原发性肝癌的中医体质类型分布及其预后因素分析

  目的  探讨原发性肝癌的中医体质类型分布及其预后因素。  方法  采用标准化的中医体质分类量表, 对151例原发性肝癌患者进行中医体质辨识并分析中医体质类型等因素对肝癌预后的影响。  结果  患者的体质类型分布为: 平和质37例(24.5%), 气虚质36例(23.8%), 阳虚质25例(16.6%), 湿热质21例(13.9%), 气郁质14例(9.3%), 瘀血质10例(6.6%), 特禀质4例(2.6%), 阴虚质2例(1.3%), 痰湿质2例(1.3%)单因素及多因素分析结果提示体质类型为气虚质、临床分期、AFP水平和CLIP评分均是生存期的独立影响因素、其中气虚质是值得进一步研究的可能影响患者预后的独立危险因素。  结论  肝癌患者的偏颇体质主要以气虚质、阳虚质和湿热质三种体质为主。气虚质是影响原发性肝癌预后的强独立危险因素。      

中药五生酊外用治疗癌性疼痛临床疗效观察

目的观察中药五生酊外用治疗癌性疼痛（简称癌痛）的疗效及其对生活质量的影响。方法将83例伴有癌性疼痛的癌症患者随机分为治疗组42例及对照组41例,共78例完成了本研究（5例出现皮肤瘙痒后退出）,其中治疗组40例,对照组38例。按疼痛数字评分法（numerical rating scale, NRS）进行疼痛程度分级。对照组给予世界卫生组织（WHO）三阶梯止痛方案治疗;治疗组在WHO三阶梯止痛方案治疗基础上,给予中药五生酊外涂治疗,2组疗程均为7 d。采用NRS、生活质量表评价中药五生酊外用配合WHO三阶梯方案对癌性疼痛的疗效及其对生活质量的影响。结果（1）用药第7天,2组患者的NRS评分均较用药前1 d下降,差异有统计学意义（P＜0．01）,但组间比较,差异无统计学意义（P＞0．05）。（2）治疗组总有效率为82．5％,对照组为68．4％,治疗组的总疗效优于对照组,差异有统计学意义（P＜0．05）。在轻度疼痛患者中,治疗组的疗效优于对照组,2组比较差异有统计学意义（P＜0．05）;在中、重度疼痛患者中,2组比较差异无统计学意义（P＞0．05）。（3）用药第7天,2组的生活质量评分均明显改善,与用药前1 d比较差异有统计学意义（P＜0．01）;但治疗后组间比较,差异无统计学意义（P＞0．05）。结论对于轻度癌痛患者,中药五生酊外用有一定治疗作用;但对于中、重度癌痛患者,中药五生酊外用联合三阶梯止痛治疗未能提高疗效,也未能使患者的生活质量得到进一步改善。     

中医体质类型与原发性肝癌预后的相关性

目的 探讨中医体质类型与原发性肝癌预后的相关性.方法 采用标准化的9种中医体质分类量表对151例原发性肝癌患者进行中医体质辨识,对所有患者进行随访以了解患者生存期,用Kaplan-Meier法计算患者的总体生存期和中位生存期,采用Log-rank检验进行亚组分析.结果 中位生存期最长的是体质类型为平和质的患者;最短的是气虚质.4种主要体质类型的平均生存期和中位生存期如下:平和质的中位生存期为13.3个月;气虚质为3.7个月;阳虚质和湿热质分别为6.1个月和10.2个月.4种体质生存期之间的差异无统计学意义(P >0.05).将平和质和气虚质的中位生存期进行单因素对比,结果 示,两者之间的差异存在统计学差异(P<0.05).结论 中医体质与生存期有一定的相关性.气虚质是4种主要体质中预后最差的一种,其中位生存期为3.7个月.     

切脉针灸治疗恶性肿瘤思路探析

简版：恶性肿瘤在我国的发病率及死亡率呈现逐年递增趋势。切脉针灸作为中医学的一部分，在恶性肿瘤治疗上有其独特的治疗效果及优势。笔者通过对切脉针灸的深入研究，剖析梳理其中蕴含的主要思想内涵，系统分析俞氏切脉针灸的原理机制，并探讨其在恶性肿瘤中的具体运用。     

Treatment of advanced non-small cell lung cancer with extracorporeal high frequency thermotherapy combined with Chinese medicine

Objective： To observe the clinical efficacy and benefit response of extracorporeal high frequency thermotherapy （EHFT） combined with Chinese medicine （CM） in the treatment of patients with advanced non-small cell lung cancer. Methods： The study adopted a prospective, small sample and randomized controlled method, and the advanced non-small cell lung cancer patients were assigned to two groups according to the table of random digits, one having the treatment of EHFT combined with CM （the treatment group）, the other only with CM （the control group）. The patients in the treatment group were treated with EHFT one hour once per day, together with CM differentiation decoction, 250 mL orally taken, twice daily for 14 days as one cycle, and 3-4 cycles was performed. The patients in the control group were treated only with CM differentiation decoction using the same dose as the treatment group. The efficacies were evaluated after three to four cycles of treatment. Primary endpoints were disease control rate （DCR） and time to progression （TTP）. Secondary endpoints were overall survival time and 1-year survival rate. Results： Sixty-six patients accomplished the study. After the patients underwent different treatments, none of the patients got a complete response or partial response in both groups. In the treatment group, DCR was 72.2%, and 10 had progression of disease （28.8%）, while the DCR of the control group was 63.3%, and 11 had progression of disease （36.7%）; there was a significant statistical difference （P0.05）, suggesting that the combined regimen had superiority on the DCR. As for long-term efficacy, the median survival time （MST） of the treatment group was 7.5 months, TTP was 5.5 months, and 1-year survival rate was 21.4 %; in the control group, the results were 6.8 months, 4.5 months and 16.6% respectively. There was significant statistical difference on TTP （P0.05）, but no difference on MST or 1-year survival rate. Conclusion： EHFT combined with CM differentiation has better tolerance and short-term efficacy in the treatment of patients with advanced NSCLC.     

胃癌的中医药治疗进展

胃癌是我国常见的消化道恶性肿瘤之一。中医药在胃癌治疗的进展中起着越来越不可或缺的重要作用。     

121例ⅢB/Ⅳ期非小细胞肺癌中医证型分布

目的:观察晚期(ⅢB/Ⅳ期)非小细胞肺癌(NSCLC)患者的中医证型特点和分布规律。方法:采取回顾性调查方式,对纳入121例ⅢB/Ⅳ期NSCLC的病例进行资料采集,数据输入数据库,中医辨证分型参照《肿瘤中医诊疗指南》,由3人以上经验丰富的住院及主治医师进行辨证分型,最后由科室主任审核并确定。结果:121例ⅢB/Ⅳ期NSCLC中医证型以脾虚痰湿型最多见,占52.1%(63/121),与其他中医证型相比较有显著差异(P<0.05)。分层分析:ⅢB期、IV期(M1a)期NSCLC中脾虚痰湿型分别占50.0%(14/28)、57.1%(20/35),均与其他中医证型相比较有显著差异(P<0.05);IV期(M1b)期NSCLC中以脾虚痰湿、气阴两虚型为主,分别占50.0%(29/58)、29.3%(17/58),脾虚痰湿型与其他中医证型相比较有显著差异(P<0.05)。结论:晚期(ⅢB/Ⅳ期)NSCLC的中医证型以脾虚湿瘀为主。     

原发性肝癌的中医体质调查分析

目的 探讨原发性肝癌患者的中医体质分布情况.方法采用标准化的9种中医体质分类量表对151例原发性肝癌患者进行中医体质辨识.结果 患者的体质类型分布为:平和质37人(24.5%),气虚质36人(23.8%),阳虚质25人(16.6%),湿热质21人(13.9%),气郁质14人(9.3%),瘀血质10人(6.6%),特禀质4人(2.6%),阴虚质2人(1.3%),痰湿质2人(1.3%).结论 肝癌患者的偏颇体质主要以气虚质、阳虚质和湿热质3种体质为主.体质类型存在性别差异,男性以气虚、阳虚和湿热质为主,而女性以阳虚质为主.