反流性食管炎中医证型分布特征与心理因素关系的研究

发布时间：2018-02-23 04:42

本文关键词： 反流性食管炎中医证型心理因素　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】：研究目的:本次研究是以反流性食管炎(reflux esophagitis,RE)为研究对象,分为文献研究和临床研究两部分。文献研究部分,通过收集、分析既往中医研究RE的文献,总结文献中RE中医的证型名称与分布特征。临床研究部分,通过统计学方法对RE患者的临床相关资料进行分析、处理,对RE患者中医证型与心理因素相关性进行研究,并以此为基础,探讨RE中医证型与精神心理因素的关系。从而进一步加深中医对RE的认识,为该病的中医辨证标准化的建立提供参考依据,使中医辨证论治能更加客观化、标准化,为临床预防、治疗RE提供理论支持。研究方法:1.文献研究人工检索包括中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(SinoMed)、中文科技期刊数据库(VIP,重庆维普)、万方数据库在内的截至2015年12月所有有关RE中医研究文献。下载、阅读、筛选文献,整理归纳中医药学对RE的研究文献,并进行文献分析评价。2.临床研究①对99例RE患者的临床相关资料进行调查、整理,运用统计学方法分析其中医证候的分布特点。②通过Z氏焦虑与抑郁自评量表对99例RE患者心理因素进行评价,进而运用统计学方法进行处理,进而分析患者中医证型分布与心理因素的相关性。结果:1.文献研究结果:本次文献研究一共纳入91篇文献报道,共计10258例病例,所载共32种中医证型,其中尤以肝胃郁热证、肝胃不和证为多。2.临床研究结果:本次临床研究,一共收集病例数为99例。①患者中医证型的所占比例由高到低依此为:肝胃不和证(20.2%)脾胃虚弱证(19.2%)肝胃郁热证(17.2%)=脾胃湿热证(17.2%)痰气郁结证(14.1%)胃阴亏虚证(12.1%)。②99例RE患者焦虑程度情况分布为:无焦虑(50.5%)轻度焦虑(41.4%)中度焦虑(8.1%),无重度焦虑患者。无焦虑患者中,脾胃湿热证和脾胃虚弱证人数相等,且患者数最多;轻度焦虑患者中,肝胃不和证患者数最多;中度焦虑患者中,无胃阴亏虚证、肝胃郁热证及脾胃虚弱证。经卡方检验,中医证型分布与焦虑程度具有统计学差异(χ2=21.519,P=0.0180.05)。③99例RE患者中抑郁程度情况分布为:无抑郁(79.8%)轻度抑郁(15.1%)中度抑郁(5.1%),无重度抑郁患者。无抑郁患者中证型分布依次为:脾胃虚弱证18(18.2%)脾胃湿热证16(16.2%)肝胃不和证13(13.1%)=肝胃郁热证13(13.1%)胃阴亏虚证10(10.1%)痰气郁结证9(9.1%);轻度抑郁患者中肝胃郁热证和痰气郁结证最多;中度抑郁患者中只出现肝胃不和证和痰气郁结证。经卡方检验,中医证型分布与抑郁程度具有统计学差异(χ2=1 8.896,P=0.0420.05)。结论:1.文献研究:RE的中医证候类型多以肝胃郁热证和肝胃不和证为主,其病变部位在胃、肝及脾,病理属性以实证或虚实夹杂证为多,单纯虚证可见但相对较少;病理性质实证多见热、气滞及痰湿,虚证多见阴虚。2.临床研究:①RE中医的6个证型中以肝胃不和证和脾胃虚弱证多见。②RE患者焦虑程度与中医证型分布具有一定的相关性,其中肝胃不和证的焦虑患者最多。③RE患者抑郁程度与中医证型分布具有一定相关性,其中肝胃不和证的抑郁患者最多。
[Abstract]:Objective: the purpose of this study is to reflux esophagitis (reflux esophagitis RE) as the research object, is divided into two parts: literature research and clinical research. The literature research part, through the collection, analysis of the previous RE traditional Chinese medicine research literature, summarizes the references of RE in Chinese name and distribution. The part of clinical study through statistical methods, the related clinical data of RE patients were analyzed, to study the correlation of RE with TCM syndrome type and psychological factors, and on this basis, to explore the relationship between RE and the TCM syndrome type of psychological factors. In order to further deepen the understanding of RE in traditional Chinese medicine, and provide the reference for the standards of TCM syndrome of the disease the establishment of the TCM can be more objective, standard for clinical prevention and treatment of RE, to provide theoretical support. Research methods: 1. literature research of artificial retrieval including China academic journals full text database (CNKI), China biomedical literature database (SinoMed), Chinese scientific journal database (VIP, Chongqing VIP, Wanfang database), as of December 2015 all about RE Chinese medicine research literature. Download, reading, screening literature, summarizing TCM of RE research literature, and literature analysis and evaluation of the.2. clinical research 1. Investigation on 99 cases of patients with RE related clinical data, using statistical methods to analyze the distribution characteristics of TCM syndromes. Through Z's anxiety and depression self rating scale for the evaluation of the psychological factors of RE patients in 99 cases, and the use of statistical methods for processing, analysis of the correlation between patients with TCM syndromes and psychological factors then. Results: 1. literature research results: the literature study included 91 reported, a total of 10258 cases, contained a total of 32 kinds of TCM syndrome type, especially in the heat stagnation of liver and stomach, liver and stomach And as a multi.2. clinical research results: the clinical study, collected a total number of cases was 99 cases. The patients with TCM syndrome type proportion from high to low: according to the syndrome of disharmony between liver and stomach (20.2%) stomach syndrome (19.2%) heat stagnation of liver and stomach (17.2%) = 17.2% (spleen stomach damp heat syndrome gas phlegm stagnation syndrome) (14.1%) the stomach yin deficiency syndrome 99 cases (12.1%). The degree of anxiety in patients with RE distribution: (50.5%) no anxiety and mild anxiety (41.4%) moderate anxiety (8.1%), no patients with severe anxiety. The anxiety of patients, and the number of spleen stomach damp heat syndrome of spleen stomach deficiency and equal. The maximum number of patients with mild anxiety; patients, patients with liver stomachdisharmony number; moderate anxiety in patients without stomach yin deficiency, stagnation of liver and stomach heat syndrome and spleen stomach deficiency. By chi square test, type distribution and degree of anxiety syndrome has a statistically significant difference (x 2=21.519, P= 0.0180.05) in 99 cases of depression. The degree distribution for RE patients: No depression (79.8%) mild depression (15.1%) moderate depression (5.1%), no patients with severe depression. Depression in patients with syndrome type distribution is as follows: the weakness of the spleen and stomach syndrome 18 (18.2%) 16 (16.2%) of spleen stomach damp heat syndrome of disharmony between liver and stomach 13 (13.1% = 13) heat stagnation of liver and stomach (13.1%) stomach yin deficiency of 10 (10.1%) sputum stagnation syndrome (9.1%); 9 patients with mild depression of liver stomach heat syndrome and gas stagnation syndrome; liver stomach disharmony syndrome and gas stagnation syndrome appear only moderate depression patients. By chi square test, the distribution of TCM syndromes and the degree of depression has a statistically significant difference (2=1 8.896, P=0.0420.05 1.). Conclusion: the literature research: TCM syndrome types of RE with heat stagnation of liver and stomach and liver stomach disharmony, the lesions in the stomach, liver and spleen, pathological properties to empirical or the actual card is more visible but relatively simple deficiency; the pathological nature of empirical heat, qi stagnation and phlegm dampness, deficiency of yin deficiency.2. Clinical study: 6 syndromes of RE in TCM syndrome of disharmony between liver and stomach and spleen and stomach syndrome. The degree of anxiety has a certain correlation with the distribution of TCM Syndromes of RE patients, the disharmony between liver and stomach in patients with anxiety most. The degree of depression is a relationship between the RE and the distribution of TCM syndromes, including disharmony between liver and stomach depression were the most.

【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

【参考文献】