中晚期原发性支气管肺癌寒热病性研究

【作者】 李炜弘；

【导师】 严石林；

【作者基本信息】 成都中医药大学 ， 中医诊断学， 2003， 硕士

【摘要】 目的：探讨中晚期原发性支气管肺癌寒热病性。方法：1、拟定寒、热证候的常见辨证因子，进行半定量分析，建立寒热证候辨证量化标准。2、调查279例肺癌的中医证型。3、采用所拟寒热量化标准，对279例肺癌的寒热辨证因子进行调查。4、采用X~2检验、积分排序、Ridit分析等统计学处理方法，对肺癌不同的中医证型、TNM分期、病理、KNS评分、疼痛分级进行寒热积分的比较。结果：1、确定寒证辨证因子39项，热证辨证因子48项，拟定寒热辨证量化标准。2、寒热辨证因子积分比较，寒证以寒热喜恶等积分排序居前，热证以舌、脉、痰等积分排序居前。3、肺癌中医证型以气虚痰湿、气阴两虚所占比例最高。4、肺癌的寒热病性与肺癌的中医证型、TNM分期、KNS评分间有相关性。气虚痰湿型、气滞血瘀型的寒证积分明显高于热证，阴虚内热型、热毒炽盛型的寒证积分明显低于热证；寒性辨证因子多见于Ⅲ期、Ⅳ期，热性辨证因子多见于Ⅱ期、Ⅲ期；寒性辨证因子集中在70分以下的低分段，热性辨证因子集中在70分以上的高分段。结论：1、肺癌的病机以气虚、阴虚为主，兼痰湿、瘀血为患。2、肺癌病性越偏于寒者，其一般状态越差。3、肺癌的寒证以虚寒较突出，热证以肺热甚较突出。4、肺癌的热证多出现在中晚期的前期阶段，中晚期的后期则以虚寒为病理基础，且肺癌的病性以寒为主。更多还原

【Abstract】 Objective: To study the character of clinical zheng pattern about Lung cancer during the metaphase and terminal; to find tendency of Cold zheng and Heat zheng. Method: 1, To find the factors of differentiation of syndromes about Cold and Heat, proceeding half quantitative analysis, then to set up the quantitative standard of differentiation of syndromes of Cold and Heat. 2, To investigating zheng pattern of the traditional Chinese medicine of 279 case of Lung cancer 3, To adopt the quantitative standard above mention , investigating the factors of differentiation of Cold and Heat about 279 case of Lung cancer. 4; The data from statistics is be deal with by X2 examining, queuing accumulative points and Ridit analyze etc. To attain the differentia through comparing Cold’s score and Heat’s score of TNM period, pathology, KNS assessment’s grade , degree of pain and zheng pattern in traditional Chinese medicine . Result: 1, Make certain the 39 factors of differentiation of syndromes about Cold and 48 factors of differentiation of syndromes about Heat, to establish the quantitative standard of differentiation of syndromes of Cold and Heat. 2, The comparison about Cold-Heat’s score show that the feeling of cold and heat etc. is superiority in Cold zheng while the physical sign of tongue, pulse and phlegm etc. is superiority in Heat zheng. 3, Deficiency of both Qi and Yin, Qi Deficiency and Phlegm Dampness is majority in traditional Chinese medicine about Lung cancer. 4, There are relative between the quantity of Cold-Heat with zheng pattern in traditional Chinese medicine, TNM period and KNS assessment’s grade. The Cold score about Qi Deficiency and Phlegm Dampness and Qi stagnation and Blood stasis are higher than theHeat’s while the Cold score about interior Heat caused by Yin Deficiency and dominance of Heat in Interior are lower than the Heat’s. The most Cold factors of differentiation of syndromes are display in HI-IV periods while the most Heat factors of differentiation of syndromes are display in II-El periods. The most Cold factors of differentiation of syndromes are be find on the level of blow 70 cents, while the most Heat factors of differentiation of syndromes are be find on the level of above 70 cents. Conclusion: 1, The chief pathogenesis is Qi Deficiency and Yin Deficiency, accompany with Phlegm Dampness and stagnated Blood about Lung cancer. 2, More cold quantity company more badly situation in Lung cancer. 3, The most Cold zheng shows Deficiency-Cold , and the most Heat zheng shows Lung-Heat about Lung cancer. 4, Most heat zheng occur in prophase; Deficiency-Cold is pathologic foundation in terminal period of Lung cancer.更多还原