基于半结构化访谈法的肠癌患者中医症状的挖掘和分析

Analyses of TCM Symptoms of Patients with Colorectal Cancer Based on the Semi-structured Interview

目的:分析提炼肠癌患者的中医症状,为确定中医药治理肿瘤的中医疗效评价指标提供一定依据。方法:用半结构化访谈的定性研究方法就3个框架性问题进行深入访谈,全面真实的记录病程中患者感受,然后对访谈资料进行整理审核,建立数据库,借助定性分析软件nvivo 6.0进行编码分析,并按照《中医临床诊疗术语》等的描述进行标化,最终提炼出其中的中医症状。结果:根据分析结果提炼出了西医治疗手段干预前后的中医症状,干预前有便血、腹痛等23个中医症状,干预后有便秘、便溏等20个中医症状。结论:患者对大便异常的描述最为详尽,共有11个症状,说明肠癌患者对大便异常最为关注;腹部、消化道症状以及神疲、乏力、舌麻、指(趾)麻、脱发等症状也是患者非常关注的,提示这些症状可以作为肠癌患者的中医疗效评价指标。

Objective：To search and analyze the TCM symptoms of the patients with colorectal cancer,and to offer a foundation for efficacy evaluation in cancer treating with TCM.Methods：Three main questions were made by professors at first.And then,researchers interviewed selected patients with colorectal cancer face to face according to the questions and recorded all the information that the patients offered with sound recorder.After that,researchers transformed these sound records into words records in TXT form to create a database.With the help of nvivo 6.0（a software）,researchers analyzed the records and search the TCM symptoms related to colorectal cancer on the terms standard in the book ＂TCM clinical diagnosis and treatment terms＂.Results：Researchers found 23 TCM symptoms such as hemafecia/bellyache before intervention by modern medicine and 20 after that like constipation/loose stool.Conclusion：The most detailed description made by patients was abnormal bowel movements and there were 11 symptoms,which manifested that patients paid more attention to abnormal bowel movements.The symptoms of abdomen and gastrointestine and fatigue,tongue numbness,fingers（toes） numbness,hair loss and other symptoms were also the focuses of patient,which suggested that these symptoms could be used as efficacy evaluation in treating colorectal cancer with TCM.