基于大样本量的过早搏动中医证候学初步研究

发布时间：2018-03-18 13:37

本文选题：大样本　切入点：过早搏动　出处：《河南中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:本研究通过对大样本量的过早搏动患者进行问卷调查和相关实验室检查等临床数据的采集,应用频数、回归、聚类等统计学方法对临床资料进行数据挖掘,初步探索过早搏动的证候特征及证候分类。方法:1采用临床研究的方法,根据诊断、纳入标准及排除标准,采集来自郑州市区三家三级甲等医院(包括河南中医药大学第二附属医院、河南中医药大学第一附属医院、河南省中医研究院)2010年5月~2016年1月期间,心血管科门诊及住院病人中临床资料完整的过早搏动患者共1137例。2调查者完成入组患者的“中医证候调查表”,包括症状、体征、相关检查等信息的采集。3研究者将调查表全部内容录入Epidata 3.1数据库,并进行审查、核对。4应用数据分析软件SPSS 20.0,对数据库进行统计学分析。最终得出过早搏动(即心悸病)的中医证候学分布规律。结果:1过早搏动中医辨证分型中,依据出现频率,从多到少排名前5位的依次是:气阴两虚瘀热互结证、心神不宁证、痰火扰心证、气血不足证、心脉瘀阻证。2过早搏动的病性要素中,虚性要素按所占比例排列依次为气虚、阴虚、血虚等,实性要素按所占比例排列依次为血瘀、郁热、痰浊、气滞等。3过早搏动发生的病位要素中,发病主要集中在心、肾、脾、肝,与胆、胃等脏腑有一定联系。4心悸及并见症状、体征出现频数最高的前20位依次是:心悸、乏力、胸闷、气短、脉沉、苔白、失眠、多梦、神疲、口干、少气懒言、头晕、大便不调、烦躁、健忘、脘痞、胸痛、舌暗红、口渴喜饮、急躁易怒等。5心悸病(过早搏动)气阴两虚瘀热互结型与高血压病、功能性早搏有Logistic回归关系;心神不宁型与心衰、心律失常有Logistic回归关系;痰火扰心型与心律失常、吸烟史有Logistic回归关系;气血不足型、心脉瘀阻型与以上危险因素不具有Logistic回归关系。6通过提取公因子,得出过早搏动中医证候17种证型,最终合并为8种证型。7通过聚类分析,结合相关临床知识,最终得到过早搏动的5种证型。结论:通过相关统计学方法,对过早搏动的临床症状、体征、相关检查进行分析,有助于其分型,归纳病位、病性、主要危险因素等,为中医证候的规律性研究提供依据。
[Abstract]:Objective: in this study, the clinical data were collected by questionnaire survey and laboratory examination, and the clinical data were mined by frequency, regression, clustering and other statistical methods. To explore the syndromes characteristics and classification of premature pulsatile. Methods: 1. According to diagnosis, inclusion criteria and exclusion criteria, From May 2010 to January 2016, three Grade 3A hospitals (including the second affiliated Hospital of Henan University of traditional Chinese Medicine, the first affiliated Hospital of Henan University of traditional Chinese Medicine, Henan Institute of traditional Chinese Medicine) were collected from Zhengzhou. A total of 1137 premature pulsatile patients with complete clinical data from outpatients and inpatients in cardiovascular department completed the TCM Syndrome questionnaire, including symptoms and signs. 3. 3 researchers entered all the contents of the questionnaire into the Epidata 3.1 database and examined it. The data analysis software SPSS 20.0 was used to analyze the database statistically. Finally, the distribution of TCM syndromes of premature pulsation (i.e. palpitation) was obtained. The top five from more to less are as follows: syndrome of Qi and Yin deficiency of blood stasis and heat, syndrome of heart restlessness, syndrome of phlegm and fire disturbing heart and heart, syndrome of deficiency of qi and blood, and syndrome of stagnation of heart vein. 2 among the disease factors of premature pulsation, deficiency factor is listed as qi deficiency according to the proportion. Yin deficiency, blood deficiency and so on, solid factors are blood stasis, stagnation of heat, phlegm, stagnation of qi and so on in the order of proportion. 3. The disease is mainly concentrated in heart, kidney, spleen, liver, and gallbladder. Stomach and other viscera have certain connection with .4 palpitation and symptoms, the first 20 places with the highest frequency of physical signs are: palpitation, fatigue, chest tightness, shortness of breath, heavy pulse, white fur, insomnia, dreamy, tired, dry mouth, less breath and lazy talk, dizziness, unregulation of stool, Dysphoria, amnesia, epigastric distension, chest pain, tongue blush, thirst and drinking, irritability and irritability, etc., are associated with hypertension and hypertension, and functional premature beats have Logistic regression relationship, and restless heart type and heart failure. Arrhythmia had Logistic regression relationship; phlegm and fire disturbed heart type and arrhythmia, smoking history had Logistic regression relationship; Qi-blood deficiency type, heart vein stasis type and above risk factors had no Logistic regression relationship .6 by extracting common factor, 17 syndromes of premature pulsatile syndrome of TCM were obtained, which were combined into 8 syndromes by cluster analysis, combined with relevant clinical knowledge, and finally obtained 5 syndrome types of premature pulsatility. Conclusion: through the method of correlation statistics, 5 syndrome types of premature pulsation are obtained. The analysis of clinical symptoms, signs and related examinations of premature pulsatile is helpful to the classification, induction of disease, disease, main risk factors and so on, and provides the basis for the study of the regularity of TCM syndromes.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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