进展期胃癌胃镜下中医辨证分型探讨

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1、提要目的：探讨进展期胃癌各中医证型的胃镜下典型表现，为中医辨证治疗提供客观依据。方法：1.临床选择符合纳入标准的进展期胃癌患者51例，结合文献研究制定临床观察表，收集病历；2.通过胃镜下观察51例患者的黏膜表现，与传统中医的望、闻、问、切四诊相结合，并进行数据录入；3.采用SPSS17.0统计软件处理分析，对进展期胃癌的中医证候规律进行分析。结果：胃镜下两种证型与肿瘤部位及胃癌Borrmann分期之间没有显著性差异（P>0.05），但是与肿瘤表面是否有溃疡、是否有活动性出血、Hp感染、舌质、舌苔表现出一定的相关性；脾胃虚弱型患者比较明显的胃镜像为肿瘤隆起少见溃疡；粘膜充血水肿，出血在瘀毒内蕴型

2、中较明显；脾胃虚损证患者胃镜下肿瘤溃疡面积小于瘀毒内蕴型；Hp感染在瘀毒内蕴证中多见；淡白舌白腻苔在脾胃虚弱证中较多见；舌暗红苔薄黄在瘀毒内蕴型中多见，均具有统计学意义（P<0.05）。结论：胃镜下两种证型与肿瘤部位及胃癌Borrmann分期之间没有显著性差异，但是与肿瘤表面是否有溃疡、是否有活动性出血、Hp感染、舌质、舌苔表现出一定的相关；脾胃虚损证患者胃镜下见少见溃疡，且溃疡面积最小，淡白舌白腻苔。瘀毒内蕴证患者胃镜下多见溃疡与活动性出血，溃疡面积较大，HP感染阳性，暗红舌苔薄黄。关键词进展期胃癌；胃镜；中医证型GastroscopePerformanceofAdvancedGastric

3、CancerandtheRelevanceofTCMSyndromeTypesResearchSpeciality:ChinesemedicineClinicalAuthor:WangyongsenTutor:ProfessorCaozhiqunAbstract:Objective:TheaimofthisstudywastoexplorethetypicalperformanceofTCMsyndrometypeofadvancedgastriccancerundergastroscopeandprovideanobjectivebasisforTCMtreatment.Methods:1.

4、51casesofadvancedgastriccancermettheinclusioncriteriawereselectedintheclinical,thencombinationofthebasisoftheliteraturetodevelopclinicalobservationtableandcollectofcases.2.CombiningwiththetraditionalChineselook,smell,andasked,cuttingthefourdiagnostic,toobservethemucousmembraneperformanceofthe51patie

5、ntsundergastroscopeanddataentry.3.ProcessingandanalysisusingstatisticalsoftwareSPSS13.0toanalysistheChinesemedicinesymptomlawofadvancedgastriccancer.Results:ThereisnosignificantdifferencebetweenthetwosyndrometypesoftumorandgastriccancerBorrmannstagesundergastroscope（P>0.05）,butshowsomecorrelationwit

6、hwhetherthereisulcerationinthesurfaceofthetumor,whetherthereisactivebleeding,HPinfection,tongueproperandcoatedtongue.TheperformancesofPatientswithspleendeficiencyundergastroscopearetumorupliftrareulcers;mucosalcongestionandedema,andtheecchymosisintrinsictypeshowmoreobvioushemorrhage;Patientswithsple

7、endeficiencyunderendoscopictumorulcerarealessthanEcchymosisintrinsictype;HPinfectionwasmorecommonintheEcchymosisintrinsicsyndrome;Paletongue,greasyfurweremorecommoninthespleenandstomachDeficiencySyndr