小儿脑瘫中医证候及证素规律的临床研究

发布时间：2018-02-25 20:35

本文关键词： 小儿脑瘫证候证素分布组合　出处：《辽宁中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:探讨小儿脑瘫中医证候及证素规律,加深对本病的中医认识,规范其中医辩证,为指导临床提高辨证准确性及治疗效果提供参考。方法:通过对89例脑瘫患儿进行病历资料调查,采集中医四诊信息,编制填写《小儿脑瘫中医证素临床调查表》,建立证候证素研究数据库,并通过SPSS19.0统计分析软件,利用频数统计及聚类分析等方法,对提取的小儿脑瘫中医证素进行统计描述。结果:1.证候分布特征:89例患儿共分为6个证型,分别为肝肾不足证(55.06%)、脾肾虚弱证(16.85%)、痰瘀阻滞证(8.99%)、心脾两虚证(7.87%)、脾虚肝亢证(6.74%)、阴虚风动证(4.49%)。2.证素分布规律:本研究提取小儿脑瘫中医证素12个,其中病位证素4个,病性证素8个。病位证素中,肾出现频率(占全部病例数的百分比,下同)最高,为71.91%,余下依次为肝(61.80%)、脾(31.46%)、心(7.87%);病性证素包括精亏(71.91%)、血虚(62.92%)、阴虚(59.55%)、气虚(31.46%)、痰(8.99%)、瘀血(8.99%)、阳亢(6.74%)和动风(4.49%)。病性组合中,虚性组合占79.78%,远高于虚实夹杂组合和实性组合。3.证素组合规律:证素组合有五证素组合(55.06%)、四证素组合(31.46%)和两证素组合(13.48%)3种类型,分别对应一种证素组合形式,即两病位证素+三病性证素组合(55.06%)、两病位证素+两病性证素(31.46%)和两病性证素(13.48%)。4.证素聚类分析:聚类分析结合中医理论,认为可分4类:肾与精亏一类、肝与阴虚、血虚一类、脾与气虚一类,余下证素为一类。结论:研究结果显示,脑瘫患儿多于学龄前期(3~7岁)入院诊治,且男性患儿多于女性患儿。纳入病例中医辩证共分六个证型,其中以肝肾不足证最为多见。脑性瘫痪中医病位主要在肾、肝、脾三脏,与心相关;病性证素包括精亏、血虚、阴虚、气虚、痰、瘀血、阳亢、动风。其中,肾、肝为主要的病位证素,二者的组合为分布最多的病位证素组合;精亏、血虚、阴虚为主要的病性证素,三者的组合为分布最多的病性证素组合。病性方面,小儿脑瘫具有以本虚为主、或见虚实夹杂的特点。证素组合,包括两证素、四证素、五证素组合三种,尤以五证素组合(即两病位证素+三病性证素)为多,这种组合即为肝+肾+阴虚+血虚+精亏的组合。聚类分析结果提示肾精亏损、肝阴血虚和脾气虚弱为本病重要病机,而痰、瘀血等病理产物亦与本病关系密切。
[Abstract]:Objective: to probe into the law of TCM syndromes and syndromes in children with cerebral palsy, to deepen the understanding of TCM on this disease, and to standardize the dialectical of TCM in children with cerebral palsy. Methods: 89 cases of cerebral palsy were investigated by medical records, and the information of four diagnoses of TCM was collected. To compile and fill out the clinical questionnaire of TCM syndromes in children with cerebral palsy, to establish the research database of syndromes syndromes, and to use the methods of frequency statistics and cluster analysis through SPSS19.0 statistical analysis software. The extracted TCM syndromes of children with cerebral palsy were statistically described. Results: 1. The characteristics of syndrome distribution in 89 children were divided into 6 syndromes. They were liver and kidney deficiency syndrome, spleen and kidney deficiency syndrome, spleen and kidney deficiency syndrome, spleen and kidney deficiency syndrome, phlegm and blood stasis block syndrome, phlegm and blood stasis block syndrome, phlegm and blood stasis block syndrome, phlegm and blood stasis block syndrome, phlegm and blood stasis syndrome, phlegm and spleen deficiency syndrome, Qi 7.87g, spleen deficiency and liver hyperactivity syndrome, liver hyperactivity syndrome, Yin deficiency and wind movement syndrome, respectively. The distribution of syndromes: 12 syndromes of children with cerebral palsy were extracted in this study, among which 4 syndromes were found in the position of disease. The frequency of kidney appearance (percentage of total cases, the same below) was the highest. For 71.91, the rest is the liver with 61.80m, the spleen with 31.46m, the heart with 7.87s and the heart with 7.87s. The syndrome elements of the disease include the essence deficiency 71.91g, the blood deficiency 62.92o, the yin deficiency 59.555am, the deficiency of qi 31.46x, the phlegm 8.9999, the blood stasis 8.99m, the Yang hyperactivity 6.7445) and the moving-wind 4.4974. The combination of deficiency is 79.78, which is much higher than that of the combination of deficiency and reality and the combination of substance. 3. The law of combination of syndromes and elements: there are five combinations of syndromes and five elements, and the combination of four syndromes is 31.4646) and the combination of two syndromes is 13.48g, corresponding to one kind of combination of evidence elements, respectively. That is, the combination of syndrome factors of two diseases, syndrome factors of three diseases, factors of syndrome of three diseases (55.06g), factors of syndrome of two diseases of disease (31.46) and factors of syndrome of two diseases (13.4848.4.The cluster analysis of syndromes: cluster analysis combined with the theory of traditional Chinese medicine (TCM), it is believed that there are 4 kinds of syndromes: kidney and essence deficiency, liver and yin deficiency, blood deficiency, etc. Spleen and qi deficiency, the remaining syndromes belong to one class. Conclusion: the results of the study show that the number of children with cerebral palsy is more than that of pre-school children (37 years old), and the number of male children is more than that of women. The syndrome of deficiency of liver and kidney is the most common. The position of TCM disease of cerebral palsy is mainly in kidney, liver and spleen, which is related to heart; the factors of disease syndrome include essence deficiency, blood deficiency, yin deficiency, deficiency of qi, phlegm, blood stasis, hyperactivity of yang, moving wind. Among them, kidney, kidney, blood deficiency, yin deficiency, qi deficiency, phlegm, blood stasis, hyperactivity of yang, moving wind. Liver is the main syndrome element, the combination of the two is the most distributed syndrome element, the essence deficiency, blood deficiency and yin deficiency are the main syndromes of disease, the combination of the three is the most distributed combination of disease syndrome factors. The children's cerebral palsy is characterized by the deficiency of essence or the inclusion of deficiency and reality. The combination of syndromes is composed of two syndromes, four syndromes, and five syndromes, especially the combination of five syndromes (that is, two disease syndromes and three diseased syndromes), which is mainly composed of two syndromes, four syndromes and five syndromes. The results of cluster analysis indicated that deficiency of kidney essence, deficiency of liver yin and blood and deficiency of temper were important pathogenesis of this disease, and phlegm, blood stasis and other pathological products were closely related to this disease.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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