中国人肿瘤患者韩医四象人体质的临床研究

【作者】 郭羽永；

【导师】 殷东风；

【作者基本信息】 辽宁中医药大学 ， 中医内科学， 2010， 博士

【摘要】 目的:应用韩医四象医学理论,分析辽宁中医药大学附属医院204例恶性肿瘤患者在四象人体质类型(太阳人、少阳人、太阴人和少阴人)中的分布规律,及不同背景因子和中医证型的肿瘤患者在四象人体质类型中的分布规律。材料与方法:2009年2月～2009年8月在中国辽宁中医药大学附属医院肿瘤科就诊或住院、病理诊断明确的恶性肿瘤患者204例,调查患者的四象人体质数据。研究对象按入院时间先后入组,调查以横断面现场调查法实施。调查问卷的填写是在具有中医本科以上教育背景的调查员的协助下,由调查对象采用自填法,或者由调查员逐条询问填写。对所有调查对象均取得知情同意。为确保调查数据的准确性,所有研究人员在调查前统一进行培训,调查中统一标准、统一方法,以减少调查过程中的偏倚;调查问卷回收后逐项核查,剔除不合格(性别、年龄、手术状况、化疗状况、放疗状况、西医诊断、PS、中医证型等主要项目缺失以及缺失条目较多和有逻辑错误)的问卷;合格问卷采用EpiData 3.02双录入法录入数据。四象人体质量表由大韩韩医学会四象医学会拟定的四象体质分类调查表(QSCCⅡ)项目中121项中的32个问项构成。四象体质分类调查表基本内容根据四象医学的《格致高》、《东医寿世保元》和(QSCCⅡ)软件WrnQSCCⅡ99version制成。QSCCⅡ是四象体质医学会公认的体质诊断统一检查方法。以此作为体质分类的参考制定四象人体质量表。本研究所用四象人体质量表的信度系数为Cronbach’a=0.76。一般调查包括性别、年龄、手术状况、化疗状况、放疗状况、西医诊断、中医证型等内容。四象人调查:采用四象人体质量表,用横断面现场问卷调查法。通过四象人体质量表调查所得的资料,进行四象人体质判断。对每个四象人体质判定后,采用构成比描述四象人类型的分布情况;统计分析使用SPSS15.0完成。对肿瘤患者背景因子(年龄、性别、手术、化疗、放疗)及中医证型分组,采用X2检验比较各亚组四象人体质构成的差异性。统计分析使用SPSS15.0完成,以P <0.05为有统计学意义。结果:1.肿瘤患者中太阴人77例(37.7%),少阴人56例(27.5%),少阳人58例(28.4%),太阳人13例(6.4%);太阴少阴人占65.2%,太阳少阳人占34.8%。2.少阴人女性偏多,少阳人男性偏多;60岁以上者太阴人最多,其次为少阴人和少阳人,60岁以下者少阳人最多,在统计学上有显著差异(p<0.05)。3.中医证型阴虚热毒型中少阳人最多,阳虚寒毒型中太阴人最多,差异具有显著意义(p<0.05),其他两个证型中无明显四象体质特殊分布。结论:恶性肿瘤患者四象体质阴性者明显多于阳性者,随着阳气的减弱肿瘤患病在逐渐增加,肿瘤患者体质与阳气有密切的关系。更多还原

【Abstract】 Purpose: To analyze the distribution law of the 204 patients who suffer from tumor and come from department of internal oncology ,affiliated hospital of Liaoning university of Traditional Chinese Medicine in the style of four images constitution according to the theory of four images (Taiyang people ,Shaoyang people, Taiyin people and Shaoyin people )of Korean Medicine.Also To analyze the distribution law of different background factor and different pattern of TCM in the style of four images constitution.Material and method:To make a survey of four images constitution date of 204 patients who visited or were hospitalized in department of internal oncology, affiliated hospital of Liaoning university of Traditional Chinese Medicine between February ,2009 and August ,2009, with definite pathologic diagnosis . Researching object entered the group according to hospitalized time , transected field investigation were made ,then filled in the item of questionnaire one by one by patients who got informed consent or surveyors who were given unified training before investigation to assure the accuracy and reduce bias in the course of inquiry. When the questionnaires were reclaimed , checked one by one item ,then eliminated that unqualified .All the qualified questionnaires’data were inputed the computer by EpiData 3.02 double-entry method.Physical Inventory of four images people was made of 32 questions which from QSCCⅡ121 items studied out by four images institute of Medicine in Korean Medicine according to Gezhigao , Medical Book of Eastern Medicine and WrnQSCCⅡ99version in QSCCⅡ. QSCCⅡwas an unified constitutional check-up method and was acknowledged by four images institute of Medicine. Reliability coefficient in physical Inventory of four images of this research was 0.76.The content of survey was consisted of sex, age, operation, chemotherapy, radiation treatment , western diagnosis, pattern of TCM and so on . Physical Inventory of four images was adopted when investigated on spot, then got the judgement of four images constitution by the datum that collected .After the determent of four images constitution, proportion was adopted to describe the complexion of distribution of the style of four images. Statistical analysis will be conducted by using SPSS15.0, The chi-square test will be used to compare various background factors of the proportional difference among different groups , The difference is of significance in statistics science(P<0.05)Results:1. In the patients of tumor, there were 77 Taiyin people ,taking up 37.7%; there are 56 Shaoyin people ,taking up 27.5%; there were 58 Shaoyang people ,taking up 28.4%; there were 13 Taiyang people ,taking up 6.4%; people with negative constitution take up 65.2%,while positive constitution people holded 34.8%.2. There were more female in Shaoyin people ,and more male in Shaoyang people ; Above all 60 years old, Taiyin people were the most of all, Shaoyin people were in the next place and Shaoyang people in the third place;while below 60 years old, Shaoyang people took up the most propotion, there was significant difference (p<0.05)。3. As the facet of pattern of TCM was Concerned , about the deficiency of Yin and fire-toxicity syndrome pattern , the number of Shaoyang people was the maximum ; about the deficiency of yang and cold toxin pattern , Taiyin people were the most of all, the difference was significant(p<0.05)。Conclusions:There are more negative constitution than positive constitution in the patients of tumor, and corresponding to the decrease of yang qi , people suffering from tumor increase gradually, so there is osculating relationship between constitution of tumorous patients and yang qi of body.更多还原