鼻咽癌放、化疗前及放、化疗过程中证型的分布特点及动态演变规律的研究

摘要

目的：通过对128例鼻咽癌患者放、化疗前和放、化疗过程中中医证型变化的临床现象学调研，初步了解鼻咽癌病变治疗过程中证型的分布特点及动态演变规律。方法：随机抽取符合纳入标准的128例鼻咽癌患者，根据临床实际情况和治疗需求，将其分为放疗前诱导化疗组54例，同期放化疗组74例，对各个病例在放、化疗前及放、化疗过程中表现出的临床证型变化进行动态演变规律的观察，将观察结果进行统计学分析处理。结果：128例鼻咽癌患者放、化疗前的辨证分型为：邪热壅肺型、血瘀阻络型、痰浊凝聚型、血瘀痰凝型四种证型，各证型病例数分别占不同的百分比。同期放化疗过程中的辨证分型为：津液亏损型、热毒炽盛型、肺胃阴虚型、脾胃失调型、气阴两虚型五种证型；诱导化疗后的辨证分型为：湿热中阻型、脾胃气虚型、气血亏虚型三种证型，经统计学分析比较各观察周期证型变化情况有统计学意义（P<0.05），并具有一定特点及规律性。结论：初步得出了鼻咽癌放、化疗前及放、化疗过程中的证型的分布特点及动态演变规律，但其科学性及实用性有待进一步临床验证。%　　Objective:To initially Clear up that the distribution characteristics and dynamic evolution regularity of NPC patient’s TMC Syndrome Patterns before chemotherapy and radiotherapy and in it by Clinical phenomenon investigation of valid 128 cases of NPC patients. Method:Randomly selected 128 cases of NPC patients met the inclusion criteria,according to Clinical actual circumstance and the need of the treatment,the 128 cases of NPC patients were divided into 74 cases accepted to Concurrent chemoradiotherapy and 54 cases accepted to inductive chemotherapy before radiotherapy. Then,we carried on the dynamic state observation of every NPC patient’s TMC Syndrome Patterns before chemotherapy and radiotherapy and in it. Finally,the results were analyzed by statistics. Result:Before chemotherapy and radiotherapy,128 cases of NPC patients had the four kinds of TMC Syndrome Patterns that were accumulation of pathogenic heat in the lung pattern,blood stasis pattern,phlegm stasis pattern,blood and phlegm stasis pattern,and the cases of each syndrome patterns accounted for several different percentage. The five kinds of NPC TMC Syndrome Patterns during Concurrent chemoradiotherapy that were body fluid being damaged pattern ,dominance of heat in the interior pattern ,deficiency of lung and stomach Yin pattern,spleen and stomach maladjustment pattern,pattern of dual deficiency of Qi and Yin. The NPC TMC Syndrome Patterns during induction chemotherapy were moist heat obstruction pattern,deficiency of spleen-QI and stomach-QI pattern,deficiency of both QI and blood pattern ,The statistical analysis of the TMC Syndrome Patterns changing during each observation period was esignificant difference(P<0.05),and it showed the distribution characteristics and dynamic evolution regularity of TMC Syndrome Patterns.Conclusion:Initially,we obtained the distribution characteristics and dynamic evolution regularity of NPC patient’s TMC Syndrome Patterns before chemotherapy and radiotherapy and in it,but its the science and practicality need further clinical validation.