幽门螺杆菌感染者的证候特点及其证型分布规律的研究

发布时间：2018-03-10 21:12

本文选题：Hp感染者　切入点：证侯特点　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:分析Hp感染的相关因素,为预防提供方向;研究Hp感染者的证侯特点,为尽早诊断提供依据;探讨Hp感染者的证型分布规律,为治疗提供思路。方法:本次研究模拟采用大数据与临床研究相结合的方法,搜集符合研究目标的人群,形成研究分析的全数据集,探索分析在实际情况下Hp感染者的相关特点。通过参考权威书籍综合临床经验,设计出相应临床研究观察表;收集2016年4月-2016年6月就诊于南京市中医院,并行13C尿素呼气试验或胃镜检查的患者201例,根据检查结果将患者分为两组,其中Hp阳性患者共104例,为Hp阳性组;Hp阴性患者97例,为Hp阴性组;根据患者的临床研究资料,建立数据库。应用相关统计学方法,分析Hp感染的相关因素及其证侯特点,Hp感染者的证型分布规律。结果:(1)不同性别、年龄、婚姻状况的人群中,Hp阳性率不能认为有差异(P0.05);Hp感染在外出就餐、饮酒方面无统计学差异(P0.05);而与分餐,吸烟存在显著差异(P0.05),不分餐人群的Hp阳性率明显高于分餐人群,吸烟人群的Hp阳性率明显高于不吸烟人群;(2)Hp感染者主要的证侯出现频次由多至少依次为:胃脘胀满、嗳气、口臭、大便稀溏、反酸;舌象以舌红,苔黄、腻为主,脉象以弦、滑为主。胃脘胀满、嗳气、口臭、大便稀溏、苔腻在Hp阳性组与Hp阴性组中分布有统计学差异(P0.05),而反酸、舌红、苔黄在两组间分布无统计学差异(P0.05)。进一步将有统计学差异(P0.05)的症状结合不分餐、吸烟相关因素分析,得出嗳气、口臭、大便稀溏的人群,Hp感染率较高;(3)Hp感染者的证型分布:以脾胃湿热证为主,占比为37.5%,其次分别为肝胃不和证(26.0%)脾胃虚弱证(18.3%)寒热错杂证(8.7%)胃阴不足证(7.7%)胃络瘀阻证(1.9%)。结论:(1)Hp感染与性别、年龄、婚姻状况,外出就餐、饮酒无明显相关性;与分餐,吸烟存在相关性。(2)嗳气、口臭、大便稀溏对判断是否感染Hp具有较好的诊断价值,结合分餐及吸烟相关因素,得出如果就诊人群有嗳气、口臭、大便稀溏、吸烟、不分餐这些信息,建议应尽早行Hp相关检查,这样可以提高人群Hp感染的检出率,提高临床诊断Hp的筛检能力。(3)Hp感染者证型分布规律为:脾胃湿热证肝胃不和证脾胃虚弱证寒热错杂证胃阴亏虚证胃络瘀阻证。
[Abstract]:Objective: to analyze the related factors of HP infection, to provide the direction for prevention, to study the syndrome characteristics of HP infection, to provide the basis for early diagnosis, to explore the distribution pattern of HP infection. Methods: in this study, big data was used in combination with clinical research to collect people who were in line with the objectives of the study and to form a complete data set of research and analysis. To explore and analyze the relevant characteristics of HP infection in the actual situation. By referring to authoritative books to synthesize clinical experience, to design the corresponding clinical research observation table, to collect from April 2016 to June 2016 to visit Nanjing traditional Chinese Medicine Hospital, 201 patients who underwent 13C urea breath test or gastroscopy were divided into two groups according to the results of the examination, including 104 patients with HP positive, 97 patients with HP negative, who were HP negative, according to the clinical data of the patients. To establish the database, to analyze the related factors of HP infection and its syndromic characteristics, and to analyze the distribution pattern of HP infection by using the relevant statistical method. Results: different sex, age, and age. There was no significant difference in HP positive rate between the two groups, but there was no significant difference in drinking, but there was a significant difference in smoking between the two groups, and the HP positive rate in the non-meal group was significantly higher than that in the meal group. The positive rate of HP in smoking population was obviously higher than that in non-smoking population. The frequency of HP infection was at least in the following order: full stomach, belching, halitosis, loose stool, acid regurgitation, red tongue, yellow fur, greasy tongue, string pulse. The gastric distension, belching, halitosis, loose stools, clothiness in HP positive group and HP negative group were significantly different (P 0.05), but regurgitated, tongue red, and so on. There was no statistical difference in the distribution between the two groups (P0.05). Further, the symptoms with statistical difference (P0.05) were combined with non-meal, smoking related factors were analyzed, and the results showed that there was belching and bad breath. The prevalence of HP infection in the population with dilute stools was higher. The distribution of the syndrome types of HP infection was mainly spleen and stomach dampness and heat syndrome. The proportion was 37.5, followed by liver and stomach disharmony (26.0) spleen and stomach weakness syndrome and 18.3C) cold and heat disorder syndrome 8.7m) stomach yin deficiency syndrome 7.7. conclusion there is no significant correlation between sex, age, marital status, dining out, alcohol consumption, sex, age, marital status, dining out and drinking. Smoking has correlation. 2) belching, bad breath and loose stools have good diagnostic value in judging whether or not infected with HP. Combined with meal and smoking related factors, it is concluded that if there are belching, halitosis, loose stools, smoking, and smoking, In order to improve the detection rate of HP infection in the population, it is suggested that HP related examination should be carried out as soon as possible. To improve the screening ability of clinical diagnosis of HP. The distribution rule of syndrome type of HP infection is: spleen and stomach dampness heat syndrome liver and stomach disharmony syndrome spleen and stomach deficiency syndrome cold heat disorder syndrome stomach yin deficiency syndrome stomach deficiency syndrome stomach collaterals stasis syndrome.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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