老年人抗生素相关性腹泻的证候分布规律研究

发布时间：2018-03-02 07:28

本文关键词： 老年人 AAD 菌群失调流行病学调查苦寒伤胃　出处：《山东中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:运用流行病学方法对老年人抗生素相关性腹泻发病的危险因素、证候分布等方面进行调查研究,探讨其发病规律,以期对今后老年人抗生素相关性腹泻的诊断和治疗提供指导。方法:选择我院2014年10月—2015年12月符合老年人抗生素相关性腹泻纳入标准的80例患者,对其临床资料进行调研分析。观察内容包括患者人口学特征,基础疾病,抗生素应用的原因、种类及时间,腹泻次数、大便性状及相关症状和体征,舌苔脉象以及辅助检查等,采用EXCEL 2003进行数据管理,运用SPSS 21.0统计软件对计数资料进行χ2检验及秩和检验。结果:1.老年人抗生素相关性腹泻的发病率与性别无关。2.老年人抗生素相关性腹泻患者以70-79岁居多,占51.2%。3.老年人抗生素相关性腹泻患者中83.75%患有基础病,排前3位的依次是心脑血管疾病(38.98%)、呼吸系统疾病(22.03%)、糖尿病(17.8%)。4.老年人抗生素相关性腹泻患者使用抗生素的原因主要为呼吸系统感染(53.75%)、尿路感染(12%)和预防应用(13.75%)。5.引起老年人抗生素相关性腹泻的抗生素,以三代头孢(22.96%)、广谱青霉素类(19.26%)和碳青霉烯类(14.81%)居多。6.当抗生素使用时间14天,腹泻发病率明显升高。7.老年人抗生素相关性腹泻各证型中,脾肾阳虚证最多,占56.25%,其次为脾胃虚弱证,占23.75%。结论:老年人抗生素相关性腹泻的危险因素主要有:使用广谱抗生素、患有基础疾病、抗生素使用时间长等。老年人抗生素相关性腹泻有寒湿困脾证、湿热内蕴证、脾胃虚弱证、脾肾阳虚证4种证型,尤以脾肾阳虚证、脾胃虚弱证常见。
[Abstract]:Objective: to investigate the risk factors and syndromes distribution of antibiotic associated diarrhea in the elderly by means of epidemiological method. Methods: from October 2014 to December 2015, 80 patients who met the criteria of antibiotic associated diarrhea in our hospital were selected. The clinical data were investigated and analyzed. The observation included demographic characteristics of patients, basic diseases, causes, types and time of antibiotic use, number of diarrhea, stool traits and related symptoms and signs, tongue coating pulse and auxiliary examination, etc. Using EXCEL 2003 for data management, The statistical software SPSS 21.0 was used to test the count data by 蠂 2 test and rank sum test. Results: 1. The incidence of antibiotic associated diarrhea in the elderly was not related to sex. 2. The majority of elderly patients with antibiotic associated diarrhea were 70-79 years old. 83.75% of the elderly patients with antibiotic associated diarrhea had basic diseases, The top three were cardio-cerebrovascular diseases (38.98), respiratory diseases (22.03) and diabetes (17.8). The main reasons for the use of antibiotics in elderly patients with antibiotic associated diarrhea were respiratory infection (53.75g) and urinary tract infection (12g) and preventive use of 13.75g. Antibiotics for antibiotic associated diarrhea in the elderly, Among the three generations of cephalosporium 22.96m, broad-spectrum penicillin 19.26) and carbapenem 14.81), the incidence of diarrhea increased significantly when antibiotics were used for 14 days. The incidence of diarrhea in the elderly patients with antibiotic associated diarrhea was the most in all the syndrome types, spleen and kidney yang deficiency syndrome was the most. Conclusion: the main risk factors of antibiotic associated diarrhea in the elderly are: the use of broad-spectrum antibiotics, suffering from basic diseases, the second is deficiency of spleen and stomach, the second is deficiency of spleen and stomach, and the second is deficiency of spleen and stomach. The antibiotics were used for a long time. There were four syndrome types of antibiotic associated diarrhea in the elderly, including cold and dampness syndrome, damp-heat accumulation syndrome, spleen and stomach deficiency syndrome, spleen and kidney yang deficiency syndrome, especially spleen and kidney yang deficiency syndrome, and spleen and stomach deficiency syndrome.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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