急性胰腺炎发病特点及中医干预现状研究

发布时间：2018-06-28 07:43

本文选题：急性胰腺炎 + 回顾性研究　；参考：《广西中医药大学》2016年硕士论文

【摘要】：目的:通过对急性胰腺炎患者住院病历进行回顾性研究,总结分析急性胰腺炎发病特点及中医干预现状,为临床中医药防治急性胰腺炎提供理论参考。方法:收集来自广西中医药大学第一附属医院脾胃病科2010年11月至2015年11月期间收治住院所有第一诊断为急性胰腺炎的患者病历,共计160例。采用回顾性分析的方法对患者基本信息、发病年龄、性别、发病季节、发病诱因、实验室结果、中医诊断及中医治疗方法等,采用SPSS17.0统计软件对数据进行统计分析。结果:1.急性胰腺炎患者一般资料:研究的160例患者中,男性患者103例,女性患者57例,男女比例1.8:1;发病年龄与性别有统计学差异(P0.05),男性患者主要分布在青中年,而女性患者发病随着年龄的增长而增多。2.急性胰腺炎发病在不同季节中比较差异有统计学意义(P0.05),以夏秋季为发病高峰,夏季患者51例,秋季患者46例;在24节气中差异有统计学意义(P0.05),以处暑为最高,其次是立冬。3.急性胰腺炎发病病因中以胆道疾病居首位,在不同病因中比较差异有统计学意义(P0.05);发病病因与性别差异有统计学意义(P0.05),女性以胆道疾病为多,男性以饮酒、饮食不节、高脂血症较多;发病病因与发病年龄整体上有统计学差异(P0.05),胆道疾病以71岁以上最多,饮酒因素、饮食不节、不明原因因素均以31-40岁最多,高脂血症以41-50岁最多,手术创伤1例分布在51-60岁年龄段;发病病因与季节无统计学差异(P0.05)。4.急性胰腺炎中医诊断以腹痛为主;中医证型在季节的分布整体上存在差异(P0.05),其证型以湿热壅滞为主且以夏季最多,肝郁气滞证以春季最多,饮食停滞证以冬季最多,瘀毒互结证以秋季最多,内闭外脱证在各个季节中所占比例较少。5.急性胰腺炎中医治疗以中药内服、中药灌肠、中药烫疗为主;中药内服方以大柴胡汤、清胰汤、大承气汤为主;中西医与单纯西医两种治疗住院天数比较差异有统计学意义(P0.05),中西医治疗较单纯西医治疗住院时间短;中西医治疗和西医常规治疗效果比较差异有统计学意义(P0.05),中西医治疗总有效率95.49%,纯西医常规治疗总有效率85.19%。结论:1.急性胰腺炎发病在男性中以青中年为主,病因以饮酒因素、高脂血症为主,而女性以老年为主,病因以胆道因素为主;病因分布没有明显的季节性。急性胰腺炎发病与季节、节气有关系,发病季节以夏秋为主,发病节气以处暑、立冬为主。2.急性胰腺炎中医诊断以腹痛为主,各中医证型在季节分布中整体上存在差异。急性胰腺炎中医治疗以中药内服、中药灌肠、中药烫疗方法为主,中药方以大柴胡汤、清胰汤、大承气汤运用最多;中西医结合治疗比纯西医常规治疗住院时间缩短,总体疗效较佳,值得推广。
[Abstract]:Objective: to summarize and analyze the characteristics of acute pancreatitis (AP) and the current situation of TCM intervention in order to provide theoretical reference for the prevention and treatment of acute pancreatitis with traditional Chinese medicine (TCM). Methods: a total of 160 cases of acute pancreatitis were collected from the Department of spleen and stomach Diseases of the first affiliated Hospital of Guangxi University of traditional Chinese Medicine from November 2010 to November 2015. The basic information, age, sex, season, inducement, laboratory results, diagnosis and treatment of TCM were analyzed retrospectively. SPSS 17.0 software was used to analyze the data. The result is 1: 1. General data of patients with acute pancreatitis: among 160 patients in the study, 103 were male and 57 were female, the ratio of male to female was 1.8: 1.The age of onset was significantly different from that of sex (P0.05). The incidence of female patients increased with age. 2. 2. The incidence of acute pancreatitis was significantly different in different seasons (P0.05), with summer and autumn as the peak, 51 cases in summer and 46 cases in autumn, and the difference in 24 solar terms was statistically significant (P0.05), with the End of Heat as the highest, followed by the Beginning of Winter. 3. Among the causes of acute pancreatitis, biliary tract disease was the first cause, and the difference was statistically significant in different etiology (P0.05), the etiology and sex difference was statistically significant (P0.05), the female was more in biliary tract disease, the male was drinking alcohol, the diet was not proper. The etiology and age of hyperlipidemia were significantly different from those of age (P0.05), the most of biliary diseases were over 71 years old, the most of drinking, diet and unknown factors were 31-40 years old, and the most of hyperlipidemia were 41-50 years old. One case of surgical trauma was distributed in 51-60 years old, and there was no statistical difference between etiology and season (P0.05). 4. The TCM diagnosis of acute pancreatitis was mainly abdominal pain, the distribution of TCM syndromes was different in the whole season (P0.05), the syndrome types were mainly damp-heat stagnation and summer, liver stagnation in spring and diet stagnation in winter. The most common syndromes of blood stasis and toxin were in autumn, and the proportion of internal and external syndromes in each season was less. 5. The traditional Chinese medicine treatment for acute pancreatitis is Chinese medicine enema, traditional Chinese medicine hot therapy, traditional Chinese medicine internal prescription to big Chaihu decoction, Qing Yi Tang, Dachengqi decoction; There was significant difference in hospitalization days between traditional Chinese and western medicine and simple western medicine (P0.05). The hospitalization time of traditional Chinese and western medicine was shorter than that of pure western medicine. There was significant difference between traditional Chinese and western medicine treatment and routine treatment (P0.05). The total effective rate of traditional Chinese and western medicine therapy was 95.49 and the total effective rate of pure western medicine routine treatment was 85.19. Conclusion 1. Acute pancreatitis was mainly caused by youth and middle age in male, alcohol consumption and hyperlipidemia were the main etiology, while old age was the main cause and biliary tract was the main etiology in female. There was no obvious seasonal distribution of the etiology. The incidence of acute pancreatitis is related to season and solar terms. The season of acute pancreatitis is mainly summer and autumn, and the term of onset is the End of Heat, the Beginning of Winter. 2. Abdominal pain is the main diagnosis of acute pancreatitis. Traditional Chinese medicine is used to treat acute pancreatitis mainly by taking Chinese medicine, enema of traditional Chinese medicine, hot treatment of traditional Chinese medicine. Traditional Chinese medicine prescriptions include Dachaihu decoction, Qingyi decoction, Dachengqi decoction, and combination of traditional Chinese and Western medicine, and the hospitalization time is shorter than that of routine treatment of pure western medicine. The overall curative effect is better, it is worth popularizing.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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