社区常见慢性疾病的发病与脾胃相关性研究

发布时间：2018-05-16 07:54

本文选题：社区常见慢性疾病 + 中医证型　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的：1.统计社区慢性疾病与脾胃的相关性2.从脾胃调理预防社区慢性病提供初步数据支持。方法：本研究采用病历回顾进行研究,制定调查表,收集广东省中医院2014年1月-12月关于社区常见慢性疾病门诊病历,收集病历中症状、体征、辅助检查及中西医诊断(中医辨证),对符合纳入条件的病历进行分类(按病种、中医症型)进行比较,并对患者年龄、性别进行统计分析,来探讨社区常见慢性疾病中中医证型与脾胃脏腑相关性,了解社区慢性疾病证候分布特点。结果：1.在研究的964份病历中,性别及年龄统计中发现,常见慢性疾病发病以50-59岁为中点呈正太分布趋势,50岁以上患者占62.4%,提示社区常见慢性疾病多因后天调养不当引起；2.脾胃作为主导或者关联原因出现频次最高,占总数31.2%,在其余8个非消化系统疾病中,脾胃因素均有存在,脾胃影响在高血压、糖尿病、冠心病、慢阻肺(COPD)、慢性支气管炎、骨关节炎(膝关节)、慢性盆腔炎及功能性子宫出血中分别占13%、20%、14%、55%、21%、6%、23%、31%,脾胃在消化系统之外的慢性疾病中,与呼吸道疾病关系最为密切,其次为妇科疾病,与骨关节疾病关系最弱。3.在非脏腑辨证的396份病历中,痰病及瘀病作为第一聚类,占了58.6%,证明其影响范围广。且第一聚类和第二聚类结果均与脾胃功能有密切关系。结论：社区常见慢性疾病发病多在50岁以上,女性患者居多。在消化系统疾病中,脾胃脏腑起主导作用,在高血压、糖尿病、冠心病、慢阻肺、慢性支气管炎、骨关节炎、慢性盆腔炎及功能性子宫出血8个非消化系统疾病中起着不同程度影响。而因脾胃失常所致的痰瘀、气血疾病更是直接导致冠心病、慢阻肺及慢性支气管炎的直接原因。脾胃作为“后天之本”有明确的临床意义。在后天的生活调理当中,应该注重脾胃调养,未病防治；已患有慢性疾病的患者,虽然发病病因未在脾胃,也应该既病防变,避免进一步损伤脾胃。
[Abstract]:Purpose 1. The correlation between chronic diseases and spleen and stomach in community was 2. 5%. From the spleen and stomach conditioning to prevent chronic diseases in the community to provide preliminary data support. Methods: a retrospective study was conducted and a questionnaire was developed to collect the outpatient medical records of common chronic diseases in the community from January to December 2014 in Guangdong Provincial Hospital of Chinese Medicine, and to collect the symptoms and signs in the medical records. Auxiliary examination and diagnosis of traditional Chinese and Western medicine (TCM syndrome differentiation), classification of medical records (by disease type, TCM syndrome type), and statistical analysis of age and sex of patients, To explore the relationship between TCM syndromes of common chronic diseases and spleen and stomach viscera, and to understand the distribution characteristics of community chronic disease syndrome. The result is 1: 1. In 964 medical records of the study, gender and age statistics showed that the incidence of common chronic diseases, 50-59 years old as the midpoint of the distribution trend of patients over 50 years old accounted for 62.4 points, suggesting that common chronic diseases in the community are caused by improper nurture. The spleen and stomach were the leading or associated cause with the highest frequency, accounting for 31.2% of the total. In the other 8 non-digestive system diseases, the spleen and stomach factors were all present. The influence of spleen and stomach were in hypertension, diabetes, coronary heart disease, chronic obstructive pulmonary disease, chronic bronchitis, diabetes mellitus, coronary heart disease, chronic bronchitis, chronic bronchitis. Osteoarthritis (knee joint, chronic pelvic inflammatory disease and functional uterine bleeding) accounted for 1320 and 14, respectively. The spleen and stomach had the most close relationship with respiratory tract diseases, followed by gynecological diseases, and the weakest. 3 with osteoarticular diseases, the spleen and stomach had the most close relationship with respiratory diseases outside of the digestive system, and the spleen and stomach had the most close relationship with the diseases of the digestive system, followed by gynecological diseases, and with bone and joint diseases. In the 396 cases of non-viscera syndrome differentiation, phlegm disease and stasis disease, as the first cluster, accounted for 58. 6%, which proved that the influence range was wide. The results of the first cluster and the second cluster were closely related to the function of spleen and stomach. Conclusion: the incidence of common chronic diseases in the community is over 50 years old, female patients are the majority. In digestive system diseases, spleen and stomach viscera play a leading role in hypertension, diabetes, coronary heart disease, chronic obstructive pulmonary disease, chronic bronchitis, osteoarthritis, Chronic pelvic inflammatory disease and functional uterine bleeding play an important role in 8 non-digestive system diseases. The phlegm and blood stasis caused by spleen and stomach disorders, qi and blood diseases are the direct causes of coronary heart disease, chronic obstructive pulmonary disease and chronic bronchitis. Spleen and stomach as the "acquired basis" has a clear clinical significance. In the day after tomorrow life conditioning, should pay attention to spleen and stomach nourishment, not disease prevention and treatment; has suffered from chronic diseases, although the etiology is not in the spleen and stomach, but also should be disease prevention, to avoid further injury of spleen and stomach.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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