135例胃癌、食管癌术后患者辨证与体质辨识相关性的临床研究

发布时间：2018-06-21 07:55

  本文选题：胃癌 + 食管癌　； 参考：《辽宁中医药大学》2016年硕士论文

【摘要】：目的:探讨胃癌、食管癌术后患者中医辨证分型及与中医体质的关系。方法:选取2014年4月-2015年8月就诊于本院门诊及住院处并符合本次研究标准的135例胃癌、食管癌术后患者,应用聚类分析(K-均值聚类)方法及填写《中医体质测评量表》,对其进行中医证型的聚类分析及中医体质的调查,并分析主要中医体质与中医证型的关系。结果:1.胃癌、食道癌两组患者乏力、睡眠欠佳、纳差等症状均较突出,达40%以上;两组相比,胃癌组腹痛、腹胀、便溏、怕冷、消瘦所占比例更高,在31-43%之间,食管癌组进食哽噎、呕吐痰涎、便秘等症状所占比例较胃癌组更为明显,在37-48%之间。2.四诊信息经聚类分析后胃癌分脾胃虚寒型(26例),脾虚痰湿型(21例),胃阴不足型(17例),肝气犯胃型(13例),气血两虚型(12例)5型;食管癌分为痰气交阻型(19例),气阴两虚型(16例),肝胃不和型(11例)3型。3.135例患者中医体质的总体分布平和质占8.89%,8种偏颇体质占91.11%。其中,8种偏颇体质中以阳虚质、气虚质、气郁质为主,这三种体质占全部调查体质类型的65.18%,其余的体质占比在3-9%之间,而血瘀质和湿热质最少,此次调查无特禀质。4.胃癌中气虚质与气血两虚型、脾虚痰湿型显著相关(P0.05);胃癌阳虚质与脾胃虚寒型(不论术后无癌及有癌)显著正相关(P0.01),但与脾虚痰湿型显著负相关(P0.05);术后复发或转移的胃癌肝气犯胃型(P〈0.01)和食管癌肝胃不和型(P〈0.05)均与气郁质显著相关。结论:1.135例胃癌、食管癌术后患者的中医证型分别聚类为5类、3类比较符合临床实际。2.135例胃癌、食管癌术后患者的偏颇体质以阳虚质、气虚质、气郁质多见。3.胃癌患者出现的阳虚质与其本来体质相关,胃癌、食管癌患者的气郁质与疾病的修饰有关,气虚质可能是胃癌患者的主要病机基础。
[Abstract]:Objective: to explore the relationship between TCM syndrome differentiation and TCM constitution in patients with gastric cancer and esophageal carcinoma. Methods: 135 patients with gastric cancer and esophageal cancer were selected from April 2014 to August 2015, who were treated in outpatient and inpatient department of our hospital and met the criteria of this study. By using the cluster analysis method and filling out the TCM physique Evaluation scale, the cluster analysis of TCM syndromes and the investigation of TCM physique were carried out, and the relationship between TCM constitution and TCM syndrome type was analyzed. The result is 1: 1. The symptoms of fatigue, poor sleep and anorexia in gastric cancer and esophageal cancer groups were more than 40%, and the proportion of stomach pain, abdominal distension, loose stools, fear of cold and weight loss in gastric cancer group was higher than that in stomach cancer group, and between 31 and 43%, esophageal cancer group ate and choked. Vomiting, sputum, salivation, constipation and other symptoms were more obvious than gastric cancer group, between 37-48%. According to cluster analysis, 26 cases of gastric cancer were divided into two types: deficiency of spleen and stomach of cold type (n = 26), spleen deficiency of phlegm and dampness type (n = 21), deficiency of stomach yin type (n = 17), invasion of liver qi by stomach type (n = 13), deficiency of both qi and blood in 12 cases (n = 12). Esophageal carcinoma was divided into phlegm and qi stagnation type (n = 19), Qi and yin deficiency type (n = 16) and liver-stomach disharmony type (n = 11). Among the 8 kinds of partial physiques, Yang deficiency and Qi stagnation are the main ones. These three kinds of physiques account for 65.18 of the total types of physique investigated, while the remaining ones are between 3 and 9%, while blood stasis and dampness and heat are the least. This investigation has no special quality. 4. Deficiency of Qi and Blood in gastric carcinoma, There was a significant positive correlation between yang deficiency of gastric cancer and deficiency of spleen and stomach cold type (no cancer or cancer after operation), but a negative correlation with spleen deficiency phlegm dampness type (P < 0.01), and a significant negative correlation with spleen deficiency phlegm dampness type (P < 0.01), and a negative correlation with spleen deficiency phlegm dampness type (P < 0.01). There was a significant correlation between liver and stomach disharmony (P < 0.05) and qi stagnation in esophageal carcinoma. Conclusion 1.135 cases of gastric cancer were divided into 5 types and 3 types of TCM syndromes respectively. The results showed that 2.135 cases of gastric cancer were in accordance with clinical practice. The partial physique of patients with esophageal cancer after operation was yang deficiency and Qi stagnation was more than .3.Conclusion: 1. 135 cases of gastric cancer were divided into 5 types and 3 types of TCM syndromes, respectively. The deficiency of yang in patients with gastric cancer is related to their original constitution, and the qi stagnation in patients with esophageal cancer is related to the modification of disease. The deficiency of qi may be the main pathogenesis of gastric cancer.
【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】：2016
【分类号】：R273
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本文编号：2047812