斑秃中医体质类型与发病相关因素、中医证型及黑点征相关性的调查分析

发布时间：2018-03-20 18:24

本文选题：斑秃　切入点：中医体质学　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】：目的:通过对240例斑秃患者一般情况及发病相关因素的搜集以及运用皮肤镜观察患者脱发部镜下征象,分析探讨斑秃中医体质类型的分布规律及其与发病相关因素、中医证型和黑点征之间的关系。方法:选择切合纳入标准的AA患者共240例,且这些病例全部收集于在江苏省中医院的皮肤科,时间限定为2016.4-2016.12。以填写调查问卷表、使用皮肤镜镜下观察的形式进行资料收集。调查问卷选用王琦等拟定的《中医体质量表》(该表目前在我国中医体质学研究中最具权威性)。原始数据采用EXCEL处理,用spsaa16.0对进行统计分析。结果:1.共调查患者240例,其中男女比例为1.03:1;年龄在15～40岁之间的人最多,病程在1年以下者最多,达到55%。小学及以下者36例(15%),初高中学历64例(26.7%),大专学历42例(17.5%),本科学历78例(32.5%)。研究生及以上20例(8.3%);活动期占58.33%。局限型176例,占73.33%,普秃30例占12.5%,全秃34例,占14.17%。证型分布中肝肾不足证比重最高(31.67%);其次为脾肾两虚证(25.83%)。主要偏颇体质类型为气虚质、阴虚质、气郁质,比重为12.92%、12.01%、11.88%。单一体质有14例,占4.83%,复合质共226例,其中四种以上复杂性复合体质比重最高,达79.33%。男性患者气虚体质最高,其次为湿热质;女性患者中,血疲质及阴虚质相同且比重最大。2.对所有计数资料采用卡方检验,AA体质类型不受性别影响(X~2=10.217,P=0.2500.05);AA体质类型分布不受年龄影响(X~2=16.197,P=0.4390.05);体质分布类型不受AA病程阶段的影响(X~2=6.549,P=0.9810.05);体质类型分布不受AA临床分期影响(X~2=8.951,P=0.9510.05)。学历高低对体质的影响不大(X~2=16.681,P=0.9880.05)。AA体质类型与临床严重度未见明显相关性(X~2=11.816,P=0.7570.05),体质不受证型影响(X~2=19.028,P=0.9660.05);体质与黑点征之间不存在相关性(X~2=5.305,P=0.7250.05);黑点征检出率与性别分布无关(X~2=3.229,P=0.0720.05)。黑点征不受年龄影响(X~2=1.777,P=0.4110.05)。黑点征的分布不受病程长短影响(X~2=0.846,P=0.6550.05)。黑点征与受教育程度无关(X~2=3.164,P=0.5310.05),黑点征随AA临床分期的不同而不同(X~2 =9.933,P=0.0090.05)。不能认为黑点征与AA临床严重度相关(X~2=4.052,P=0.1320.05)。黑点征不受AA中医证候影响(X~2=2.319,P=0.6770.05)。结论:本次调查AA体质类型中最常见的是:气虚质、阴虚质、气郁质,提示我们在进行临床诊疗的时候一方面要准确辨病,辨证,同时还要考量患者的体质类型,针对各自体制特征,有的放矢,综合用药,补正纠偏,增强疗效。体质类型与中医证型、黑点征、和AA相关因素之间没有明显相关性。黑点征是本病的特征性表现,其分布不受体质、证型、性别、年龄、病程等影响,但与本病的临床分期相关。可根据该征象开展相应临床活动,辅佐临床诊治鉴别及疗效判定,提高临床效率。
[Abstract]:Objective: to analyze the distribution of TCM physique types of alopecia areata and its related factors by collecting the general situation and the related factors of the disease in 240 patients with alopecia areata and observing the signs of alopecia areata under dermatoscope. Methods: 240 patients with AA were selected and collected in the dermatology department of Jiangsu Provincial traditional Chinese Medicine Hospital for a limited period of time from June 4 to June 12, 2016.12 to fill out the questionnaire. The questionnaire was composed of the TCM physique scale developed by Wang Qi et al. (this form is currently the most authoritative in the research of TCM physique in our country. The raw data are processed by EXCEL. Results: 1. A total of 240 patients were investigated, of whom the ratio of male to female was 1.03: 1; the number of people aged between 15 and 40 was the highest, and the course of disease was the most in less than one year. There are 36 cases of primary school and below, 64 cases of junior and senior middle school education, 42 cases of junior high school degree, 42 cases of junior college degree, 78 cases of undergraduate degree and 32.5g. The number of graduate students and over 20 cases is 8.3. The active period is 58.33. There are 176 cases of localized type, accounting for 73.33 cases, 30 cases of general alopecia, 12.5 cases of total alopecia, 34 cases of total alopecia. The proportion of deficiency of liver and kidney was the highest in the distribution of syndromes, followed by deficiency of spleen and kidney in 25.83 cases. The main types of physical bias were deficiency of qi, deficiency of yin, stagnation of qi, and specific gravity of 12.920.01 and 11.88.The single constitution was 14 cases (4.833%), and the compound was 226 cases. Among them, the proportion of more than four complex complex constitutions was the highest, reaching 79.33.The male patients with qi deficiency had the highest constitution, followed by dampness and heat; among the female patients, Blood fatigue and yin deficiency were the same and the proportion was the largest. 2. All counting data were tested by chi-square test. The physical type of AA was not affected by sex. The distribution of physical type of AA was not affected by age. The distribution of constitution type was not affected by age. The type of constitution distribution was not affected by the disease course stage of AA, and the type of constitution distribution was not affected by the disease course of AA. The distribution of physique type was not affected by the clinical stage of AA. The influence of educational level on constitution was not significant. There was no obvious correlation between the constitution type and clinical severity. There was no significant correlation between the constitution type and clinical severity, and the constitution was not affected by the syndrome type. The relationship between physique and black spot sign was not significant (P = 0.9660.05), and there was no significant correlation between physique and black spot sign (P = 0.9660.05, P = 0.9660.05, P = 0.9660.05, P = 0.9660.05, P = 0.9660.05, P = 0.9660.05, P = = =. The detection rate of the black spot sign was not related to the sex distribution. The black spot sign was not affected by age. The distribution of the black spot sign was not affected by the duration of the disease. The distribution of the black spot sign was not affected by the duration of the disease. There was no relationship between the black spot sign and the education level. The black spot sign was not related to the educational level. The black spot sign was different with the clinical stage of AA. The black spot sign was different with the clinical stage of AA. The distribution of the black spot sign was not affected by the duration of the disease. The distribution of the black spot sign was not affected by the duration of the disease. There was no correlation between the black spot sign and the education level. The black spot sign was not related to the degree of education, and the black spot sign varied with the clinical stage of AA. It can be considered that the black spot sign is related to the clinical severity of AA. The black spot sign is not affected by the TCM syndrome of AA. Conclusion: the most common type of AA constitution is deficiency of qi. Yin deficiency and qi stagnation suggest that we should, on the one hand, accurately identify diseases and syndrome differentiation, and at the same time consider the physical types of patients, in accordance with their respective institutional characteristics, with a view to their respective institutional characteristics, comprehensively use drugs, and correct and correct errors. There was no significant correlation between physique type and TCM syndrome type, blackspot sign, and AA related factors. Black dot sign was the characteristic manifestation of the disease, and its distribution was not affected by constitution, syndrome type, sex, age, course of disease, etc. But it is related to the clinical stage of the disease. According to this sign, we can carry out corresponding clinical activities, assist in clinical diagnosis and treatment, and evaluate the curative effect, and improve the clinical efficiency.
【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】：R275.9

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