慢性心力衰竭中医证候及证候要素分布规律十年文献分析

发布时间：2018-01-14 20:09

  本文关键词：慢性心力衰竭中医证候及证候要素分布规律十年文献分析　出处：《河南中医药大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 慢性心力衰竭 证候 证候要素 症状

【摘要】：目的:通过检索近10年有关慢性心衰的中医或中西医结合临床研究文献,充分收集、分析文献中CHF原发病、辨证分型、症状、证候要素分布特点,探索慢性心力衰竭常见证型及证候要素的分布规律,为今后的心衰证候规范、发病原因预防、常见证型及证候要素的临床研究提供文献依据。方法:通过检索中国知网、万方、维普3个数据库中近10年有关心力衰竭或心衰或心功能不全的中医或中西医结合的临床研究文献,借助Note Express 3.2软件导入文献题录,然后阅读题名、摘要、关键词,按照排除标准初步筛选文献。再运用“辨证论治”、“证候”、“证型”、“辨证分型”为检索词进行二次检索,将初步筛选后文献进行全文下载并阅读全文,严格根据纳入、排除标准再次进行筛选。对符合标准的文献提取相关资料信息。运用EpiData3.1软件建立数据库进行数据录入,最后将EpiData3.1软件中量化处理的数据导出至Excel表格中,运用频数、构成比描述的方法的进行统计分析。结果:(1)本课题最终共筛选出符合要求的文献206篇。具有明确的辨证分型其后有具体病例数的177篇,分型后具有症状描述的文89篇,分型后涉及原发病的文献104篇,分型后涉及证型与心功能分级的关系60篇。(2)中医辨证分型参考标准多达21种。(3)CHF原发病中冠心病所占比例最大,其次为高心病、扩心病。(4)CHF证型与心功能分级:虚证类证型心功能分级多分布在Ⅱ级~Ⅲ级,Ⅳ级、Ⅰ级亦有分布;实证类证型心功能分级多分布在Ⅲ级~Ⅳ级,Ⅱ级次之,Ⅰ级未见;虚实夹杂类证型中心功能分级多集中在Ⅲ级~Ⅳ级,Ⅱ级次之,Ⅰ级极少见。(5)CHF证候经规范后排在前11位的分别是气虚血瘀证、气阴两虚证、阳虚水泛证、心肾阳虚证、心肺气虚证、血瘀水停证、痰饮阻肺证、阴竭阳脱证、痰瘀互阻证、心血瘀阻证、阳虚血瘀证,经提取证候要素后发现CHF病性类证候要素排在前6位的分别是气虚、血瘀、阳虚、阴虚、水停、痰浊,病位类证候要素排在前3位的分别是心、肺、肾。(6)CHF症状出现频率在2%以上为心悸、气短、脉细、神疲、舌色红、苔白、舌色暗、水肿、乏力、舌色淡、脉结代、喘息、脉弱、脉数、胸闷、脉沉、口唇紫绀可认定为心衰的常见症状。结论:(1)通过文献研究,初步明确了心衰的主要证候和证候要素的分布情况,其常见证型为气阴两虚证,气虚血瘀证、阳虚水泛证、心肾阳虚证、心肺气虚证等,常见病性要素为气虚、血瘀、阳虚、阴虚、水停、痰浊,常见病位为心、肺、肾;(2)心衰最常见的病因为冠心病,其次为高心病和扩心病;(3)研究发现心功能分级与证型关系密切,心功能Ⅰ~Ⅱ级多见于心气虚证、心肺气虚证,Ⅱ~Ⅲ级多见于气阴两亏证,Ⅲ~Ⅳ级多见于痰瘀水停及虚实兼杂类证;(4)初步明确了心衰常见症状心悸、气短、神疲、水肿、乏力、喘息、胸闷、口唇紫绀、脉沉细或结代或弱或数、舌色暗红或淡红、苔白。
[Abstract]:Objective: to collect and analyze the distribution characteristics of CHF primary disease, syndrome differentiation, symptoms and syndromes in the past 10 years by retrieving the literatures of TCM or combination of traditional Chinese medicine and western medicine on chronic heart failure (CHF). To explore the distribution of common syndromes and syndromes of chronic heart failure (CHF) in order to standardize the symptoms of CHF in the future and to prevent the pathogenesis of CHF. The clinical research of common syndromes and syndromes elements provides the literature basis. Methods: through the search of Chinese knowledge network, Wanfang. There are three databases of Weip in recent 10 years about heart failure or heart failure or heart failure or heart failure of traditional Chinese medicine or integrated western medicine clinical research literature. With the help of Note Express 3.2 software, the title, abstract and key words were read, and the documents were screened according to the exclusion criteria, and then "syndrome differentiation and treatment" and "syndromes" were used. "Syndrome type", "syndrome differentiation" for the second search of the key words, after the preliminary screening of the full text download and read the full text, strictly according to the inclusion. The exclusion criteria are screened again. The relevant information is extracted from the documents that meet the standard. The database is built by using EpiData3.1 software for data entry. Finally, the quantized data in EpiData3.1 software is exported to the Excel table, and the frequency is used. Results: a total of 206 documents were selected to meet the requirements. 177 of the specific cases followed by specific syndrome differentiation were selected. There were 89 articles with symptom description and 104 articles with primary disease after typing. The relationship between syndromes and cardiac function classification after classification is 60 parts. 2) there are 21 kinds of reference criteria of TCM syndrome differentiation and classification. Coronary heart disease (CHD) is the largest among the primary diseases of CHF, followed by high heart disease. Type of CHF and classification of cardiac function: the types of deficiency syndromes were mostly distributed in grade 鈪，

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