溃疡性结肠炎内镜下表现与中医证型的相关性研究

发布时间：2018-04-23 05:07

本文选题：溃疡性结肠炎 + 肠镜　；参考：《山东中医药大学》2016年硕士论文

【摘要】：研究目的:探讨溃疡性结肠炎的不同中医证型与内镜下黏膜像的相关性,总结内镜下的辨证规律,以加强中医辨证的客观化,为溃疡性结肠炎的标准化治疗提供一定的理论依据。研究方法:1.收集溃疡性结肠炎患者的基本信息及相关临床资料,严格按照纳入标准及排除标准筛选出53例病例,阅读相关文献资料,结合本课题的研究思路设计出相应表格。2.观察53例患者结肠镜下黏膜像的特点,以及患者的相关临床资料,进行数据录入。3.采用SPSS17.0统计软件处理分析,得出结论。研究结果:1.本研究收集临床病例共53例,平均年龄为44.51±14.46岁,男女之比为2.1:1,且84.9%患者无吸烟史。本病最常见的诱发因素为饮食因素,占49.1%,其次为过度劳累,占35.8%,两者合计超过三分之二。2.患者常见临床症状前十位分别为:腹泻、腹部隐痛、黏液脓血便为主、纳差、黏液便为主、眠差、里急后重、肢体倦怠、肛门下坠、肠鸣等。3.患者结肠镜下常见黏膜像特点分布为:充血糜烂、浅溃疡形成、血管纹理不清、黏膜粗糙不平、覆着脓苔、假息肉形成,出现频率较少的症状为:蠕动不规律、结肠袋消失、渗血及黏膜桥形成。4.两种中医证型与疾病的严重程度、病变范围无统计学意义,而与肠黏膜表面是否有脓苔覆着、是否有渗血及假息肉的存在及舌质、舌苔之间有明显的相关性。大肠湿热证患者肠黏膜表面易有脓苔覆着,黏膜易有渗血,而脾虚湿蕴证患者结肠镜下易形成假息肉。红舌黄腻苔在大肠湿热证多见,而淡红舌白腻苔在脾虚湿蕴证多见。研究结论:溃疡性结肠炎多发生于中青年男性,其两种中医证型与结肠镜下黏膜表面是否有脓苔覆着、是否有渗血、假息肉的存在及舌质、舌苔之间有明显的相关性。
[Abstract]:Objective: to explore the relationship between different TCM syndromes of ulcerative colitis and mucosal image under endoscope, and summarize the law of syndrome differentiation under endoscope, so as to strengthen the objectivity of TCM syndrome differentiation. To provide a theoretical basis for standardized treatment of ulcerative colitis. Research method: 1. Collect the basic information and related clinical data of ulcerative colitis patients, select 53 cases strictly according to the inclusion criteria and exclusion criteria, read the relevant literature, and design the corresponding form. 2. The characteristics of mucosal images under colonoscopy and the clinical data of 53 patients were observed, and the data were inputted. 3. 3. SPSS17.0 statistical software is used to deal with the analysis and draw a conclusion. The result of the study was: 1. In this study, 53 clinical cases were collected, the average age was 44.51 卤14.46 years old, the ratio of male to female was 2.1: 1, and 84.9% of the patients had no smoking history. The most common inducing factor of the disease was diet, accounting for 49. 1%, followed by overwork, accounting for 35. 8%. The total of both was more than 2/3. 2. The first ten common clinical symptoms of the patients were diarrhea, abdominal pain, mucus purulent blood stool, anorexia, mucus stool, sleep loss, restlessness, limb burnout, anus fall, bowel ringing, etc. The features of common mucosal images under colonoscopy were hyperemia and erosion, shallow ulcer formation, unclear vascular texture, rough mucous membrane, abscess moss and pseudopolypus formation. The symptoms with less frequency were irregular peristalsis and disappearance of colonic bag. Blood leakage and mucosal bridge formation. There was no statistical significance between the two types of TCM syndromes and the severity of the disease, but there was a significant correlation with the presence of purulent fur on the surface of intestinal mucosa, the presence of oozing blood and false polyps and the tongue quality, and the tongue coating. The mucous membrane of patients with large intestine damp-heat syndrome is prone to be covered with pus and mucous membrane is easy to ooze blood, while spleen deficiency and dampness accumulation syndrome patients are prone to form pseudopolyps under colonoscopy. Yellow greasy fur of red tongue is more common in damp-heat syndrome of large intestine, while white greasy fur of light red tongue is more common in dampness accumulation syndrome of spleen deficiency. Conclusion: ulcerative colitis mostly occurs in young and middle-aged men. There is a significant correlation between the two TCM syndromes and whether the mucous membrane is covered with pus, whether there is blood leakage, the existence of pseudopolyps, tongue quality and tongue coating under colonoscopy.
【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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