福建及甘肃两地区男性海洛因成瘾者流行病学特征与中医证素关联研究

发布时间：2018-06-11 10:58

本文选题：福建 + 甘肃　；参考：《福建中医药大学》2017年硕士论文

【摘要】：目的:探究福建、甘肃两地区海洛因男性成瘾者的流行病学特征与中医证素关联关系,为在不同地区开展中医药临床戒毒和防复吸工作提供基础数据。方法:采用《毒品成瘾中医PRO量表》对2010-2016年福建省下属司法、公安等戒毒所和甘肃省嘉峪关市、酒泉市、平凉市下属戒毒所共524例(其中福建226例、甘肃298例)自愿参加调查的海洛因男性成瘾人员开展流行病学调查,包括人口学特征、吸毒行为特征、性行为特征、社会关系影响因素等内容。规范化收集四诊资料,应用证素辨证方法提取中医证素,在此基础上分析不同地区海洛因成瘾者中医证素特征及其与流行病学特征的关联。结果:1.流行病学特征:(1)两组吸毒人员均为男性,以汉族为主,甘肃组少数民族比例较福建组大;平均年龄分别为(38.55±s8.246)a、(39.98±s7.270)a;文化程度均以初中为主,两组学历构成比无明显差异,但福建组本科以上学历明显高于甘肃组;福建组其他职业所占比例最大,为27.4%,甘肃以无固定职业为主,占26.5%,甘肃从事农、林、牧、渔、水利生产人员较福建比例大;福建已婚比例低于甘肃。(2)两组地区吸毒年限均以1-3年为主,其次15年以上所占比例较大;吸毒方式福建以静脉注射为主,其次为烟枪吸,口服比例次之,甘肃以口服为主,其次为烟枪吸,静脉注射次之,两组在口服和静脉注射的比例具有差异。(3)吸毒原因均以好奇心理为主,其中选择"生活空虚","治疗疾病"的比例差异具有统计学意义;复吸原因均以毒友影响为主,福建组1年后复吸比例最高,甘肃组3月内复吸比例最高,甘肃组复吸时间总体较福建组短。(4)两组海洛因成瘾者均以单一性伴为主,但甘肃组多性伴比例更大;两组安全套使用率均较大,甘肃组不使用安全套原因中选择"没有想到"的比例大于福建组。(5)甘肃组每次使用毒品次数选择"每天1-2次"比例大于福建组;对毒品的渴求程度回答中,福建组缺失比例较大;吸毒后性生活方面,甘肃组总体性欲减退情况较福建严重;两组均感到海洛因成瘾对社会关系等方面影响较大,但对生活娱乐兴趣及与家人朋友矛盾程度的影响福建组小于甘肃组。2.中医证素特征两组男性海洛因成瘾者病位证素以肝、肾、脾为主,甘肃组肝病位证素相对突出:虚性证素以气虚为主,实性证素以气滞为主,甘肃组气滞证素相对突出;甘肃组各个证素成立比例明显高于福建。3.中医证素与流行病学特征的关系(1)成瘾严重程度相关指标与中医证素:①福建组:吸毒年限与血瘀、心、痰证素的成立显著相关,且为其危险因素;吸毒后健康状况变化与血瘀、心神、胆证素的成立显著相关,且为其危险因素。②甘肃组:吸毒后健康状况变化与血瘀、血虚、心神等证素的成立显著相关,且为其危险因素;脱毒后复吸时间则与血瘀、胃、湿热证素的成立显著相关,且为其保护因素;对毒品渴求程度与血瘀、痰、热证素的成立显著相关,且为其危险因素;每次使用毒品的量与心神证素的成立显著相关,且为其危险因素;每天花在毒品上的时间与肺证素的成立显著相关,且为其危险因素。(2)社会心理因素与中医证素:①福建组:对生活、娱乐兴趣下降程度与肝、脾、气虚、血虚证素的成立显著相关,且为其危险因素。②甘肃组:对生活、娱乐兴趣下降程度与血虚证素的成立显著相关,且为其危险因素;对社交活动的影响与痰、肺证素的成立显著相关,且为其危险因素。(3)其他流行病学特征与中医证素:①福建组:喜欢清淡饮食与肺证素的成立显著相关,且为其保护因素。因为出现稽延性戒断症状和失眠而复吸与心证素的成立显著相关,且为其危险因素;成瘾者婚姻情况与心神证素的成立显著相关,相对于未婚人员,已婚人员吸毒导致心神证素成立的可能性更大,离婚未再婚人员吸毒导致心神证素成立的可能性最大。②甘肃组:最终学历与胃证素的成立显著相关,且为其保护因素。结论:1.海洛因成瘾者平均年龄较吸食其他类型毒品成瘾者大;甘肃组婚姻状况较福建组复杂;但福建组总体文化水平、职业水平、经济水平较甘肃高;总体上海洛因成瘾呈现高龄化、高知化趋势,涉及各个行业,吸食海洛因等传统毒品成瘾情况有反弹趋势。2.成瘾者的好奇心理和难以抵制诱惑是导致两地吸毒和复吸的主要原因,在一定程度上反映了成瘾者的无知和安全意识的缺乏;海洛因成瘾均对两组人员的身体健康、生活兴趣、工作学习等方面造成较大影响,总体影响甘肃组更甚。3.海洛因成瘾可能与海洛因导致的多脏腑功能失调有关,以肝肾脾三脏为主,虚实夹杂是海洛因毒品成瘾的证候学特点,以里虚夹郁为主,存在一定的地域差异。4.血瘀、痰、心神证素可能与成瘾的严重程度密切相关,瘾越严重,证素的成立可能性越大,血瘀证素可能为海洛因成瘾者毒瘾严重程度的隐性指标;甘肃组热证素与瘾的关系更加密切,这可能与西北寒冷地区人们的饮食偏好肥甘厚味,加之长期吸食海洛因,体内多易出现滞热有关;脾、气虚、肝、血虚是影响海洛因成瘾者社会生活兴趣的重要中医证素;在保证营养的前提下,成瘾者应尽量提倡清淡饮食;复杂的婚姻情况可能会加重心神证素的成立可能。
[Abstract]:Objective: To explore the relationship between the epidemiological characteristics of heroin addicts in Fujian and Gansu, and to provide basic data for the clinical drug addiction treatment and anti relapse in different areas. Methods: using the PRO scale of traditional Chinese medicine of drug addiction to 2010-2016 years in Fujian Province, the Department of public security and other detoxification centers and Gansu province. A total of 524 heroin addicts in Jiayuguan, Jiuquan and Pingliang (of which 226 cases in Fujian and 298 in Gansu) were investigated voluntarily for the epidemiological investigation of heroin addicts, including demographic characteristics, drug behavior characteristics, sexual behavior characteristics, social relations and other factors. Methods the characteristics of TCM syndrome and its correlation with epidemiological characteristics of heroin addicts in different areas were analyzed. Results: 1. epidemiological characteristics were: (1) two groups of drug addicts were male, the majority of the Han people were Han, and the proportion of minority nationalities in Gansu group was larger than that of Fujian group; the average age was (38.55 + s8.246) a, (39.98 + s). 7.270) a; the educational level of the two groups had no obvious difference, but the degree of education of the Fujian group was obviously higher than that of the Gansu group; the other occupations in the Fujian group were the largest, 27.4%, and the Gansu had no fixed occupation, 26.5%. The Gansu was engaged in agriculture, forestry, animal husbandry, fishing, and water conservancy production personnel than Fujian; Fujian was married to the Fujian. The cases were lower than Gansu. (2) the number of years of drug use in the two groups was 1-3 years, followed by more than 15 years; the drug taking mode in Fujian was mainly intravenous, followed by the smoking gun, the second was the oral proportion, the Gansu was taken orally, the second was the smoking gun and the intravenous injection, and the two groups were different in the oral and intravenous injection. (3) drug abuse (3) drug abuse. The main reasons were curious psychology, among which, the proportion of "living empty" and "treating disease" was statistically significant. The cause of relapse was mainly caused by poisonous friends. The ratio of relapse in Fujian group was the highest after 1 years. In Gansu group, the ratio of relapse was the highest in March, and in Gansu group, the total relapse was shorter than that in Fujian group. (4) the two groups of heroin addicts were all single. Sex company was the main partner, but the proportion of Gansu group was larger than that of the two group. The ratio of "no thought" in Gansu group was greater than that of Fujian group. (5) the proportion of "1-2 times a day" in the use of drugs in Gansu group was greater than that of the Fujian group; in the response to the degree of drug craving, the proportion of the missing Fujian group was less than that of the Fujian group. In the aspect of sexual life after drug use, the total sexual abuses in Gansu group were more serious than that in Fujian; the two groups all felt that heroin addiction had great influence on social relations, but the interest in life and entertainment and the degree of contradiction with family and friends in the group of Fujian group were less than the.2. syndrome in the group of two groups of heroin addicts in the group of Gansu. Liver, kidney, spleen mainly, Gansu group liver disease level syndrome is relatively prominent: deficiency syndrome with Qi deficiency mainly, real syndrome with qi stagnation, Gansu group qi stagnation is relatively prominent, the proportion of Gansu group syndrome elements is significantly higher than the Fujian.3. TCM syndrome and epidemiological characteristics (1) correlation index of addiction severity and TCM syndrome: (1) Fujian Group: the duration of drug abuse was significantly related to the establishment of blood stasis, heart and phlegm syndrome, and it was a risk factor. The change of health status after drug abuse was significantly related to the establishment of blood stasis, heart God, biliary syndrome and its risk factors. (2) Gansu group: the change of health status after drug use was significantly related to the establishment of blood stasis, blood deficiency and heart God, and its risk factors; The time of drug relapse was significantly related to the establishment of blood stasis, stomach and damp heat syndrome, and it was a protective factor. The degree of drug craving was significantly related to the establishment of blood stasis, phlegm, heat syndrome and its risk factors; the amount of drug use was significantly related to the establishment of the heart syndrome element, and it was a risk factor; the time and lung spent on drugs every day. The establishment of the syndrome factor was significantly related, and it was a risk factor. (2) social psychological factors and TCM syndromes: (1) Fujian group: the decline of interest in life and entertainment was significantly related to the establishment of liver, spleen, Qi deficiency and blood deficiency syndrome, and it was a risk factor. (2) the decline of interest in life and entertainment was significantly related to the establishment of blood deficiency syndrome in the Gansu group. The risk factors, the influence on social activities and the establishment of phlegm and pulmonary syndrome, and its risk factors. (3) other epidemiological characteristics and TCM syndrome: (1) Fujian group: there is a significant correlation between the light diet and the establishment of lung syndrome, and it is a protective factor. There was a significant correlation and a risk factor; the marital status of addicts was significantly related to the establishment of the heart syndrome factor. Relative to the unmarried people, the possibility of the establishment of the heart syndrome hormone was greater than that of the unmarried people. The possibility of the establishment of the heart syndrome in the divorced unmarried people was the most likely. (2) the Gansu group: the final education and the establishment of the stomach syndrome. The average age of 1. heroin addicts was larger than that of other types of drug addicts; the marital status of the Gansu group was more complex than that of the Fujian group; but the overall cultural level, the professional level and the economic level of the Fujian group were higher than that of the Gansu group; and the general tendency of the addiction in Shanghai was higher, and the trend of high knowledge was involved in various industries. Traditional drug addiction, such as heroin, has a tendency to rebound, the curious psychology of.2. addicts and the difficulty of resisting temptation is the main cause of drug addiction and relapse in both places, to a certain extent, it reflects the ignorance and lack of safety awareness of the addicts; heroin addiction is all for the health, interest, work and study of the two groups of people. There is a great influence on the surface of the more.3. heroin addicts in the Gansu group, which may be related to the dysfunction of the multiple Zang Fu organs caused by heroin, mainly with the liver, kidney and spleen, and the deficiency and solid inclusion is the syndrome characteristics of heroin addicts, mainly with Li Xu Qi depression, and there are some regional differences in.4. blood stasis, phlegm, and the Xin Shen syndrome may be strict with addiction. The more closely related to the degree of heavy addiction, the more serious the addiction, the greater the possibility of the establishment of the syndrome element, the blood stasis syndrome may be a recessive index of the severity of the heroin addicts, and the relationship between the heat syndrome and the addiction of the Gansu group is more closely. This may be with the diet preference of the people in the cold region of the northwest and the long-term absorption of heroin. Heat related; spleen, Qi deficiency, liver and blood deficiency are the important TCM syndromes that affect the social life of heroin addicts. Under the premise of nutrition, the addicts should try to promote the light diet, and the complex marital status may aggravate the possibility of the establishment of the heart syndrome.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.7

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