甲亢的六经辨证探讨

发布时间：2018-10-18 18:56

【摘要】：目的： 研究甲状腺机能亢进症中医六经辨证分型与性别、年龄、甲状腺肿大程度、突眼程度、合并症、并发症、FT3、TT3、FT4、TT4、TSH之间的关系,从而期望能够为甲亢的治疗、预后及转归提供参考和帮助。 方法： 收集1990年1月1日至2013年3月31日期间于广州中医药大学第一附属医院住院治疗的甲状腺机能亢进患者共300例,制作调查表,填写符合纳入标准的病人相关信息,制定六经辨证方案,对病人进行辨证归纳。使用spssl1.5软件进行统计分析,计量资料符合正态分布的用t检验,不符合正态分布的用秩和检验；计数资料采用卡方检验。 结果： 在性别上,男性占130例,女性占170例,男女患者之间的比例为1：1.4；六经分型阳证者女性居多,而阴证者以男性患者为主,阴阳寒热错杂证男女患者人数相当,差异具有统计学意义(p0.01)。在年龄上,阳证、阴阳寒热错杂证以60岁以下的患者为主,而60岁以上的患者多表现为阴证,差异具有统计学意义(p0.01)。合并糖尿病患者47例,占15.67%,阳证、阴证及阴阳寒热错杂证患者中合并糖尿病的分别占14.28%、21.74%、13.10%,差异没有统计学意义(p=0.2780.05)。合并重症肌无力的患者有32例,占10.7%,阳证、阴证及阴阳寒热错杂证患者中合并重症肌无力的分别占6.80%,26.09%,3.57%,差异具有统计学意义(p0.01)。并发甲亢性心脏病的患者有102例,占34%,阳证、阴证及阴阳寒热错杂证并发甲亢性心脏病的患者所占比例分别为42.18%,39.13%,15.48%,阳证所占的比例最大,差异具有统计学意义(p0.01)。合并突眼的患者有87例,占29%,阳证、阴证及阴阳寒热错杂证患者中合并突眼率分别为41.50%、11.59%、21.43%,阳证患者所占比例最大,差异具有统计学意义(p0.01)。伴甲状腺肿大的患者有175例,占58.33%,阳证、阴证及阴阳寒热错杂证患者中伴甲状腺肿大的分别为78.91%、15.94%、57.14%,阳证患者所占比例最大,肿大程度以工度肿大多见；阴阳寒热错杂证患者次之,甲状腺肿大程度以Ⅱ、Ⅲ度肿大为主；而阴证甲亢患者多数不伴有甲状腺肿大,差异具有统计学意义(p0.01)。阳证、阴证及阴阳寒热错杂证的TSH均较正常值偏低,差异不具统计学意义。三种证型TT3、FT3均较正常值偏高,差异不具统计学意义。三种证型TT4、FT4均较正常值偏高,但阴证TT4、FT4升高幅度不明显,比阳证、阴阳寒热错杂证低,且差异具有统计学意义(p0.05)。 结论： 甲状腺机能亢进症六经分型阳证者女性居多,而阴证者以男性患者为主,阴阳寒热错杂证男女患者人数相当；阳证、阴阳寒热错杂证以60岁以下的患者为主,而60岁以上的患者多表现为阴证；甲亢合并重症肌无力的患者以阴证为主；甲亢并发甲亢性心脏病患者多为阳证；甲亢合并突眼以阳证患者所占比例最大；甲状腺肿大方面,阳证患者所占比例最大,肿大程度以Ⅰ度肿大多见,阴阳寒热错杂证患者次之,甲状腺肿大程度以Ⅱ、Ⅲ度肿大为主；甲亢属阴证部分患者主要以TT3、FT3增高为主。
[Abstract]:Purpose: To study the relationship between syndrome differentiation type and sex, age, goiter degree, degree of treatment, complication, complication, FT3, TT3, FT4, TT4 and TSH in patients with hyperthyroidism Reference to treatment, prognosis and outcome of treatment, prognosis, and outcome and help Methods: 300 patients with hyperthyroidism were collected from January 1, 1990 to March 31, 2013 in the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine. Information and Development of Six meridians Based on Syndrome Differentiation By using spssl1. 5 software for statistical analysis, the measurement data is in accordance with the t-test of normal distribution, and it does not accord with the rank sum test of normal distribution.; count Results: There were 130 males and 170 females, and the proportion between male and female patients was 1: 1. 4; 6 were male and female. In contrast, the difference was statistically significant (P. 0.01). In age, the syndrome of yang-yang and yang-yang syndrome was dominated by patients under the age of 60 and more than 60 years old. There were 47 cases (15.67%) of patients with diabetes mellitus (15.67%), and 14. 28%, 21. 74%, 13. 10%, respectively, in the patients with diabetes mellitus (14.28%, 21. 74%, 13. 10%). There were 32 patients with myasthenia gravis, accounting for 10. 7% of the patients with myasthenia gravis, accounting for 6. 80%, 26. 09%, 3. 5, respectively. The percentage of patients with hyperthyroid heart disease was 42. 18%, 39. 13%, 15. 48%, and the proportion of positive syndrome was 42. 18%, 39. 13%, 15. 48% respectively. The results showed that there were 87 cases, 29%, 41. 59%, 21. 43% respectively, and the proportion of patients with positive syndrome were 41. 50%, 11. 59%, 21. 43%, respectively. There were 175 cases of patients with goiter, accounting for 58. 33% of patients with goiter, 78. 91%, 15.94%, 57. 14%, respectively. The number of patients with yin-yang and cold-heat syndrome is the second and the extent of goiter is II and 鈪，

本文编号：2280072