中医心隐症基础理论研究及流行病学调查

发布时间：2018-06-30 18:43

本文选题：心隐症 + 心　；参考：《北京中医药大学》2009年硕士论文

【摘要】： “心隐症”的提出,起源于临床实际,在长期的观察中发现,部分患者,在一定致病因子作用下,体内已经出现病理改变,但无明显相应症状体征,只有通过现代医学检查手段(包括各种仪器检查及血液、排泄物、分泌物等物理和化学的检查)才能发现异常。针对这一问题本课题从基础理论和流行病学两方面展开研究。本文选取《内经》以来的历代中医文献中有关“心”的生理病理的主要论述,从基础理论角度,对“心”的概念,范畴加以阐释,提出在传统文献中主要包含三方面的含义:一是脏腑之心,二是神明之心,三是与心相关的心系概念。依据历代医家论述和病案记载,可以从脏腑辨证角度探讨“心隐症”的病因病机,经归纳分析得出,生理和病理上“心”的概念是以阳气为主,阴血为辅的,其主血脉与主神志的功能可以用来认识心隐症。导致本病症发生发展的原因,首先是阳气不足,心阳虚衰,病情日重则可导致气血阴阳失调,及寒、痰、瘀、浊的阻滞。因此,中医关于阳气及气化作用的理论,在本研究中是有一定科学价值的。本研究依据“心主血脉、心主神明”在心系疾病中的应用理论,选择以年龄、性别、身高、体重、体重指数、腰臀比例、收缩压、舒张压、胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、空腹血糖、心电图、心脏超声、X光检查、B型超声、血管超声、Holter为代表的相关指标以及心血管病家族史、膳食搭配、体力活动情况等进行调查,广泛的选取社区健康人群为研究对象。总共入选观察对象753例,结果发现,心隐症(312)例,非心隐症(441)例。通过相关分析,在专业知识可解释的情况下,结合SAS软件输出结果,选入9个可分析病因因素:年龄、职业、教育程度、不良饮食习惯、居处情况、四季分明、饮茶习惯、BMI、心血管病家族史,并试从医学角度加以分析。结论:通过上述理论和流行病学研究证明了“心主血脉,心主神志”的科学内涵,人之“血脉”由“心”所主、与“阳气”相关,以“阴血”为辅。阳气虚衰,血脉运行失常是导致心隐症发病的前提,也是临床防治本病的切入点。从“心主血脉”、“心主神志”理论出发治疗心血管病可取得满意疗效。因此,只有充分发挥中医从宏观立论、整体论治的优势,结合现代医学弥补中医微观辨证之不足,才能使中医基础理论进行自我更新与完善,并更好地指导临床实践。
[Abstract]:The introduction of "heart disease" originated from clinical practice. In a long period of observation, some patients have had pathological changes in the body, but there is no obvious sign of symptoms, only through modern medical examination (including physical and chemical examination of various instruments, blood, excreta, secretions, etc.) This problem can be found in two aspects: basic theory and epidemiology.
This article selects the main exposition about the physiology and pathology of "heart" in the Chinese traditional literature of the past dynasties, and interprets the concept and category of "heart" from the perspective of basic theory, and puts forward three meanings in the traditional literature: one is the heart of the viscera, the two is the heart of God, and the three is the concept of heart related to the heart. The etiology and pathogenesis of "heart hidden disease" can be discussed from the doctor's exposition and record of medical records. It is concluded that the concept of "heart" in physiology and pathology is mainly Yang Qi and Yin and blood is supplemented, and the function of its main blood vessel and main spirit can be used to recognize the heart disease. The cause of this disease is the Yang Qi, first of all. Deficiency, the heart yang deficiency, the disease day heavy can lead to Qi and blood Yin and yang imbalance, and cold, phlegm, stasis, turbidity block. Therefore, the theory of the role of Yang Qi and gasification in traditional Chinese medicine is of certain scientific value in this study.
This study was based on the theory of "heart main blood vessel, heart main deity" in heart system disease, choose age, sex, height, weight, body mass index, waist hip ratio, systolic pressure, diastolic pressure, cholesterol, triglyceride, high-density lipoprotein, low density lipoprotein, empty abdominal blood glucose, electrocardiogram, cardiac ultrasound, X light examination, B ultrasound, vascular ultrasound, Holt Er for the related indicators, family history of cardiovascular disease, dietary collocation, physical activity and so on. A wide range of community health population was selected as the research object. A total of 753 subjects were selected. The results were found, heart disease (312), non heart disease (441). Through correlation analysis, in the case of interpretable professional knowledge, combined with SAS The results of the software output were selected as 9 factors: age, occupation, education, bad eating habits, living conditions, four seasons, tea drinking habits, BMI, family history of cardiovascular disease, and a medical analysis.
Conclusion: through the theoretical and epidemiological studies above, the scientific connotation of "heart blood vessel and heart main spirit" is proved. The "blood vessel" of "blood" is related to "Yang Qi", is related to "Yang Qi", and is supplemented by "Yin blood". The deficiency of Yang Qi and abnormal blood circulation are the precondition for the pathogenesis of heart disease, but also the breakthrough point of clinical prevention and treatment of this disease. In order to make the basic theory of traditional Chinese medicine new and perfect, the basic theory of traditional Chinese medicine can be improved and the clinical practice can be better guided.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R259;R181.3

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