溃疡性结肠炎的证型分布规律及其相关因素研究

发布时间：2017-12-27 10:05

本文关键词：溃疡性结肠炎的证型分布规律及其相关因素研究　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:研究溃疡性结肠炎(UC)的中医证型分布规律及其相关因素的关系,为临床诊治提供依据。方法:收集2015.11-2017.03江苏省中医院诊治的溃疡性结肠炎患者的临床资料,总结UC中医证型分布规律及其相关因素的关系。结果:共收集300例病例,其中男性167例,女性133例,男女比例为1.26:1,年龄最小14岁,最大76岁,平均年龄为41.65± 13.35岁,中位年龄41岁。病史为1-29年。缓解期77例(占25.67%),活动期223例(占74.33%)。活动期临床类型初发型14例(占6.29%),复发型209例(占93.72%);活动期内严重程度轻度126例(占56.50%)、中度55例(占24.66%)、重度42例(占18.83%);病变范围直肠型(E1)72例(占32.29%),左半结肠型(E2)82例(占36.77%),广泛结肠型(E3)69例(占30.94%)。经统计,中医辨证可分为六型,即脾虚湿热证140例(占46.67%),大肠湿热证90例(占30.00%),肝郁脾虚证37例(占12.33%),脾肾阳虚证22例(占7.33%),阴血亏虚证7例(占2.33%),寒热错杂证4例(占1.33%)。肠镜下表现与中医证型有一定的相关性,UC缓解期以脾虚湿热证多见,活动期以大肠湿热、脾虚湿热证多见;UC活动期大肠湿热证症状较重,肠粘膜病变程度比较严重,见于中、重度;而脾虚湿热证、肝郁脾虚证、脾肾阳虚证症状相对较轻,肠粘膜病变程度较轻,见于轻度;UC活动期大肠湿热证症状较重,肠粘膜病变范围以E3为主;而脾虚湿热证症状相对较轻,肠粘膜病变范围相对较局部,以E1、E2为主。结论:临床上缓解期以脾虚湿热证为主,活动期以大肠湿热、脾虚湿热证为主,活动期证型分布与严重程度、病变范围有关。
[Abstract]:Objective: To study the distribution of TCM syndrome types of ulcerative colitis (UC) and its related factors, and to provide a basis for clinical diagnosis and treatment. Methods: the clinical data of patients with ulcerative colitis diagnosed by 2015.11-2017.03 Jiangsu Province Traditional Chinese Medicine Hospital were collected, and the relationship between UC TCM Syndrome Distribution and related factors was summarized. Results: a total of 300 cases were collected, including 167 males and 133 females. The male to female ratio is 1.26:1, the youngest is 14 years old, the largest is 76 years old, the average age is 41.65 + 13.35 years old, and the median age is 41 years old. The history of the disease was 1-29 years. The remission period was 77 cases (25.67%), and the active period was 223 cases (74.33%). Active clinical onset type 14 cases (6.29%), recurrent in 209 cases (93.72%); activities during the period of the severity of mild in 126 cases (56.50%), 55 (24.66%) cases of moderate and severe in 42 cases (18.83%); the lesion of rectal type (E1) 72 cases (32.29%) that left colon type (E2) and 82 cases (36.77%), wide type (E3) of 69 cases of colon (30.94%). According to statistics, TCM can be divided into six types, namely, spleen deficiency and dampness heat syndrome in 140 cases (46.67%), damp heat syndrome in 90 cases (30%), 37 cases of liver stagnation and spleen deficiency syndrome (12.33%), Yang deficiency of spleen and kidney in 22 cases (7.33%), Yin and blood deficiency in 7 cases (2.33%), 4 cold and heat syndrome (1.33% cases). Endoscopic manifestations and syndromes have some relevance, UC remission in spleen deficiency and dampness heat syndrome, active in the large intestine damp heat, spleen deficiency and dampness heat syndrome more active UC; damp heat syndrome of severe symptoms, the severity of intestinal mucosal lesions is more serious, in moderate and severe; and heat dampness, spleen deficiency and liver stagnation and spleen deficiency card, spleen and kidney yang deficiency syndrome is relatively light, the degree of intestinal mucosal lesion was found in the light, mild; active UC damp heat syndrome of severe symptoms, intestinal mucosal lesions in the E3; and the spleen deficiency damp heat syndrome of relatively mild symptoms, intestinal mucosal lesions are relatively local, E1, E2. Conclusion: spleen deficiency and dampness heat syndrome are the main causes of remission in the clinical stage, mainly in the large intestine, dampness heat, spleen deficiency and dampness heat syndrome. The distribution of syndromes in active stage is related to the severity and the range of lesions.
【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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