耳鸣与脾胃的相关性研究

发布时间：2018-05-30 11:00

本文选题：耳鸣 + 脾胃　；参考：《广州中医药大学》2014年硕士论文

【摘要】：研究目的耳鸣为临床上常见的顽症之一,迄今为止,耳鸣的发病机制仍无突破性的研究进展。本文通过对200例耳鸣患者进行详细的耳鸣信息采集及脾胃功能调查,了解耳鸣的发病与脾胃的关系,探讨耳鸣严重程度、耳鸣特征与脾胃功能的相关性,从中医脾胃角度探讨耳鸣的病因病机,为合理选择治疗方案提供临床依据。研究方法收集广州中医药大学第一附属医院耳鼻喉科2013年1月至2014年1月门诊及住院部诊断为耳鸣的患者作为研究对象。首先,详细调查其耳鸣部位、声响、病程、听力状况、是否经过治疗、治疗效果等基本信息,同时了解其脾胃系疾病史和日常饮食、用药、压力、睡眠等情况,分别评价其耳鸣严重程度和脾胃功能,进行耳鸣心理声学测试及听力学检查。其次,将所有患者信息输入电脑,建立数据库。最后,统计耳鸣患者存在脾胃系疾病的比例,分析其整体脾胃功能与健康成人的差异,比较不同严重程度的耳鸣患者脾胃功能差异,探讨其脾胃功能失调的潜在因素,并对具有不同耳鸣特征的患者脾胃功能进行单因素分析,探讨耳鸣特征与脾胃功能的关系,进一步分析耳鸣特征对中医辨证的意义。研究结果 1.耳鸣患者的一般资料：共计收集病例200例。其中,男121例(占60.50%),女79例(占39.50%)。年龄15-79岁,平均42.68±12.99岁；病程8天-33年,平均36.76±52.35月。职业：专业技术人员57例,文职33例,退休24例,个体经营者15例,公务员11例,工人9例,学生8例,其它43例。耳鸣部位：左耳39例(19.50%),右耳47例(23.50%),双耳95例(47.50%),头颅内12例(6.00%),头颅外3例(1.50%),身体外3例(1.50%),说不清1例(0.50%)。伴听力下降111例(55.50%),听力正常89例(49.50%)。 2.200例耳鸣患者存在脾胃系统器质性疾病者105例占52.5%,整体脾胃功能平均积分与健康成人比较明显升高(P0.05),不同等级的耳鸣患者脾胃功能积分随耳鸣程度的加重而升高,差异有统计学意义(P0.05)。 3.脾胃失调的病因调查：79.5%患者嗜食肥甘厚味,73.50%患者嗜食寒凉食物,66.50%的患者在耳鸣发病前存在压力,80.00%的患者在耳鸣发病前存在睡眠问题。 4.分别对具有不同耳鸣部位、声响、主调声频率、残余抑制试验结果、佛德曼曲线类型的患者脾胃功能进行单因素分析,其差异均无统计学意义(P0.05)。 5.169例耳鸣患者既往经过西医、中医补肾、活血化瘀等治疗的无效率为84.02%。结论 1.耳鸣患者大多存在脾胃系统器质性疾病及脾胃功能失调,耳鸣的严重程度与脾胃功能大致呈负相关,脾胃功能失调可能是耳鸣发病的基本病机。 2.耳鸣患者多存在嗜食肥甘厚味及寒凉食物的不良饮食习惯,且多存在熬夜或失眠的问题及压力较大,这些是导致其脾胃功能失调的主要原因。使用寒凉药物可能成为耳鸣的诱因。 3.耳鸣的部位、耳鸣声响特征、耳鸣主调声频率、残余抑制试验结果、佛德曼曲线类型与脾胃功能无关,患者所描述及耳鸣心理声学检测所得到的耳鸣特征对中医辨证的意义不大。
[Abstract]:research objective
Tinnitus is one of the common clinical symptoms, so far, the pathogenesis of tinnitus still has no breakthrough. In this paper, 200 cases of tinnitus patients were collected in detail, and the relationship between the onset of tinnitus and the spleen and stomach was investigated. The severity of tinnitus, the relationship between the characteristics of tinnitus and the function of the spleen and stomach were discussed. The etiology and pathogenesis of tinnitus were explored from the perspective of spleen and stomach in Chinese medicine.
research method
The patients who were diagnosed as tinnitus in the outpatient and inpatient department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2013 to January 2014 were collected as the research object. First, to investigate the location, sound, course, hearing status, treatment, treatment effect and other basic information, and to understand the history of spleen and stomach diseases and daily drinking. To evaluate the severity of the tinnitus and the function of the spleen and stomach, and to carry out the acoustic and audiological examination of the tinnitus. Secondly, the information of all the patients was input to the computer and the database was set up. Finally, the proportion of the patients with tinnitus had the spleen and stomach diseases, and the difference between the overall function of the spleen and the stomach and the healthy adults was analyzed. The difference of spleen and stomach function of patients with different severity of tinnitus was compared, and the potential factors of spleen and stomach dysfunction were discussed. The single factor analysis of spleen and stomach function in patients with different tinnitus characteristics was carried out to explore the relationship between the characteristics of tinnitus and the function of spleen and stomach, and the significance of tinnitus characteristics to TCM syndrome differentiation was further analyzed.
Research results
1. general data of patients with tinnitus: a total of 200 cases were collected. Among them, 121 men (60.50%), 79 women (39.50%). The average age was 42.68 + 12.99 years old; the course of disease was 8 days -33 years, average 36.76 + 52.35 months. The other 43 cases were in the position of tinnitus: 39 cases (19.50%) in left ear, 47 in right ear (23.50%), 95 in double ears (47.50%), 12 in the skull (6%), 3 (1.50%) outside the skull and 3 (1.50%) outside the body.
In 2.200 cases of tinnitus, 105 cases of spleen and stomach systemic diseases were 52.5%, the average integral of spleen and stomach function increased significantly (P0.05). The score of spleen and stomach function in different grades of tinnitus patients increased with the aggravation of tinnitus degree, the difference was statistically significant (P0.05).
3. the cause of the disorder of spleen and stomach: 79.5% patients were fat and sweet, 73.50% were addicted to cold food, 66.50% of the patients had pressure before the onset of tinnitus, and 80% of the patients had sleep problems before the onset of tinnitus.
4. the single factor analysis of the function of the spleen and stomach in patients with different tinnitus location, sound, primary tone frequency and residual inhibition test, and the difference of the function of the spleen and stomach of the patients with the type of the Buddha's curve was not statistically significant (P0.05).
5.169 cases of tinnitus were treated by western medicine, Chinese medicine for tonifying kidney, activating blood circulation and removing blood stasis, and the ineffective rate was 84.02%.
conclusion
1. patients with tinnitus are mostly organic diseases of the spleen and stomach and dysfunction of spleen and stomach. The severity of tinnitus is negatively related to the function of spleen and stomach, and the dysfunction of spleen and stomach may be the basic pathogenesis of the onset of tinnitus.
2. patients with tinnitus exist most of the bad eating habits of fat, sweet, thick and cold food, and there are many problems of staying up late or insomnia and pressure. These are the main causes of the dysfunction of the spleen and stomach.
3. the location of the tinnitus, the characteristics of the tinnitus sound, the tone frequency of the tinnitus and the results of the residual inhibition test, the type of the Buddha's curve has nothing to do with the function of the spleen and stomach. The characteristics of the tinnitus described by the patients and the acoustic detection of the tinnitus have little significance to the syndrome differentiation of traditional Chinese medicine.
【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】：2014
【分类号】：R276.1

【参考文献】