健脾补精法联合化疗治疗中晚期胃癌的临床研究
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摘要
肿瘤,在现代社会越来越被人们所重视。随着科技的进步,中医在治疗癌病方面得到了快速进展,并取得了令人瞩目的成就。本文在中医理论的指导下,基于导师章永红教授关于诊治肿瘤病的学术思想及对胃癌的认识,以“健脾补精”为主线,探索中医药对胃癌的认识,并探讨健脾补精法在治疗胃癌中的具体运用。通过对临床病例的观察,总结疗效,研究健脾补精法结合化疗对中晚期胃癌患者的临床疗效。
论文的第一部分为西医理论研究。根据近五年现代医学对胃癌的文献研究,总结了近年来西医对于胃癌的病因、发病机制、治疗及实验室研究方面的进展,为之后的中医联合化学治疗胃癌临床研究奠定基础。
论文的第二部分为中医理论研究。着眼于胃之生理、病理及其与它脏的关系,从理论上系统探讨胃癌的病因病机、辩证分型和中医治则；总结了古代医家对胃癌的认识、现代医家对胃癌的理解。并从中找出为健脾补精法治疗胃癌提供的理论依据。同时提出胃癌虽正虚为主,但亦不可忽视邪毒的存在,故在发病及演变过程中,须扶正固本与祛邪解毒并举。视患者病情变化不断变化,针对性使用和、清、利、化、疏、降等治法,达到缓解临床症状、提高生活质量、延长生存期。
论文的第三部分为临床研究。将40例胃癌患者随机分为两组,分别观察两组临床疗效,采用中医症候、生活质量评分、癌灶疗效,安全性等指标进行比较。结果显示：健脾补精法治疗中晚期胃癌在减轻症状、缓解化疗副反应,提高生活质量等方面相对单纯化疗有较好疗效。从而进一步说明了健脾补精法在治疗胃癌时能有效地缓解临床症状、提高生活质量、延长生存期。
论文第四部分总结了导师对治疗胃癌的新理念：健脾补精；通过对本次试验组方、药理、结果的分析,对用药机理的探讨进一步论证了健脾补精法在治疗胃癌上的意义。提出健脾补精法联合化疗对胃癌患者的症状、化疗副反应,生活质量等方面有一定缓解作用,可以作为临床提高胃癌患者生活质量的常用中医方法之一,但由于客观因素的制约,本次试验尚存在很多不足之处。展望了新的研究思路,强调进一步深入探索的重要性和必要性。
People pay more and more attention on cancer in modern society. With the developing of technology,the TCM make a big progress at the treament of the cancer,and make a remarkable achievement. This thesis is under the construction of theory of TCM and based on the knowledge of gastric cancer and especially on Professor Zhang's academic idea about researching and treating cancers. We follow the principle of "Strengthening Spleen and Supplementing Jing" so as to study the knowledge of gastric cancer from the perspectives of TCM and discuss the practical applications of" the method of Strengthening Spleen and Supplementing Jing " in treatment of gastric cancer. By means of observing clinical therapeutic cases, effects are summed up and the clinical therapeutic of this TCM method with chemotherapy in treating cancer is investigated, too.
The first part of the thesis concerns study in theory:it summarizes the etiology and pathogenesis,threament and laboratory studies of the gastric cancer with literatures of five years in contemporary medical.And it establishes a theoretical and practical foundation of the study for the method of Strengthening Spleen and Supplementing Jing with chemotherapy in treatment of gastric cancer.
The second part of the thesis concerns study in theory:the knowledge of not only ancient medical scholars but also contemporary medical scholars about treatment of gastric cancer was summed up in three aspects including etiology and pathogenesis, TCM treatment and key clinical experiences.It is believed that the theoretical foundation about the method of strengthening spleen and supplementing jing would be found from above.At the same time,it is also supposed that not only the deficiency of vital -Qi about gastric cancer,but also the existence of pathogenic toxin.Above this, supporting vital-Qi and expelling pathogenic toxin are equal importance.With the changes of patients'diseases,it would be used all kinds of methods as expelling,harmonizing,cleaning,descending to reach to the aim of reliefing the disease improving life quality and prolonging survival time.
The third part of the thesis is as to clinical study. By analyzing effects of 40 gastric cancer cases, we observed and compared with the following indexes:TCM symptom, the standard of life quality, treatment effect of cancer foci and safety et al.It can finally make a conclusion that the method of strengthening spleen and supplementing jing has a better effect in these aspects of relieving symptom and side effects of chemotherapy,improving life quality, TCM treatment.
The forth part is generalization and analysis of experimental results, and a discussion about the mechanism of the prescription. Finally, the significance of srengthening spleen and supplementing jing in treatment of gastric cancer is summarized.
论文的第一部分为西医理论研究。根据近五年现代医学对胃癌的文献研究,总结了近年来西医对于胃癌的病因、发病机制、治疗及实验室研究方面的进展,为之后的中医联合化学治疗胃癌临床研究奠定基础。
论文的第二部分为中医理论研究。着眼于胃之生理、病理及其与它脏的关系,从理论上系统探讨胃癌的病因病机、辩证分型和中医治则；总结了古代医家对胃癌的认识、现代医家对胃癌的理解。并从中找出为健脾补精法治疗胃癌提供的理论依据。同时提出胃癌虽正虚为主,但亦不可忽视邪毒的存在,故在发病及演变过程中,须扶正固本与祛邪解毒并举。视患者病情变化不断变化,针对性使用和、清、利、化、疏、降等治法,达到缓解临床症状、提高生活质量、延长生存期。
论文的第三部分为临床研究。将40例胃癌患者随机分为两组,分别观察两组临床疗效,采用中医症候、生活质量评分、癌灶疗效,安全性等指标进行比较。结果显示：健脾补精法治疗中晚期胃癌在减轻症状、缓解化疗副反应,提高生活质量等方面相对单纯化疗有较好疗效。从而进一步说明了健脾补精法在治疗胃癌时能有效地缓解临床症状、提高生活质量、延长生存期。
论文第四部分总结了导师对治疗胃癌的新理念：健脾补精；通过对本次试验组方、药理、结果的分析,对用药机理的探讨进一步论证了健脾补精法在治疗胃癌上的意义。提出健脾补精法联合化疗对胃癌患者的症状、化疗副反应,生活质量等方面有一定缓解作用,可以作为临床提高胃癌患者生活质量的常用中医方法之一,但由于客观因素的制约,本次试验尚存在很多不足之处。展望了新的研究思路,强调进一步深入探索的重要性和必要性。
People pay more and more attention on cancer in modern society. With the developing of technology,the TCM make a big progress at the treament of the cancer,and make a remarkable achievement. This thesis is under the construction of theory of TCM and based on the knowledge of gastric cancer and especially on Professor Zhang's academic idea about researching and treating cancers. We follow the principle of "Strengthening Spleen and Supplementing Jing" so as to study the knowledge of gastric cancer from the perspectives of TCM and discuss the practical applications of" the method of Strengthening Spleen and Supplementing Jing " in treatment of gastric cancer. By means of observing clinical therapeutic cases, effects are summed up and the clinical therapeutic of this TCM method with chemotherapy in treating cancer is investigated, too.
The first part of the thesis concerns study in theory:it summarizes the etiology and pathogenesis,threament and laboratory studies of the gastric cancer with literatures of five years in contemporary medical.And it establishes a theoretical and practical foundation of the study for the method of Strengthening Spleen and Supplementing Jing with chemotherapy in treatment of gastric cancer.
The second part of the thesis concerns study in theory:the knowledge of not only ancient medical scholars but also contemporary medical scholars about treatment of gastric cancer was summed up in three aspects including etiology and pathogenesis, TCM treatment and key clinical experiences.It is believed that the theoretical foundation about the method of strengthening spleen and supplementing jing would be found from above.At the same time,it is also supposed that not only the deficiency of vital -Qi about gastric cancer,but also the existence of pathogenic toxin.Above this, supporting vital-Qi and expelling pathogenic toxin are equal importance.With the changes of patients'diseases,it would be used all kinds of methods as expelling,harmonizing,cleaning,descending to reach to the aim of reliefing the disease improving life quality and prolonging survival time.
The third part of the thesis is as to clinical study. By analyzing effects of 40 gastric cancer cases, we observed and compared with the following indexes:TCM symptom, the standard of life quality, treatment effect of cancer foci and safety et al.It can finally make a conclusion that the method of strengthening spleen and supplementing jing has a better effect in these aspects of relieving symptom and side effects of chemotherapy,improving life quality, TCM treatment.
The forth part is generalization and analysis of experimental results, and a discussion about the mechanism of the prescription. Finally, the significance of srengthening spleen and supplementing jing in treatment of gastric cancer is summarized.
引文
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