重症肌无力中医证素分布规律研究

发布时间：2018-07-03 00:25

本文选题：重症肌无力 + 文献回顾　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：目的:本研究以中医理论为基础,收集了近20年有关重症肌无力证型研究及治疗的中医临床文献,总结得出重症肌无力的证素特点及证型分布规律,为重症肌无力临床规范辨证提供理论指导。方法:从中国知网文献数据库筛选近20年有关重症肌无力辨证的文献,建立数据库,对所收集到的证型和证素通过统计学方法进行频次、频率、聚类等分析,研究探讨其规律,再根据相关的中医理论对结果进行全面分析。结果:1.收集到有关中医药辨证治疗重症肌无力的临床研究文献28篇,纳入病例共计7989例,归纳不同辨证分型共计22个,其中频率5%的前4个证型分别为脾气虚型、脾肾阳虚型、气阴两虚型、肝肾阴虚型。2.提取到重症肌无力证素共计18个,其中包含6个病位证素(脾、肾、肝、胃、经络、肺)及12个病性证素(气虚、阴虚、阳虚、血虚、热、血瘀、湿、津亏、气陷、气滞、痰、动风)。3.据病位证素分布特点数据可以得知重症肌无力的主要病位在脾。由病性证素分布特点可知,气虚是该病最主要的病性证素。据复合病位证素分布表得知,这里脾+肾的病位组合出现频次最多,说明了先天之本肾与后天之本脾相结合,共同致痿。从病性虚实分布表看出,虚性病性证素在总病性中占比明显高于实性类病性证素,这说明重症肌无力的病机特点为虚实夹杂、但以虚性病性为主。通过对各表的分析,可以得知本病的确没有有关寒性病性证素的样本。4.通过聚类分析得出,重症肌无力的证素聚类中,脾、气虚为一类;肾、阴虚、阳虚为一类;胃、肝、血虚、经络、血瘀、湿、热为一类,可能提示这3类为重症肌无力基本病机单位。结论:(1)通过收集相关文献结合《中医内科学》教材中有关辨证分型,我们可以将重症肌无力的证型归纳为:脾气虚型、脾肾阳虚型、肝肾阴虚型、湿热浸淫型、脉络淤阻型。(2)重症肌无力主要证素共18个,其中病位证素包括脾、肾、肝、胃、经络、肺;病性证素包括气虚、阴虚、阳虚、血虚、热、血瘀、湿、津亏、气陷、气滞、痰、动风。(3)证素特点的认识:脾是最主要的病位证素;气虚是主要病性证素;脾与肾二证素结合致痿;虚实夹杂,本虚标实,以虚为主是病机特点;痿病无寒。
[Abstract]:Objective: Based on the theory of traditional Chinese medicine, this study collected the clinical literature about the research and treatment of myasthenia gravis in the past 20 years, summed up the characteristics of myasthenia gravis and the pattern of syndrome distribution, and provided theoretical guidance for the clinical standard differentiation of myasthenia gravis. Method: screening from the Chinese knowledge network database for nearly 20 years. The literature of myasthenia gravis syndrome differentiation, the establishment of a database, the collection of syndrome and syndrome through statistical methods, frequency, frequency, clustering analysis, study its laws, and then according to the related theory of traditional Chinese medicine to carry out a comprehensive analysis. Results: 1. collection of clinical literature about TCM syndrome differentiation for myasthenia gravis 2 8 cases were included in the total of 7989 cases, including 22 different types of syndrome differentiation, of which the first 4 syndromes of frequency 5% were spleen qi deficiency type, spleen kidney yang deficiency type, Qi Yin deficiency type, liver kidney yin deficiency type.2. extraction to myasthenia gravis 18, including 6 syndrome elements (spleen, kidney, liver, stomach, meridian, lung) and 12 disease factors (Qi deficiency, Yin) Deficiency, Yang deficiency, blood deficiency, heat, blood stasis, damp, Tianjin, qi stagnation, qi stagnation, phlegm, movement wind).3. according to the distribution characteristic data of the disease position syndrome factor can be found that the main disease of myasthenia gravis is in the spleen. It shows that the congenital kidney is combined with the spleen of the day after the disease. From the distribution table of the disease, it can be seen that the proportion of venereal syndrome in the total disease is obviously higher than that of the solid disease syndrome, which indicates that the pathogenesis of myasthenia gravis is virtual and solid, but it is mainly a virtual venereal disease. It is true that the disease does not have a sample of cold sex syndrome factor.4. through cluster analysis. In the cluster analysis of myasthenia gravis, spleen and Qi deficiency are a class, kidney, yin deficiency and yang deficiency are a class; stomach, liver, blood deficiency, meridian, blood stasis, dampness, heat are one type, which may suggest that these 3 types are basic pathogenesis units of myasthenia gravis. (1) collects related literature by collecting relevant literature < Chinese Medicine Medicine > teaching material about syndrome differentiation, we can conclude the syndrome type of myasthenia gravis: spleen qi deficiency type, spleen kidney yang deficiency type, liver kidney yin deficiency type, damp heat immersion type, choroid stasis type. (2) the main syndromes of myasthenia gravis are 18, including the spleen, kidney, liver, stomach, meridian, lung; syndrome factors including Qi deficiency, yin deficiency and yang deficiency Blood deficiency, heat, blood stasis, wet, Tianjin loss, gas depression, qi stagnation, sputum, moving wind. (3) the characteristics of the syndrome: the spleen is the most important syndrome factor; Qi deficiency is the main syndrome factor; the spleen and kidney two syndrome are combined with flaccid, deficiency and solid, the deficiency is the main point of the disease machine, and the disease is not cold.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.7

【参考文献】