谢晶日教授治疗功能性腹胀的中医证治规律

发布时间：2018-05-07 06:59

本文选题：功能性腹胀 + 痞证　；参考：《黑龙江中医药大学》2017年硕士论文

【摘要】：功能性腹胀(Functional bloating,FB)属于功能性胃肠病(Functional gastrointestinal disorders,FGIDs)中功能性肠道疾病(Functional bowel disorders,FBD)的一组症状谱。本课题将从祖国医学的角度,对谢晶日教授诊治FB进行科学的研究。目的:通过相关的统计学方法,分析并总结谢晶日教授诊治FB的辨证方法及药物的使用规律。方法:(1)收集数据:运用电子信息诊疗系统收集1 08例FB患者的性别、年龄、首诊处方、中医证型诊断。(2)数据预处理:将数据(性别、年龄、证型、药物)的规范化描述。(3)建立数据库:将数据输入数据库,本库的内容包括性别、年龄、证型、药物。性别按男女分类,男记为" 1",女记为“0”;年龄按年龄段分类,属于该段者记为"1",反之记为“0”;按证型、药物的有无,有者记为"1",无者记为"0"。(4)统计学分析:使用SPSS 19.0对数据库中的数据进行统计分析。建立性别比例图、年龄分布表、证候类型分布表、药物使用频次表、药物功效频次统计表、聚类分析图。结果:(1)108例FB患者按中医证型分类,肝胃不和型患者最多,饮食内停和胃阴不足型患者最少。其中,肝胃不和者29例,占比26.85%;脾胃虚寒者24例,占比22.22%;脾胃湿热者16例,占比14.82%;痰湿中阻者15例,占比13.89%;饮食内停者12例,占比11.11%;胃阴不足者12例,占比11.11%。(2)患者初诊处方共有中药药物71味,使用频次百分比超过50%的药物有6味,分别是白术、茯苓、陈皮、党参、佛手、砂仁。(3)谢晶日教授治疗FB最常使用补虚、理气、利水渗湿和化湿药,占总药物使用次数的71.81%。(4)对使用频次最高的50味药物进行聚类分析,可以分成7类药物:第1类药物:黄连、吴茱萸、槟榔;第2类药物:栀子、黄芩、大黄等;第3类药物:丁香、木香、白豆蔻等;第4类药物:藿香、猪苓、泽泻等;第5类药物:柴胡、香橼、白芍等;第6类药物:白术、陈皮、茯苓等;第7类药物:北沙参、石斛、生地黄等。结论:谢晶日教授认为脾胃虚弱导致气机不畅是FBE主要病机,还另有肝郁、痰饮、湿热、食积等病理变化。谢晶日教授治疗FB,重视脏腑间的相互作用,强调肝脾同调,以健脾疏肝为基本治法。注重气机的调畅,恢复脾气升清、胃气降浊的正常生理功能。谢晶日教授治疗FB的治法以补虚、理气为主,再辅助以化痰、祛湿、清热、养阴等治法。
[Abstract]:Functional abdominal distention is a group of symptom spectrum of functional bowel disordersof functional gastrointestinal disordersof functional gastroenteropathy (FGIDs). From the point of view of traditional Chinese medicine, Professor Xie Jingri's diagnosis and treatment of FB will be studied scientifically. Objective: to analyze and summarize Professor Xie Jingri's diagnosis and treatment of FB by statistical methods. Methods data were collected by using electronic information diagnosis and treatment system. Sex, age, prescription of first visit, diagnosis of TCM syndrome type. 2) data preprocessing: data (sex, age, syndrome type, type of FB) were collected. The standardized description of drugs. 3) establish a database: enter the data into the database. The contents of this database include gender, age, syndromes, drugs. Sex is classified by sex as "1" for men and "0" for women, "1" for those who belong to the paragraph by age, and "0" for those who belong to the paragraph. Statistical analysis: SPSS 19.0 was used to analyze the data in the database. Establish sex ratio chart, age distribution table, syndrome type distribution table, drug use frequency table, drug efficacy frequency statistical table, cluster analysis chart. Results 108 cases of FB patients with FB were classified according to TCM syndromes. The patients with liver and stomach disharmony type were the most, the patients with diet stopping and stomach yin deficiency type were the least. Of these, 29 cases (26.85%) were at odds with the liver and stomach; 24 cases (22.2222) had cold deficiency of the spleen and stomach; 16 cases (14.82%) had dampness and heat of the spleen and stomach; 15 cases (13.89%) were obstructed in phlegm and dampness; 12 cases (11.11%) were stopped in the diet; 12 cases were deficient in stomach yin. There are 71 kinds of traditional Chinese medicine in the prescriptions of patients at first visit, and there are 6 kinds of drugs that use more than 50% of the drugs. They are Atractylodes macrocephala, Poria cocos, Chen Pei, Codonopsis pilosula, Buddha hand, Amomum villosum.) Professor Xie Jingri's treatment of FB is most often used to replenish deficiency and regulate qi. Cluster analysis of 50 drugs with the highest frequency of use can be divided into seven categories: class 1: Coptis chinensis, Evodia rutaecarpa, Areca nut; Class 2: Gardenia jasminoides, Scutellaria baicalensis, Rhubarb et al; class 3 drugs: clove, woody, cardamom, etc.; class 4: patchouli, Polyporus umbellata, alisma et al.; class 5: Radix Bupleurum, Citron, Radix Paeoniae Alba, class 6: Atractylodes macrocephala, Chen Pei, Poria cocos, etc. Class 7: Radix Ginseng, Dendrobium, Rehmannia et al. Conclusion: professor Xie Jingri thinks that deficiency of spleen and stomach leading to unobstructed qi is the main pathogenesis of FBE, and there are also pathological changes such as liver depression, phlegm and drink, dampness and heat, food accumulation and so on. Professor Xie Jingri treated FB with emphasis on the interaction between viscera and viscera, emphasizing the homology of liver and spleen, and taking invigorating the spleen and soothing the liver as the basic treatment method. Pay attention to the unobstructed Qi, restore the temperament clear, the normal physiological function of stomach qi. Professor Xie Jingri's treatment of FB is based on tonifying deficiency, regulating qi, and then helping to eliminate phlegm, remove dampness, clear heat and nourish yin.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R259

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