基于证素辨证分析对原发性骨质疏松症证型分布的研究

发布时间：2018-06-03 13:26

本文选题：原发性骨质疏松症 + 病机　；参考：《山东中医药大学》2016年硕士论文

【摘要】：研究目的:通过证素辨证方法对原发性骨质疏松症(POP)进行辨证分析,探讨其中医证型分布特点,并分析不同证型与患者的一般情况、发病特点及临床指标的相关性。从而为本病中医分型客观化寻找依据,有利于全面探析其证治规律,为POP的早期诊断、分型、确立治法、选方用药提供理论支持。研究方法:采用统一的信息收集表对80例原发性骨质疏松症患者的证素信息等资料进行采集,应用证素辨证研究方法,分析原发性骨质疏松症中医证型分布特点,利用统计学方法计算中医证型与各发病因素的相关性,并对其特点进行总结归纳。结果:1.病位证素以肾最多见,其次是脾、肝、筋骨、心、经络。病性证素中,虚证证素以阳虚最多见,其次是阴虚、气虚、血虚、精亏;实证证素出现次数最多的是血瘀,其余依次为气滞、寒、热、痰、湿。2.常见中医证型按出现频次排序前5位依次为:肝肾阴虚、脾肾阳虚、气虚血瘀、肾阳虚、筋骨痹阻。3.不同证型与发病因素的相关性:(1)各证型中性别分布无统计学差异(P0.05);骨密度分布无统计学差异(P0.05);身高、体重、BMI分布无统计学差异(P0.05)。(2)骨痛症状在不同证型中的分布有统计学差异(P0.05)。气虚血瘀组和筋骨痹阻组均与其他3组存在统计学差异(p0.05),而气虚血瘀组与筋骨痹阻组之间无统计学差异(p0.05)。(3)有否脊柱变形在不同证型中的分布无统计学差异(P0.05)。(4)骨折发生率在不同证型中的分布中有显著统计学差异(P0.01)。气虚血瘀组与其余4组存在统计学差异(P0.05)(5)骨质疏松症有否合并高血压在各证型中的分布无统计学差异(P0.05)。(6)骨质疏松症有否合并冠心病在各证型中的分布有显著统计学差异(P0.01)。气虚血瘀组与筋骨痹阻组、肝肾阴虚组、脾肾阳虚组存在显著性差异(P0.01),与肾阳虚组存在统计学差异(P0.05)。结论:1.原发性骨质疏松症病位主要在肾,多或可涉及肝、脾。病理性质虚中夹实,阳、阴、气虚均较为多见。实性病理因素以血瘀、气滞为主。2.筋骨痹阻证多出现骨痛症状。气虚血瘀证多发骨痛、骨折,多合并冠心病。3.研究结果提示原发性骨质疏松症的治疗应以补肾为主,兼顾肝、脾,重视活血化瘀法的应用。对于气虚血瘀型患者强调活血止痛,预防骨折。
[Abstract]:Objective: to analyze the syndrome differentiation of primary osteoporosis (POP) by syndrome element differentiation, to discuss the distribution of TCM syndrome types, and to analyze the relationship between different syndromes and patients' general situation, disease characteristics and clinical indexes. So as to find the basis for the objective classification of TCM, which is conducive to the comprehensive analysis of the law of syndrome and treatment, for the early diagnosis of POP, typing, the establishment of treatment methods, the choice of prescription to provide theoretical support. Methods: the information of syndromes of 80 patients with primary osteoporosis was collected by using a unified information collection table, and the distribution characteristics of TCM syndromes of primary osteoporosis were analyzed by syndrome differentiation. The correlation between TCM syndromes and various factors was calculated by statistical method, and its characteristics were summarized. The result is 1: 1. Kidney is the most common syndrome, followed by spleen, liver, bones, heart, meridian. Among the factors of disease syndrome, deficiency syndrome is characterized by deficiency of yang, followed by deficiency of yin, deficiency of qi, deficiency of blood and deficiency of essence; the most frequent occurrence of syndrome factor is blood stasis, and the others are stagnation of qi, cold, heat, phlegm, dampness, and dampness. The most common TCM syndromes in order of frequency are liver and kidney yin deficiency, spleen and kidney yang deficiency, qi deficiency and blood stasis, kidney yang deficiency, and stagnation of muscles and bones. There was no significant difference in sex distribution among different syndrome types (P 0.05); there was no significant difference in bone mineral density (P 0.05); there was no significant difference in the distribution of height, body weight and BMI; there was no significant difference in the distribution of bone pain symptoms in different syndromes (P 0.05. 0. 05; P 0. 05; P 0. 05; P 0. 05; P 0. 05; P 0. 05; P 0. 05; P 0. 05; P 0. 05; P 0. 05); There was statistical difference between Qi deficiency and blood stasis group and the other three groups, but there was no significant difference between Qi deficiency and blood stasis group and bone obstruction group. (P 0.05) there was no significant difference in the distribution of spinal deformity in different syndromes. There was significant difference in the distribution of incidence rate among different syndromes (P 0.01). There was statistical difference between the Qi deficiency and blood stasis group and the other four groups (P < 0.05). There was no significant difference in the distribution of osteoporosis with hypertension in each syndrome type. There was no significant difference in the distribution of osteoporosis with coronary heart disease (P 0.01). There was significant difference between Qi deficiency and blood stasis group and stagnation group, liver and kidney yin deficiency group, spleen and kidney yang deficiency group (P 0.01), and there was statistical difference between Qi deficiency group and kidney yang deficiency group (P 0.05). Conclusion 1. Primary osteoporosis is mainly located in the kidney, more or may involve liver, spleen. The pathological nature of deficiency in the inclusion of consolidation, Yang, Yin, Qi deficiency are more common. Solid pathological factors were blood stasis and qi stagnation. The symptoms of bone pain are often found in the syndrome of arthralgia of the muscles and bones. Qi deficiency and blood stasis syndrome multiple bone pain, fracture, more complicated with coronary heart disease. 3. The results suggest that primary osteoporosis should be treated mainly by tonifying the kidney, taking into account the liver and spleen, and paying attention to the application of the method of promoting blood circulation and removing blood stasis. For Qi deficiency and blood stasis type patients emphasis on promoting blood circulation to relieve pain and prevent fracture.
【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

【相似文献】