当前位置:主页 > 硕博论文 > 医学博士论文 >

基于口苦症状的流行病学调查及中西医身体观的比较研究

发布时间:2019-05-17 18:29
【摘要】:目的口苦是中医学理论体系中具有较大理论与临床意义的症状。本课题以对口苦症状的流行病学调查为基础,并结合人体试验与文献研究,就以下问题进行研究。1,调查北京市4所三甲医院14岁以上住院病人口苦症状的发生状况、科室与疾病分布及影响口苦症状发生的相关因素,以明确与口苦症状关系密切的疾病因素及其他相关因素;2,调查全国14岁以上健康人群口苦症状的发生状况以及导致口苦症状发生的相关因素,以明确口苦症状在健康人群的发生率,以及相关行为因素及体质因素;3,通过人体试验,研究健康成人不同个体对苦味主观感受的个体差异,以及性别、吸烟两个因素对苦味感受的影响;4,通过文献学研究及中西医理论体系的对比研究,系统整理历代医家对" 口苦"病机及治疗的认识,探讨中西医身体观的差异,并以口苦为例,探讨中西医诊疗思维的差异。方法1,选取北京市4所三甲医院,使用统一的流行病学调查表,对4所医院符合纳入标准的住院病人进行流行病学调查。调查内容主要包括个人基本信息,如性别、年龄、身高、体重、民族等;口苦症状的发生情况,包括发生频率、程度、发生时间以及是否伴有其他味觉异常等;生活习惯,包括吸烟、饮酒、睡眠时间、饮食口味、膳食结构等;症状学情况,如上腹部疼痛、反酸、口腔溃疡、口臭,以及情绪相关症状;既往病史,主要包括牙科治疗、腹部或中耳手术以及脂肪肝、胆囊炎、鼻炎、中耳炎、慢性咽炎等疾病;此外还有针对肝病及胃-食管疾病的辅助检查项目。2,通过"问卷星"平台在网络上发布流行病学调查问卷,对全国14岁以上健康人群口苦症状发生状况及其影响因素进行流行病学调查。调查内容主要包括个基本信息、口苦症状发生的状况、生活习惯,同时引入中医体质学量表,对调查对象是否存在湿热体质或气郁体质进行评估。所有数据使用EPidata3.1录入后,使用SPSS20.0进行统计学分析。3,选用苦丁茶作为苦味试剂,采用随机、单盲、对照的临床试验方法,将志愿者随机编为3组,每组志愿者均分别接收不同浓度的苦丁茶浸出液,然后借鉴VAS法,由志愿者在"苦味标度线"上标记出刚刚接受测试液苦味程度。录入数据,采用t检验或非参检验,分别按照性别和是否吸烟进行统计分析。4,选择9名健康志愿者,采用三向交叉拉丁方实验设计,每位志愿者均接受三种不同浓度的苦丁茶浸出液,然后由志愿者在"苦味标度线"上标出刚刚接受测试液的苦味程度。通过拉丁方分析,研究苦味感受能力的个体差异。5,系统考察历代中医学文献,从医学理论形成初期的社会文化背景及后期的医学发展着手,对比研究中西医理论体系,从身体观角度入手,以口苦症状为例,探讨中西医两个医学体系诊疗思维的差异。结果1,对北京市4所三甲医院住院病人的调查共调查病人782人,收集有效问卷766份,口苦症状发生率为53.79%。口苦症状的发生率与年龄层成正相关。住院病人口苦发生率最高的科室依次为肝病科(66.67%),消化科(61.80%),神经内科(60.66%)。在具体疾病方面,脂肪肝、胆囊炎、胃-食管疾病、慢性咽炎、牙科治疗为口苦症状发生的危险因素(OR值及相应的95%CI均大于1),幽门螺杆菌感染是口苦的重要危险因素,OR=2.463。症状方面,上腹部疼痛、嗳气、反酸、胁痛、口腔溃疡、口臭、阴囊潮湿/带下、头痛、眩晕均为口苦症状发生的危险因素(OR值及相应的95%CI均大于1)。行为因素方面,吸烟是口苦症状发生的危险因素,且随日吸烟数的升高,口苦症状的发生率亦相应升高。饮食上,食用过多肉类是口苦症状发生的危险因素,而进食新鲜蔬菜水果则是口苦症状发生的保护性因素。情绪方面,焦虑、烦躁、抑郁与自觉压力均为口苦症状发生的危险因素,且口苦症状发生率与不良情绪的程度成正相关。2,对全国健康人群的网络调查共收集有效问卷715份,口苦症状发生率为43.92%。口苦症状的发生率与年龄层近似成正比。行为因素方面,口苦症状发生与吸烟密切相关,进食过多肉类为口苦症状发生的危险因素,且口苦症状发生率与日常进食肉类比例成正比;进食新鲜水果蔬菜则是口苦症状发生的保护性因素。体质方面,湿热体质与气郁体质均为口苦症状发生的危险因素,湿热体质口苦症状的发生率高于气郁体质,湿热体质与气郁体质的兼夹体质口苦症状发生率高于非兼夹体质。3,对健康人群苦味味觉感受度的研究发现,女性对不同浓度苦味试液所感受到的苦味程度均高于男性,证明女性对苦味的感受能力比男性敏感;不吸烟人群对不同浓度苦味试液所感受到的苦味程度均高于吸烟人群,证明不吸烟人群对苦味的敏感性高于吸烟人群。对个体苦味感受能力的拉丁方研究则显示,不同个体对苦味的感受能力存在个体差异。4,比较中西医理论形成与发展的过程,认为中医学理论体系在形成初期,以术数理论为基本工具,在生成论的自然哲学下,借助阴阳五行等说理工具,对人体生命现象和疾病现象进行的理论构建。而现代西方医学,则是在文艺复兴的背景下,以机械论的哲学思想,在现代理化突破及新的认识工具等的基础上,形成的一套新的医学理论体系。结论1,北京市14岁以上住院病人口苦症状平均发生率为53.79%,我国14岁以上健康人群口苦症状平均发生率为43.92%。2,影响口苦症状发生的因素有很多。在疾病方面,口苦症状与消化系统疾病,如肝病、胃-食管疾病及神经系统疾病的关系最为密切;行为方面,吸烟、进食大量肉食及腌渍食品为口苦症状的危险因素;进食新鲜水果蔬菜则是其保护性因素;情绪方面,焦虑、烦躁、抑郁等不良情绪及过大的压力是口苦症状发生的危险因素;体质上,湿热体质及气郁体质为口苦症状的高发体质。3,不同个体对苦味的味觉感受能力有较大的差异,女性人群、不吸烟人群对苦味的敏感度高于男性、吸烟人群。4,中西医对口苦症状诊疗意义的不同认识,是由于中西医截然不同的身体观与疾病观导致的,这也是中西医理论难以通约的根本原因。
[Abstract]:The purpose of the invention is to have a large theoretical and clinically relevant symptom in the theoretical system of traditional Chinese medicine. This topic is based on the epidemiological investigation of bitter and bitter symptoms, and studies the following problems in combination with the human body test and the literature study. the related factors of the distribution of the department and the disease and the symptoms of the bitter oral and bitter symptoms, so as to identify the disease factors and other related factors which are closely related to the symptoms of the oral and bitter symptoms;2. To investigate the occurrence of the bitter symptoms of the healthy people over the age of 14 and the related factors leading to the occurrence of the bitter symptoms of the oral cavity, to determine the incidence of bitter symptoms in the healthy population, as well as related behavioral factors and physical factors; and 3, to study the individual differences of the subjective feelings of the bitter taste of different individuals in healthy adults and the influence of the two factors of sex and smoking on the bitter taste through the human body test; and 4, Through the study of the literature and the comparative study of the theoretical system of the traditional Chinese and western medicine, the system has finished the understanding of the pathogenesis and treatment of the "bitter taste" in the past dynasties, and probes into the difference of the traditional Chinese medicine and the western medicine, and takes the bitter taste as an example to study the difference of the thinking of the traditional Chinese medicine and the western medicine. Method 1,4 hospitals in Beijing were selected, and a unified epidemiological survey was used to conduct an epidemiological survey of 4 hospitals in accordance with the criteria for inclusion. The contents of the survey include basic personal information such as gender, age, height, body weight, ethnicity, etc. The occurrence of bitter symptoms, including frequency, degree, time of occurrence, and other taste abnormalities, including smoking, drinking, sleep time, Diet taste, dietary structure, etc. Symptoms, such as abdominal pain, anti-acid, oral ulceration, bad breath, and mood-related symptoms, including dental treatment, abdominal or middle ear surgery and fatty liver, cholecystitis, rhinitis, otitis media, chronic pharyngitis, etc.; In addition, there was an auxiliary examination project for liver disease and stomach-esophageal disease.2, an epidemiological survey was published on that network through the "questionnaire star" platform, and the epidemiological investigation was carried out on the incidence of the bitter symptoms and the influencing factors of the healthy population over the age of 14. The contents of the investigation mainly include basic information, the status and living habits of the bitter symptoms, and the introduction of the physical constitution of the Chinese medicine. All the data were recorded with EPidata3.1, and the statistical analysis was carried out using SPSS10.0.3. The bitt tea was used as the bitter agent, and the volunteers were randomly assigned to 3 groups by using a randomized, single-blind and controlled clinical trial method. Each group of volunteers received a different concentration of the Kudingcha extract. The degree of bitterness of the test solution just accepted was then marked on the "bitter-scale line" by the volunteers using the VAS method. the data is input, the t-test or the non-parametric test is adopted, the statistical analysis is carried out according to the sex and whether or not smoking is carried out respectively,4,9 healthy volunteers are selected, three-way cross-Latin square experimental design is adopted, and each volunteer is used for receiving three different concentrations of the Kudingcha leaching solution, The degree of bitterness of the test solution just accepted by the volunteers was then marked on the "bitter-scale line". Through the analysis of the Latin square, the individual difference of the bitter taste ability was studied.5. The systematic study of the literature of the traditional Chinese medicine, from the medical theory to the initial social and cultural background and the later medical development, compared the theoretical system of the traditional Chinese and western medicine, from the perspective of the body view, Taking the symptoms of bitter taste as an example, the differences of the treatment thinking of the two medical systems of the traditional Chinese medicine and the western medicine are discussed. As a result,782 of the patients in 3 hospitals in Beijing were investigated,766 cases of effective questionnaires were collected, and the incidence of bitter and bitter symptoms was 53.79%. The incidence of bitter symptoms was positively correlated with age. The highest incidence of the incidence of stomachache in the in-patient department was the liver disease (66.67%), the digestive system (61.80%), and the neurology department (60.66%). In the case of specific diseases, fatty liver, cholecystitis, stomach-esophageal disease, chronic pharyngitis, dental treatment were the risk factors of oral and bitter symptoms (OR and corresponding 95% CI were both greater than 1), and H. pylori infection was an important risk factor for bitter taste, OR = 2.463. The risk factors (OR value and corresponding 95% CI of the corresponding 95% CI of the upper abdominal pain, the abdominal pain, the antiacid, the pain of the oral cavity, the oral ulcer, the bad breath, the scrotum wet/ the lower, the headache, and the vertigo were all the symptoms of the oral and bitter symptoms (the OR value and the corresponding 95% CI were both greater than 1). In terms of behavioral factors, smoking is a risk factor in the occurrence of bitter symptoms, and the incidence of bitter symptoms is also increased with the increase of daily smoking number. Eating too much meat on a diet is a risk factor for bitter symptoms, while eating fresh vegetable and fruit is a protective factor for bitter symptoms. The emotional aspect, anxiety, restlessness, depression and self-conscious pressure are the risk factors of oral and bitter symptoms, and the incidence of bitter symptoms is positively related to the degree of bad mood. The incidence of bitter symptoms is approximately proportional to age. In the aspect of behavior, the symptoms of bitter taste are closely related to smoking, the risk factors of eating too much meat as a bitter symptom, and the incidence of bitter symptoms are directly proportional to the proportion of the daily eating meat; and the fresh fruit and vegetables are the protective factors of the bitter symptoms. In that aspect of constitution, the damp-heat constitution and the air-stagnation constitution are the risk factors of the bitter symptom, the occurrence rate of the damp-heat constitution oral bitter symptom is higher than that of the qi-stagnation constitution, the heat-heat constitution and the air-stagnation constitution, and the incidence of the bitter symptom of the body is higher than that of the non-human body. The study of the taste of the bitter taste of the healthy population found that the degree of bitterness of the female to the bitter test solution of different concentration was higher than that of the male, and it was shown that the feeling of the female to the bitter taste was more sensitive than that of the male. The degree of bitterness of the non-smoking population to the bitter test solution at different concentrations is higher than that of the smoking population, and the sensitivity of the non-smoking population to the bitter taste is higher than that of the smoking group. The study of the Latin square of the ability of the individual's bitter taste shows that individual differences in the perceived ability of different individuals to the bitter taste.4. The process of the formation and development of the theory of traditional Chinese and western medicine is of the view that the theoretical system of traditional Chinese medicine is the basic tool in the early stage and in the theory of the number of operation. In the natural philosophy of the generation theory, by means of the theory of Yin and Yang and the five elements, the theory of life and disease of the human body is constructed. The modern western medicine, under the background of the Renaissance, is a new medical theory system based on the philosophy of mechanical theory, the modern physical and chemical breakthrough and the new knowledge tool. Conclusion 1. The average incidence of bitter symptoms in patients over 14 years of age in Beijing is 53.79%, and the average incidence of bitter symptoms in the healthy population over 14 years of age is 43.92%. In the aspect of disease, the symptoms of the mouth and the digestive system are the most closely related to the digestive system diseases, such as the liver disease, the stomach-esophageal disease and the nervous system diseases; the behavior, the smoking, the consumption of a large amount of meat and the salted food are the risk factors of the bitter symptoms, and the fresh fruit vegetables are the protective factors thereof; The emotional aspect, anxiety, restlessness, depression and other bad mood and excessive pressure are the risk factors of the bitter symptoms of the mouth; the body constitution, the damp-heat physical constitution and the qi-stagnation constitution are the high-incidence body constitution of the bitter symptoms, and 3, the taste perception ability of the different individual to the bitter taste has a great difference, the female population, The sensitivity of the non-smoking population to the bitter taste is higher than that of the male and the smokers.
【学位授予单位】:北京中医药大学
【学位级别】:博士
【学位授予年份】:2017
【分类号】:R24

【相似文献】

相关期刊论文 前10条

1 李红,李凤恩;一起食源性人体感染旋毛虫流行病学调查[J];中华预防医学杂志;2000年01期

2 王劲松;关于开展网络流行病学调查的建议[J];中华预防医学杂志;2000年02期

3 ;工伤造成的死亡:流行病学调查[J];中国医师杂志;2000年09期

4 张辉,谢米娜,朱广林,贺玉香,唐惠华;邵阳市回族人民血小板减少流行病学调查[J];湖南医学;2000年06期

5 黄小涛,周华武,陈树东,郑瑞洪;一起风疹暴发的流行病学调查[J];疾病监测;2000年12期

6 刘洁,刘万华;我院住院病人使用“路泰”的流行病学调查[J];天津药学;2000年02期

7 曾光;加强现场流行病学调查工作刻不容缓[J];中华预防医学杂志;2001年04期

8 蒋里;一起风疹爆发的流行病学调查[J];安徽预防医学杂志;2001年05期

9 刘莉;重庆市肺结核流行病学调查[J];广西预防医学;2001年S1期

10 孙琳,朱道建;扬州市2000年疫点流行病学调查处理状况分析[J];江苏卫生保健;2001年02期

相关会议论文 前10条

1 王大猷;;“药害”事件流行病学调查方案设计与实施[A];新医药卫生改革与药学发展高峰论坛暨《中国药学杂志》第十二届编委会会议论文集[C];2009年

2 张晶;魏梅;姚国英;方秉华;郑敏;;2006年上海市0-6岁儿童单纯性肥胖症流行病学调查[A];膳食变迁对民众健康的影响:挑战与应对——第二届两岸四地营养改善学术会议学术报告及论文摘要汇编[C];2010年

3 任宏;袁政安;王晔;顾宝柯;吴寰宇;金必红;李燕婷;;智能手机信息采集技术在现场流行病学调查中的应用研究[A];华东地区第十次流行病学学术会议暨华东地区流行病学学术会议20周年庆典论文汇编[C];2010年

4 郭薇;周伊兰;;2007年1348例镇江市车祸发生流行病学调查[A];中华医学会急诊医学分会第十三次全国急诊医学学术年会大会论文集[C];2010年

5 王盛祥;;我院1930例烧伤住院病人的流行病学调查[A];中华医学会第五次全国烧伤外科学术会议论文汇编[C];1997年

6 张淑娟;井立彬;潘国伟;刘红梅;刘丽君;;辽宁省成人吸烟流行病学调查(摘要)[A];第12届全国吸烟与健康学术研讨会暨第二届烟草控制框架公约论坛论文集[C];2005年

7 韦臻;罗学荣;叶海森;袁秀洪;管冰清;;长沙市对立违抗性障碍的流行病学调查[A];中国心理卫生协会儿童心理卫生专业委员会第十次学术交流会论文集[C];2006年

8 高兴斌;王同德;张善绘;张会永;李友祥;曹长兰;卜祥云;刘德义;段敏;;123694例交通伤流行病学调查[A];《中华急诊医学杂志》第七届组稿会论文汇编[C];2008年

9 田克恭;;我国人与犬猫共患病流行病学调查与防控对策[A];第3届全国人畜共患病学术研讨会论文集[C];2011年

10 孙弋淇;杨向东;;便秘的流行病学调查[A];第十五届中国中西医结合大肠肛门病学术交流会议论文集萃[C];2012年

相关重要报纸文章 前10条

1 农业部兽医局;2009年全国高致病性禽流感和口蹄疫等主要动物疫病流行病学调查方案[N];农民日报;2009年

2 ;2010年全国高致病性禽流感和口蹄疫等主要动物疫病流行病学调查方案[N];农民日报;2010年

3 记者 宜秀萍;我省建立食品安全事故 流行病学调查员制度[N];甘肃日报;2012年

4 记者 张昊;流行病学调查将着力培养高级人才[N];健康报;2014年

5 记者朱玉;每例非典病人都要有详细流行病学调查[N];人民日报;2003年

6 记者 黄景莲;我市城乡前瞻性流行病学调查工作进展顺利[N];巴彦淖尔日报(汉);2007年

7 记者 王夕 李鹏;中国流行病防控体系还有漏洞?[N];北京科技报;2013年

8 记者 朱玉;接到病例报告尽快进行流行病学调查[N];新华每日电讯;2003年

9 本报记者 黄朝武;农业部将对流行性动物疫病展开全面调查[N];农民日报;2011年

10 李天舒;我国慢性肾脏病急需“摸底”[N];中国消费者报;2010年

相关博士学位论文 前10条

1 黄玉政;南京地区日本血吸虫病的流行病学调查及其基于血清差异多肽检测方法的建立与应用[D];扬州大学;2016年

2 张小卫;甘肃省高血压流行病学调查及肾上腺素能受体相关基因多态性分析[D];兰州大学;2016年

3 司鹏飞;基于口苦症状的流行病学调查及中西医身体观的比较研究[D];北京中医药大学;2017年

4 张久松;西尼罗病毒感染病原体检测方法与流行病学调查研究[D];中国人民解放军军事医学科学院;2005年

5 苏中华;中国五地区普通人群饮酒和健康状况流行病学调查[D];中南大学;2004年

6 王宏;北京地区成年女性压力性尿失禁流行病学调查研究[D];中国协和医科大学;2006年

7 李志峰;广州及周边地区蝙蝠携带SARS(样)冠状病毒、狂犬病毒和禽流感病毒的初步流行病学调查[D];第一军医大学;2006年

8 王洁;北京万寿路地区老年周围动脉硬化闭塞病的流行病学调查[D];中国人民解放军军医进修学院;2002年

9 陆晨;乌鲁木齐市天山区成人慢性肾脏病流行病学调查及社区干预模式的建立[D];华中科技大学;2010年

10 马道新;人巨细胞病毒流行病学调查及其核酸疫苗研究[D];山东大学;2004年

相关硕士学位论文 前10条

1 匡乃峰;山东省高水平运动员跟腱腱病病因流行病学调查[D];泰山医学院;2014年

2 孙喜娟;哈尔滨市部分宠物门诊犬瘟热病例流行病学调查与防制[D];东北农业大学;2015年

3 王振;规模化羊场细菌病的流行病学调查及细菌性病原的分离鉴定和系统进化分析[D];山东农业大学;2015年

4 孙世雄;2014年甘肃省三个地区绵羊布氏杆菌病的流行病学调查[D];甘肃农业大学;2015年

5 王东英;小儿咳嗽变异性哮喘的流行病学调查[D];长春中医药大学;2015年

6 李成元;鲁中南地区规模化羊场流行病学调查和溶血性曼氏杆菌灭活苗的研制[D];山东农业大学;2015年

7 于亨;甘肃省青年高血压及其危险因素的流行病学调查研究[D];兰州大学;2016年

8 卢海英;河田鸡白血病流行病学调查[D];福建农林大学;2016年

9 孟静;乙型肝炎病毒感染医院流行病学调查:一项横断面研究[D];吉林大学;2016年

10 梁伟;甘肃省中老年人群高血压流行病学调查及治疗现状研究[D];兰州大学;2016年



本文编号:2479314

资料下载
论文发表

本文链接:https://www.wllwen.com/shoufeilunwen/yxlbs/2479314.html


Copyright(c)文论论文网All Rights Reserved | 网站地图 |

版权申明:资料由用户bd024***提供,本站仅收录摘要或目录,作者需要删除请E-mail邮箱bigeng88@qq.com