应用聚类分析法对小儿“脱被征”的中医证型研究

发布时间：2018-05-05 01:37

本文选题：“脱被征” + 中医证型　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:探讨小儿“脱被征”的中医证型及其分布规律,为对小儿“脱被征”防治提供客观的辨治规律依据。方法:本研究选择于2015年11月1日-2017年1月31日在广西中医药大学附属瑞康医院儿科门诊就诊和病房住院患儿及接受体检保健儿童为调查对象。制定调查资料表,对具有“脱被征”的患儿进行问卷调查,收集中医四诊信息,依据病例纳入标准收集了237例儿童进行研究。采用spss19.0软件进行聚类分析,依据聚类结果,再由临床专家依据专业知识与临床实际进行探讨分析后,最终确定证型名称。结果:小儿“脱被征”的中医证型主要是寒热夹杂,心肝郁热,脾胃蕴热,脾失健运4型。1、症状分布:所调查的四诊资料中,出现频率在20%以上的症候依次有形体匀称、手足温、舌质淡红、口臭、苔薄白、大便成形、睡眠安稳、睡眠不安翻身多、纳正常、食少、磨牙、背部汗多、腹痛、打鼾、苔厚、头额汗多、大便干硬如羊屎状、烦躁易怒、难入睡、梦话、舌质偏红21个指标。2、各证型的辨证要点如下:寒热夹杂证的辨证内容:遗尿、手足凉、口干、流涎、易惊、手足心汗多、偏食肥甘、偏食辛辣、偏食酸甜、大便稍干、大便偏烂、大便粘、大便臭秽、苔黄厚腻、苔白厚腻、剥苔。心肝郁热证的辨证内容:难入睡、夜啼、梦话、喜俯卧、易醒、烦躁易怒、多动、咬手指癖、过食易饥、舌质偏红。脾胃蕴热证的辨证内容:睡眠不安翻身多、打鼾、磨牙、腹痛、头额汗多、肩颈汗多、背部汗多、食少、不欲食、大便干硬如羊屎状、舌质淡、苔厚。脾失健运证的辨证内容:睡眠安稳、口臭、形体匀称、手足温、纳正常、大便成形、舌质淡红、苔薄白。3、证型分布:小儿“脱被征”的主要中医证型有脾胃蕴热证共有79例,约占33.33%,心肝郁热证共有69例,约占29.11%,脾失健运证共有47例,约占19.83%,寒热夹杂证共有42例,约占17.72%。结论:小儿“脱被征”的中医证型归为心肝郁热证、脾胃蕴热证、脾失健运证、寒热夹杂证4个证型。其中脾胃蕴热证及心肝郁热证最常见,其次为脾失健运证、寒热夹杂证。
[Abstract]:Objective: to explore the TCM syndromes and their distribution pattern of children's "detachable symptoms", so as to provide an objective basis for the prevention and treatment of children's "detachable symptoms". Methods: from November 1, 2015 to January 31, 2017, the children in the pediatric outpatient and ward of Ruikang Hospital affiliated to Guangxi University of traditional Chinese Medicine were investigated. The investigation data table was made, and the questionnaire was conducted to collect the information of four diagnoses of TCM. 237 cases of children were collected according to the criteria of inclusion of cases. Cluster analysis was carried out by using spss19.0 software. According to the clustering results, the clinical experts discussed and analyzed according to their professional knowledge and clinical practice, and finally determined the name of syndrome type. Results: the TCM syndromes of children with "detachable symptoms" were mainly composed of cold and heat, heart and liver stagnation, spleen and stomach heat, spleen incapacitation and transportation, and symptom distribution: in the four diagnoses investigated, the symptoms with frequency of more than 20% were symmetrical in turn. Warm hands and feet, reddish tongue, bad breath, thin fur, stool formation, stable sleep, restless sleep, normal appetite, less food, molars, back sweating, abdominal pain, snoring, thick fur, head and forehead sweat, hard stool like sheep shit, irritable irritability, Difficult to sleep, tongue red 21 indicators. 2, the main points of syndrome differentiation: cold and heat mixed syndrome differentiation content: enuresis, cold hands and feet, dry mouth, salivation, easily frightened, heart and heart sweat, partial eating fat, partial spicy, partial sour and sweet, Stool slightly dry, stool partial rot, stool sticky, stool smelly, moss Huang Hou greasy, white thick moss, peeling moss. The dialectical content of heart-liver heat syndrome: difficult to fall asleep, night cry, sleep talk, prone to lie down, easy to wake up, irritable, hyperactive, finger bite, food easy to hunger, tongue red. Syndrome differentiation of spleen and stomach heat: restless sleep, snoring, grinding teeth, abdominal pain, head and forehead sweat, shoulder and neck sweat, back sweat, food less, do not want to eat, stool dry like sheep shit, light tongue, thick fur. The content of syndrome differentiation: sleep stability, halitosis, symmetry of body, hand and foot temperature, normal absorption, stool formation, pale red tongue, thin white fur, distribution of syndromes: there were 79 cases of spleen and stomach heat syndrome in the main TCM syndromes of children. There were 69 cases of heart and liver depression and heat syndrome (29.11%), 47 cases (19.833%) of spleen incapacitation and transportation syndrome, 42 cases of cold and heat inclusion syndrome (17.72%). Conclusion: the TCM syndromes of children with "removing symptoms" can be classified into four syndromes: the syndrome of stagnation of heat in heart and liver, the syndrome of heat accumulation of spleen and stomach, the syndrome of incapacitation of spleen and transportation of spleen, and the syndrome of inclusion of cold and heat. Spleen-stomach heat accumulation syndrome and heart-liver stagnation-heat syndrome is the most common, followed by spleen failure and transport syndrome, cold and heat mixed syndrome.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R272

【参考文献】