测,记录其病理类型结果。3.分析134例胃息肉中医证型、病理类型的分布特点。4.探讨134例胃息肉中医证型与活检病理类型之间的关系。5.探讨胃息肉中医证型、病理类型与TK1和CEA水平之间的关系。研究结果：1.胃息肉发病以中老年多见,平均年龄54.35±11.73岁,男性发病率高于女性,男女比例为1.16：1。2.134例胃息肉患者中脾胃虚寒证10例(7%),脾虚湿蕴证7例(5%),脾胃湿热证41例(31%),肝郁气滞证25例(19%),脾虚湿瘀证41例(31%),气滞血瘀证4例(3%),气滞痰阻证6例(4%)。女性多以肝郁气滞为主,男性多以脾胃湿热为主,中青年患者多见脾胃湿热证及肝郁气滞证,而老年患者则以脾虚湿瘀证为主。3.134例胃息肉患者中炎性息肉59例(44%,男36例,女23例),增生性息肉21例(15%,男7例,女14例),腺瘤性息肉24例(18%,男18例,女6例),腺息肉5例(4%,男2例,女3例),混合性息肉21例(16%,男6例,女15例),组织学阴性息肉4例(3%,男3例,女1例),其中男性以炎性息肉和腺瘤性息肉为主,女性则以炎性息肉、增生性息肉及混合性息肉为主,不同病理类型的息肉在各年龄段的分布无差异。4.胃息肉中医证型与病理类型之间存在相关性,炎性息肉和腺瘤性息肉均以脾虚湿瘀及脾胃湿热为主,表明湿瘀、湿热与其病理环境的形成有关,增生性息肉以肝郁气滞、脾胃湿热为主,表明气滞、湿热是其主要的病理因素。5.中医证型、病理类型与TKl和CEA水平的关系：不同中医证型和TK1、CEA水平的关系比较中,均无显著性差异,7种胃息肉病理类型中,腺瘤性息肉的TK1和CEA含量最高,与组织学阴性息肉比较,不同病理类型的TK1水平具有显著统计学差异(P0.05),不同病理类型(除腺息肉外)的CEA水平也具有显著统计学差异(P0.05)。研究结论：1.胃息肉发病以中老年多见,男性发病率高于女性。2.中医证型分布规律：脾胃湿热证脾虚湿瘀证肝郁气滞证脾胃虚寒证脾虚湿蕴证气滞痰阻证气滞血瘀证,女性多以肝郁气滞为主,男性多以脾胃湿热为主,中青年患者多见脾胃湿热证及肝郁气滞证,而老年患者则以脾虚湿瘀证为主。3.病理类型分布特点：炎性息肉最多,其后依次是腺瘤性、混合性息肉、增生性息肉、腺息肉、组织学阴性息肉,其中男性以炎性息肉和腺瘤性息肉为主,女性则以炎性息肉、增生性息肉及混合性息肉为主,不同病理类型的息肉在各年龄段的分布无差异。4.胃息肉中医证型与病理类型之间存在相关性,炎性息肉和腺瘤性息肉均以脾虚湿瘀及脾胃湿热为主,表明湿瘀、湿热与其病理环境的形成有关,增生性息肉以肝郁气滞、脾胃湿热为主,表明气滞、湿热是其主要的病理因素。5.中医证型与TK1和CEA水平的关系：不同中医证型和TK1、CEA水平的关系比较中,均无显著性差异。6.病理类型与TK1和CEA水平的关系：与组织学阴性息肉比较,不同病理类型的TKl水平具有显著统计学差异(P0.05),不同病理类型(除腺息肉外)的CEA水平也具有显著统计学差异(P0.05)。7种胃息肉病理类型中,腺瘤性息肉的TK1和CEA含量最高,认为TK1和CEA可作为检测胃息肉癌变的指标。增生性息肉的TK1和CEA水平仅次于腺瘤性息肉,提示增生性息肉也有癌变可能。
[Abstract]:Objective: To explore the relationship between the TCM syndrome type of gastric polyp and its pathological type and the serological index of thymidine kinase (TK1) and CEA, and to explore the internal relationship between the TCM syndrome and the modern medical pathology and the serological index. 1. through literature investigation and expert consultation, the clinical information questionnaire of gastric polyps was formulated (see Appendix). .2. collection of case data: collect general information for patients with gastric polyps conforming to the inclusion criteria and agree to participate in this investigation, fill out all the contents in the questionnaire, complete the four diagnostics, according to the standard of TCM syndrome diagnosis, carry out the syndrome differentiation of traditional Chinese medicine, all patients take blood to our hospital for TK1 and CEA examination, before the resection of polyps An informed consent book was signed for the resection of gastric polyps. After the resection of the gastric polyps, a pathological examination was performed, and the pathological type results were recorded..3. analysis of 134 cases of gastric polyps, the distribution of pathological types, the relationship between the TCM syndrome types of 134 cases of gastric polyps and the pathological types of biopsy.5. was used to explore the TCM syndrome type of gastric polyps, the pathological type and the TK1 and CEA water. The relationship between the 1. gastric polyps was seen in the middle and old age, the average age was 54.35 + 11.73 years old, the incidence of male was higher than that of the female. The proportion of men and women was 10 cases (7%) of spleen and stomach deficiency cold syndrome in 1.16:1.2.134 patients with gastric polyps, 7 cases of spleen deficiency syndrome (5%), 41 cases of spleen and stomach damp heat syndrome (31%), 25 cases (19%) of stagnation of liver qi stagnation, 41 cases of spleen deficiency and damp stasis syndrome (3). 1%) 4 cases of qi stagnation and blood stasis syndrome (3%), stagnation of qi stagnation syndrome in 6 cases (4%). Most women were mainly with stagnation of liver qi and qi stagnation, male mostly with spleen and stomach damp heat. The middle-aged and young patients saw spleen and stomach damp heat syndrome and stagnation of liver qi stagnation, while the elderly patients with spleen deficiency and damp stasis syndrome were mainly.3.134 cases with inflammatory polyps in 59 cases (44%, 36 men, 23 cases), and 21 cases of proliferative polyp. (15%, 7 men, 14 women), 24 cases of adenomatous polyps (18%, 18 men, 6 women), 5 adenomatous polyps (4%, 2 men, 3 cases), 21 cases of mixed polyps (16%, males, females), male with inflammatory polyps and adenomatous polyps, and women with inflammatory polyps, proliferative polyps and mixed polyps There was no difference in the distribution of different pathological types of polyps in all ages. There was a correlation between the TCM syndrome type and pathological type of.4. gastric polyps. Inflammatory polyps and adenomatous polyps were dominated by spleen deficiency dampness stasis and spleen and stomach damp heat. It showed that wet heat and damp heat were related to the formation of pathological environment. Hyperplastic polyps were stagnation of liver qi and stagnation of liver and spleen and stomach. The main pathological factors, such as qi stagnation and damp heat, are the main pathological factors of.5. TCM syndrome type, pathological type and TKl and CEA level. There are no significant differences in the relationship between different TCM Syndrome Types and TK1 and CEA levels. Among the 7 types of gastric polyps, the content of TK1 and CEA in adenomatous polyps is the highest, compared with histological negative polyps, different pathological types. The level of the type of TK1 has significant statistical difference (P0.05), and the CEA level of different pathological types (except for adeno polyps) also has significant statistical difference (P0.05). Research conclusion: 1. the incidence of gastric polyps is more common in the middle and old age, the incidence of male is higher than that of the female.2. TCM syndrome type distribution rules: spleen stomach damp heat syndrome liver depression stagnation of spleen qi stagnation syndrome, spleen and stomach deficiency The spleen deficiency syndrome of cold syndrome shows qi stagnation and stagnation of qi stagnation and blood stasis syndrome with stagnation of qi stagnation and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of Qi and stagnation of spleen and stomach. The majority of the male and young patients are mainly spleen and stomach damp heat syndrome and stagnation of liver qi stagnation, while the elderly patients with spleen deficiency and damp stasis are mainly.3. pathological types: inflammatory polyps are the most, followed by adenomatous and mixed interest. Meat, hyperplastic polyps, adeno polyps, histologic negative polyps, among which men are mainly inflammatory polyps and adenomatous polyps, women are mainly inflammatory polyps, proliferative polyps and mixed polyps. There is no difference in the distribution of different pathological types of polyps in all ages. There is a correlation between the TCM syndrome type and the pathological type of.4. gastric polyps. Meat and adenomatous polyps are mainly spleen deficiency dampness stasis and spleen and stomach damp heat, indicating that wet heat and damp heat are related to the formation of pathological environment. Hyperplastic polyps are mainly stagnation of liver qi, spleen and stomach damp heat, which indicate that qi stagnation and damp heat are the main pathological factors of.5. syndrome type and TK1 and CEA level: the relationship between different TCM Syndrome Types and TK1, CEA level In comparison, there was no significant difference in the relationship between the.6. pathological type and the level of TK1 and CEA: compared with the histologic negative polyps, the TKl levels of different pathological types were significantly different (P0.05), and the CEA levels of different pathological types (except for adeno polyps) also had significant statistical differences (P0.05) in the pathological type of the.7 species of gastric polyps, adenomatous and interest. The content of TK1 and CEA in meat is the highest. It is considered that TK1 and CEA can be used as an indicator of canceration of gastric polyps. The TK1 and CEA levels of proliferative polyps are second only to adenomatous polyps, suggesting that hyperplastic polyps may also be cancerous.
【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】：R259

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