急性酒精中毒中医证候的初步研究

发布时间：2018-06-27 01:28

本文选题：急性酒精中毒 + 中医证候　；参考：《安徽中医药大学》2016年硕士论文

【摘要】：1目的通过文献调查研究和临床调查研究的方法,初步探索出急性酒精中毒的中医证侯特点、中医证素和中医辩证分型的分布规律、临床指标与中医证型的相关性,为临床中医辨证治疗急性酒精中毒提供具有参考价值的理论依据,为确立统一的和标准的急性酒精中毒中医诊疗指南或规范贡献自己的一份力量。2方法2.1文献研究通过制定检索词和检索时间两个方面,检索中医古籍知识库、中国学术期刊全文数据库(CNKI)、万方数据库、中文科技期刊数据库(维普)、国家发布的行业标准、著作和教材等文献,统计急性酒精中毒中医四诊信息的频数和百分比,根据统计结果制定急性酒精中毒中医证侯信息初步调查表。2.2制定正式急性酒精中毒中医证侯临床调查表对急性酒精中毒中医证侯信息初步调查表进行专家咨询评价和临床试填,修改完善后形成正式调查表。2.3临床研究使用急性酒精中毒中医证侯信息调查表收集临床患者一般情况(包括年龄、性别、职业、身高和体重等)、中医四诊信息和临床指标信息。2.4统计方法使用统计软件SPSS 17.0对患者的一般情况和中医四诊信息进行描述性统计分析,对整理后的中医四诊信息进行因子分析和聚类分析。3结果3.1发病特点急性酒精中毒患者的发病率男性远大于女性,为女性的4.3倍(男:女=4.3:1),发病年龄主要集中在20~50岁年龄段之间,其中以20~30岁之间患者最多,以学生居多,未婚患者与已婚患者数量相当,文化程度多在初中文化以上,常见的并发症有上消化道出血、低血糖、低血压、低钾血症、代谢性酸中毒、心律失常、急性肝损伤、双硫仑反应和呼吸衰竭等,最常见的并发症为心律失常,发生率为9%,最严重的并发症为呼吸衰竭,发生率较低,为0.6%。3.2急性酒精中毒中医证侯分布特点百分比在10%以上的共有20条,包括恶心呕吐、胃脘灼痛、多笑多言,心悸怔忡、头目胀痛、急躁易怒、目赤眩晕、气喘息粗、神识不清、面色苍白、四肢厥冷、嗳气、身热口渴、胸闷、胁痛、大便秘结、小便短黄和二便失禁、大便秘结和小便短黄,舌色以舌淡(32%)和舌绛(23.67%)为主,舌苔则以黄苔(38.00%)或白腻苔(32.00%)为主,脉象以脉弦数、脉细数和脉微欲绝为主。3.3急性酒精中毒的中医辨证分型通过对急性酒精中毒中医四诊信息进行因子分析后,结果得出11个公因子,根据中医诊断标准和临床经验判断:因子F1、公因子F5、公因子F6为脱证因子;公因子F2、F7为心阴虚证因子;公因子F3、公因子F11为肝证因子;公因子F4、公因子F10为湿热证因子;公因子F8、F9为实热证因子,经聚类分析后,将急性酒精中毒分为:湿热蕴脾证、肝火炽盛证、痰火扰心证、气阴两虚证和脱证五大型。4结论急性酒精中毒患者的中医证侯特点:前期以实证为主,病性主要为湿热,病位主要在脾胃;中期兼有实证和虚证,病性以内热为主,病位主要在肝胆;后期以虚证为主,病性以虚热为主,病位主要在心脏。病机特点:酒作为湿热之邪,前期摄入人体,首损脾胃,即湿热蕴结脾胃;中期湿热久郁化生内热,传及肝胆,此时脾胃已伤,即:脾胃虚弱,肝火炽盛;后期脾胃虚弱,聚生痰饮,痰火互结,扰乱心神,久则耗伤津液而发脱证。湿热蕴脾证、肝火炽盛证、痰火扰神证、气阴两虚证和脱证为急性酒精中毒患者常见的中医证侯类型。
[Abstract]:1 through the methods of literature investigation and clinical investigation, the characteristics of TCM syndrome of acute alcoholism, the distribution of TCM syndrome and the dialectical type of TCM, the correlation of clinical indexes and TCM syndrome types are found, and the theoretical basis for the treatment of acute alcoholism in clinical TCM syndrome differentiation is provided. A unified and standard TCM diagnosis and treatment guidelines for acute alcoholism or standard contribution to their own strength.2 method 2.1 literature research through the formulation of two aspects of retrieval words and retrieval time, retrieval of Chinese ancient books knowledge base, Chinese academic journal full text database (CNKI), Wanfang database, Chinese sci-tech journal database (VP), national hair The frequency and percentage of the four diagnosis information of acute alcoholism, the preliminary questionnaire of TCM syndrome of acute alcoholism,.2.2, the preliminary questionnaire of TCM syndrome of acute alcoholism on acute alcoholism, the preliminary questionnaire of TCM syndrome information on acute alcoholism Expert consultation and evaluation and clinical trial filling, revision and improvement, formal questionnaire.2.3 clinical study using acute alcoholism TCM syndrome information questionnaire to collect clinical patients general conditions (including age, sex, occupation, height and weight), TCM four diagnosis information and clinical index information.2.4 statistical method using the statistical software SPSS 17 A descriptive statistical analysis of the general situation of the patients and the information of four diagnosis of traditional Chinese medicine, the factors of factor analysis and cluster analysis of the four diagnosis information of traditional Chinese medicine after the arrangement were analyzed by.3 results. The incidence of acute alcoholism among the male patients was far greater than that of women, 4.3 times as much as women (male: =4.3:1), and the age of onset was mainly at the age of 20~50 years. Among them, the majority of the patients were 20~30 years old, the majority of the students, the number of unmarried patients and married patients, more culture above the junior middle school culture, the common complications were upper gastrointestinal bleeding, hypoglycemia, hypotension, hypokalemia, metabolic acidosis, arrhythmia, acute liver injury, disulfdison reaction and respiratory failure, and so on. The common complication is arrhythmia, the incidence rate is 9%, the most serious complication is respiratory failure, the incidence is low, the percentage of the TCM Syndromes of 0.6%.3.2 acute alcoholism is more than 10%, including nausea and vomiting, stomachache pain, more laughter, palpitation, headache, irritability, dizziness and gasping. Thick, pale, pale, cold face, belching, body heat thirst, chest tightness, hypochondriac pain, constipation, stool short yellow and two feces incontinence, constipation and urine incontinence, lingual color with tongue light (32%) and tongue crimson (23.67%), tongue fur with yellow moss (38%) or white greasy moss (32%), pulse image with pulse string number, pulse detail and pulse micro desire to be.3.3 urgent. The TCM syndrome differentiation of alcoholic intoxication was analyzed by factor analysis of four diagnosis information of acute alcoholism, the results obtained 11 common factors, according to the diagnosis standard and clinical experience of Chinese medicine: factor F1, common factor F5, and common factor F6 as the proof factor; public factor F2, F7 as the deficiency syndrome factor of heart Yin; public factor F3, public factor F11 as the liver syndrome factor The male factor F4 and the public factor F10 are the damp heat syndrome factor; the public factor F8 and the F9 are the real heat syndrome factors. After the cluster analysis, the acute alcoholism is divided into the characteristics of TCM syndrome of the patients with acute alcoholism: the damp heat accumulation syndrome, the liver fire flaming syndrome, the phlegm fire and the heart syndrome, the Qi Yin two deficiency syndrome and the five large.4 conclusion of acute alcohol poisoning: the early stage is mainly empirical and the disease is mainly wet. Heat, the disease is mainly in the spleen and stomach; in the middle of the disease, the main disease is heat, the disease is mainly in the liver and gallbladder, the latter is mainly in the liver and the liver, the disease is mainly in the deficiency syndrome, the disease is mainly in the heart. The disease position is mainly in the heart. The disease machine features: the wine is the damp heat evil, the early intake of the human body, the first loss of the spleen and stomach, that is, the damp heat contains the spleen and stomach; At this time, the spleen and stomach have been injured, that is, weak spleen and stomach, liver fire, weak spleen and stomach, accumulation of sputum, phlegm and fire, disturbing heart, and injure body fluid for a long time.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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