腹泻型肠易激综合征中医证型与小肠细菌过度生长及口—盲通过时间相关性研究

发布时间：2018-06-17 15:30

本文选题：肠易激综合征 + 中医证型　；参考：《福建中医药大学》2016年硕士论文

【摘要】：目的：通过氢呼气试验检测腹泻型肠易激综合征(IBS-D)不同中医证型与小肠细菌过度生长(SIBO)及口-盲通过时间(OCTT)之间的关系,探讨IBS-D中医证型与SIBO及OCTT的相关性,为本病的中医证型客观化及临床的辨证施治提供一定的依据。方法：收集2015年02月-2016年02月福建省第二人民医院门诊、住院及体检中心符合IBS-D西医诊断标准及中医诊断标准中属于肝郁脾虚、脾虚湿阻、脾胃湿热、脾肾阳虚等四类证型的病人60例。收集患者的一般资料及临床资料：姓名、性别、年龄、肠镜、大便OB、血常规、生化指标等,运用统计学方法分析IBS-D中医证型与SIBO及OCTT相关性。结果：1、年龄与SIBO关系：经卡方检验,P0.05,差异具有统计学意义；组间两两比较：20-29组与40-49组比较P0.05,差异具有统计学意义,与30-39、50-59组比较,P0.05,差异无统计学意义；30-39组分别与40-49、50-59组比较均提示P0.05,差异无统计学意义；40-49组与50-59组比较：P0.05,差异具有统计学意义。可知40-49组相比20-29组及50-59组,SIBO的阳性患者更多,其他各年龄组之间SIBO的阳性人数无显著差异性。2、年龄与OCTT之间的关系：P0.05,差异无统计学意义3、各证型与SIBO关系：三组小肠细菌过度生长情况经卡方检验,P=0.040.05,差异具有统计学意义。SIBO的阳性率方面：肝郁脾虚组中阳性率为67.9%,脾虚湿阻组中阳性率为50.0%,脾胃湿热组中阳性率为32.0%。组间两两比较：肝郁脾虚组与脾胃湿热组：P=0.010.05,差异具有统计学意义；肝郁脾虚组与脾虚湿阻组：P=0.530.05,差异无统计学意义；脾胃湿热组与脾虚湿阻组：P=0.550.05,差异无统计学意义。可见肝郁脾虚组SIBO阳性率高于脾胃湿热组,而与脾虚湿阻组无显著差异；脾胃湿热组与脾虚湿阻组在SIBO阳性率上无明显差异。4、各证型与OCTT比较：三组OCTT的人数情况,情况经卡方检验,P0.05,差异具有统计学意义。总结分析各组中的OCTT情况比例,可知肝郁脾虚组以OCTT延长者为主,脾胃湿热组以OCTT过快为主,脾虚湿阻组以OCTT正常者为主。5、SIBO与OCTT情况比较：计数资料采用卡方检验,P0.05,差异具有统计学意义。SIBO阳性患者中,以OCTT延长者为主,OCTT正常次之,OCTT过快较少；SIBO阴性患者中,以OCTT过快为多,OCTT正常次之,OCTT延长最少。结论：1、IBS-D不同中医证型的SIBO及OCTT结果存在差异,利用氢呼气检测评估SIBO及OCTT情况,有助于中医辨证。2、氢气呼气检测试验作为一种无创、简便、可靠的检测方法,在运用于研究IBS-D中医证型客观化方面具有明显价值。
[Abstract]:Objective: to detect the relationship between different TCM syndromes and intestinal bacterial overgrowth (SIBO) and oral blind transit time (OCTT) by hydrogen breath test in diarrhea irritable bowel syndrome (IBS-D), and to explore the correlation between IBS-D TCM syndrome type and SIBO and OCTT. To provide some basis for the objective of TCM syndromes and clinical application of syndrome differentiation. Methods: from February 2015 to February 2016, the outpatient, inpatient and physical examination center of the second people's Hospital of Fujian Province accorded with IBS-D diagnostic criteria of western medicine and TCM diagnostic criteria of liver stagnation and spleen deficiency dampness obstruction, spleen stomach dampness and heat. There were 60 patients with spleen and kidney yang deficiency and other four types of syndromes. The general data and clinical data of the patients were collected: name, sex, age, enteroscopy, stool OB, blood routine, biochemical index and so on. The correlation between TCM syndrome type of IBS-D and SIBO and OCTT was analyzed by statistical method. Results: the relationship between age and SIBO was statistically significant by chi-square test (P0.05), and there was no significant difference between 20-29 group (P 0.05) and 40-49 group (P 0.05) compared with 30-3950-59 group (P 0.05). The comparison between 30-39 group and 40-49-59 group showed that P0.05, there was no significant difference between 40-49 group and 50-59 group (P 0.05), the difference was statistically significant. There were more SIBO positive patients in 40-49 group than in 20-29 group and 50-59 group. There was no significant difference in the number of SIBO positive persons among other age groups. The relationship between age and OCTT was: P0.05, the difference was not statistically significant. The relationship between each syndrome type and SIBO: the overgrowth of intestinal bacteria in the three groups was tested by chi-square test (P0.040.05), the difference was significant. The positive rate of SIBO was 67.9 in liver stagnation and spleen deficiency group, 50.0 in spleen deficiency dampness block group and 32.0 in spleen stomach dampness heat group. Comparison between two groups: the difference was statistically significant between the liver stagnation and spleen deficiency group and the spleen and stomach dampness heat group, the difference was statistically significant, the difference was not statistically significant between the liver stagnation and spleen dampness deficiency group and the spleen deficiency dampness block group, the difference was not statistically significant, while the spleen and stomach dampness heat group and the spleen deficiency dampness block group had no statistical significance, the difference was not statistically significant. It can be seen that the positive rate of SIBO in liver stagnation and spleen deficiency group is higher than that in spleen and stomach dampness heat group, but there is no significant difference between spleen and stomach damp-heat group and spleen deficiency dampness block group in SIBO positive rate. 4. There is no significant difference in SIBO positive rate between spleen and stomach damp-heat group and spleen deficiency dampness block group. After chi-square test, the difference was statistically significant (P 0.05). The proportion of OCTT in each group was summarized and analyzed. The results showed that OCTT was prolonged in liver stagnation and spleen deficiency group and OCTT was too fast in spleen and stomach dampness heat group. Comparison between OCTT and OCTT in spleen deficiency dampness obstruction group: counting data were compared with OCTT by chi-square test (P0.05), the difference was statistically significant in SIBO positive patients, OCTT prolongation was the most common OCTT and OCTT was less in SIBO negative patients. When OCTT was too fast, the extension of OCTT was the least in normal OCTT. Conclusion there are differences in the results of SIBO and OCTT among different TCM syndromes of different types of IBS-D. The evaluation of SIBO and OCTT by hydrogen breath test is helpful to the diagnosis of TCM syndrome differentiation. Hydrogen breath test is a noninvasive, simple and reliable method for detecting SIBO and OCTT. It has obvious value in studying the objectification of IBS-D TCM syndromes.
【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】：2016
【分类号】：R259

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