基于高血压颈动脉粥样硬化证素诊断量表的证候分布规律研究

发布时间：2018-04-02 18:42

本文选题：高血压　切入点：颈动脉粥样硬化　出处：《山东中医药大学》2016年硕士论文

【摘要】：目的:基于前期制作的高血压合并颈动脉粥样硬化(CAS)证素诊断量表探索高血压CAS患者人群中证候分布规律,并以此指导临床治疗策略的制定。方法:通过已临床试用的高血压CAS证素诊断量表采集评估患者基本信息、危险因素、临床症状、证素成立情况等资料,运用多元统计学方法进一步验证量表的信度及效度、分析证候的分布规律。结果:量表的总信度为0.844,各个维度的Cronbachα系数均在0.6-0.85之间;结构效度上各个因子所含变量大致集中在除脾、血瘀之外的各个维度之中,测量结果基本符合量表最初的设计构想。高血压CAS多发生于老年人,男性发病年龄早于女性。男女证素成立最多见的均为痰证,男性其次为火热、血瘀、阳亢、阴虚、肝、肾、脾;女性其次为肝、阴虚、血瘀、火热、肾、阳亢、脾。吸烟对火热、痰、血瘀证素的成立影响较大;痰、血瘀、火热、肝证素的成立对斑块面积有影响。证候成立情况中以三证素组合最多见,其次为四证素、二证素、五证素、一证素的组合形式。病性证素比病位证素更多见。结论:量表的信度及效度均较满意,满足统计学要求,可以临床推广使用。痰+火热、血瘀+火热、火热+阴虚、痰+血瘀、血瘀+阴虚是证素组合的五种基本结构,痰热、瘀热、火热伤阴、痰瘀互结、阴虚血瘀是高血压CAS患者常见基本证候。
[Abstract]:Objective: to explore the distribution of syndromes in hypertensive patients with CAS based on the diagnostic scale of syndromes of hypertension combined with carotid atherosclerosis (CAS), and to guide the formulation of clinical treatment strategies.Methods: the data of basic information, risk factors, clinical symptoms and the establishment of syndromes were collected and evaluated by the CAS Diagnostic scale of Hypertension, and the reliability and validity of the scale were further verified by multivariate statistical method.Analyze the distribution of syndromes.Results: the total reliability of the scale was 0.844, and the Cronbach 伪 coefficient of each dimension was between 0.6-0.85. The variables contained in each factor in the structural validity were concentrated in the dimensions except spleen and blood stasis. The measurement results were basically in accordance with the original design of the scale.Hypertension CAS occurs mostly in the elderly, and the onset age of males is earlier than that of females.The most common syndromes of male and female syndromes were phlegm syndrome, male was followed by fire heat, blood stasis, yang hyperactivity, yin deficiency, liver, kidney, spleen, and female was liver, yin deficiency, blood stasis, fire heat, kidney, yang hyperactivity, spleen.Smoking had a great effect on the establishment of heat, phlegm and blood stasis syndrome factors, and phlegm, blood stasis, fire heat and liver syndrome factors had influence on plaque area.The combination of three syndromes is the most common, followed by four syndromes, two syndromes, five syndromes and one syndromes.The factors of disease syndrome were more common than those of disease position syndrome.Conclusion: the reliability and validity of the scale are satisfactory and can be popularized in clinic.Phlegm heat, blood stasis and heat, fire heat yin deficiency, phlegm and blood stasis, blood stasis yin deficiency are the five basic structures of syndrome element combination, phlegm heat, blood stasis heat, fire heat injury yin, phlegm and blood stasis mutual knot, yin deficiency and blood stasis are the common basic syndromes of CAS patients with hypertension.
【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

【参考文献】