脾虚在常见慢性病中的辨证意义及相关规律研究
发布时间：2018-01-26 00:08
本文关键词： 脾虚 慢性病 全科医学 证治规律 出处：《广州中医药大学》2017年硕士论文 论文类型：学位论文
【摘要】：目的:本课题通过病历回顾研究,初步探索门诊3种常见慢性病包括2型糖尿病、冠心病、慢性胃炎脾虚证型特点及用药规律,通过对慢性病脾虚证型的不同探讨脾虚证的证治规律,根据各证型的不同筛选方药,以期为社区常见慢性疾病防治提供新思路,为后续探讨中医脾胃保健与辨证施治在社区开展的可行性及经济效益提供参考。方法:收集门诊慢性病病历资料,搜集各慢性病与脾虚相关证型,对病案数据进行规范化处理,输入并建立标准化数据库,采用统计软件SPSS 22.0版对数据进行频数分析、因子分析,依据中医理论对所得到的统计结果进行分析,总结各慢性病脾虚证特点及用药规律。结果:1.本课题纳入3种慢性病脾虚证病历600份,男性260例,女性340例。其中,2型糖尿病病历男性占43.5%,女性占56.5%;冠心病男性占47.0%,女性占53.0%;慢性胃炎男性占39.5%,女性占60.5%。临床调查资料的统计结果为3种慢性病脾虚证总的男女比例差异无明显统计意义。年龄方面,2型糖尿病、冠心病年龄段在60-75岁最多,分别占39.5%、42.0%,平均年龄分别是62.5岁、68.16岁,以老年人为主。慢性胃炎的调查中年龄段在30-45岁的患者最多,占40.5%,其次是46-60岁,占30.5%,以中年患者为主体。2.3种脾虚证慢性病高频症状(10%)分布情况:2型糖尿病依次是疲倦乏力、口干、肢体麻木、睡眠障碍、胃部不适、食欲不振、头晕头痛;冠心病高频症状依次是胸闷、乏力气短、心悸、睡眠障碍、头晕头痛、胸痛、食欲不振、肢体麻木疼痛、口干、胃部不适;慢性胃炎高频症状是上腹胀、上腹痛、嗳气、睡眠障碍、食欲不振、疲倦乏力、便溏、反酸、口干、便秘、口苦、烧心、恶心欲呕。3种脾虚证慢性病证型分布情况:2型糖尿病脾虚证证型依次是脾虚湿瘀脾肾两虚脾虚痰湿气阴不足脾虚夹瘀脾胃气虚脾虚湿阻化热;冠心病的脾虚证型脾虚痰瘀脾虚夹瘀脾肾两虚气阴不足心脾两虚脾胃气虚脾虚气滞;慢性胃炎脾虚证型是脾虚气滞脾胃气虚肝郁脾虚脾虚湿阻化热脾虚湿滞气阴不足。3.通过对3种慢性病中药进行因子分析,得到几类中药群,即公因子。2型糖尿病提取出10个公因子,其中与脾气虚相关的因子有3个,与阴虚相关的因子有2个;与湿相关的因子有6个;与痰相关的因子有2个;与血瘀相关的因子有6个;与气滞相关的因子2个。冠心病中药中提取出8个公因子,与脾气虚相关的因子有3个;与痰湿相关的因子有3个;与血瘀相关的因子有3个;与阴虚相关的因子有2个;与气滞相关的因子有3个。慢性胃炎共提取了 6个公因子,与脾虚气滞相关的因子有3个,与脾气(阳)虚相关的因子有2个;与脾虚痰湿相关的因子有3个。结论:脾虚在慢性病的发病中起重要作用,本研究中,3种慢性病均与脾虚证关系密切,对于慢性病具有病程长、反复发作的特点,病机错综复杂,虚实夹杂,须在辨证基础上,重视健脾益气扶正的治法。另外,重视脾胃保健在慢性病预防中的作用,避免损伤脾胃。
[Abstract]:Objective: This study by reviewing medical records, 3 outpatient preliminary exploration of common chronic diseases including type 2 diabetes, coronary heart disease, chronic gastritis of spleen deficiency syndrome characteristics and drug law, through the study of different type of chronic diseases of the spleen deficiency of spleen deficiency syndrome and treatment rules, according to the different screening prescription of each type, in order to provide new ideas for the community to provide reference for preventing and treating chronic disease, health care and TCM syndrome differentiation in the community to carry out the feasibility and economic benefits for the subsequent study. Methods: collected the chronic disease outpatient medical records, collecting various chronic diseases and spleen deficiency syndrome, to standardize the medical record data input, and establish a standardized database, using the the statistical software SPSS 22 version of the data were analyzed by frequency analysis, factor analysis, based on the theory of TCM statistics the results of analysis, summarizes the characteristics of spleen deficiency syndrome of chronic disease and drug law. Results: 1. the research included 3 kinds of chronic diseases of spleen deficiency syndrome 600 cases, male 260 cases, female 340 cases. Among them, type 2 diabetes cases accounted for 43.5% of men, women accounted for 56.5%; coronary heart disease accounted for 47% of men, women accounted for 53% of male patients with chronic gastritis; 39.5%, women accounted for 60.5%. clinical data statistics survey results 3 kinds of chronic diseases of spleen deficiency ratio of male and female differences had no obvious statistical significance. The age, type 2 diabetes, coronary heart disease, aged 60-75, accounted for 39.5%, 42%, the average age was 62.5 years old, 68.16 years old, mainly in the elderly age. Investigation of chronic gastritis in 40.5% in 30-45 the age of patients, the most, followed by 46-60 years old, accounting for 30.5%, with.2.3 as the main body of middle-aged patients with spleen deficiency syndrome of chronic disease symptoms (10%) high frequency distribution: type 2 diabetes are fatigue, dry mouth, numbness, sleep disorders, stomach discomfort, loss of appetite, dizziness and headache; Coronary heart disease high-frequency symptoms are fatigue and shortness of breath, chest tightness, heart palpitations, sleep disorders, dizziness and headache, chest pain, loss of appetite, limb pain and numbness, dry mouth, stomach discomfort and symptoms of chronic gastritis; high frequency is abdominal distension, abdominal pain, belching, sleep disorders, loss of appetite, fatigue fatigue, diarrhea, reflux, constipation, dry mouth, bitter taste. Heartburn, nausea.3 spleen deficiency syndrome of chronic disease syndromes: type 2 diabetes spleen deficiency syndrome in spleen wet stasis spleen kidney two empty spleen yin deficiency blood stasis phlegm damp spleen qi deficiency of spleen and stomach, spleen deficiency and dampness heat of spleen deficiency syndrome; coronary heart disease of the spleen deficiency phlegm and blood stasis of blood stasis due to spleen deficiency of spleen kidney two empty gas Yin deficiency of heart and spleen two deficiency of spleen qi and stomach qi deficiency of spleen qi stagnation; chronic gastritis of spleen deficiency type is spleen deficiency and qi stagnation of spleen qi and stomach qi stagnation and spleen deficiency of spleen dampness heat of spleen dampness Qi and yin deficiency.3. through factor analysis of 3 kinds of chronic diseases in traditional Chinese medicine, several classes of Chinese medicine group, i.e. 鍏洜瀛，
本文编号：1464086
本文链接：https://www.wllwen.com/zhongyixuelunwen/1464086.html
最近更新
教材专著
