经前期综合征（PMS）的文献研究及山西中医学院女大学生PMS的证候调查研究
发布时间：2018-08-20 08:55
【摘要】：研究目的本研究主要是探索近10余年来中医文献经前期综合征(PMS)的证候分布特点,为编制调查表提供参考依据;初步探讨山西中医学院女大学生PMS的发病率及中医临床证候分布规律,为女大学生规范化的辨证施治和临床诊疗奠定重要的理论基础。研究方法通过检索近1O余年来经前期综合征的文献资料,根据纳入与剔除标准,选取符合的文献,对其证候进行统计、分析,结合PMS的中医病因病机、西医病因病理,总结中医辨证及临床诊断分型所需的诊断资料,设计所需问卷调查的项目。对山西中医学院年龄在18-25岁女大学生进行问卷调查,初步筛查出符合PMS诊断标准的受试者。对所筛选的受试者,进行经前期综合征症状、体征调查表的填写,问卷结果经调查者认真审查后,将全部数据录入EpiData3.1软件,应用SPSS17.0统计软件对所得的数据资料进行统计学分析,分析相关数据是否存在统计学意义。研究结果1.文献研究1.1文献研究资料经过规范化地提取,本病出现的主要证型(频次≥10),共计7个;其频次频率由多到少依次为:肝气郁结证(35次,16.2%)、脾肾阳虚证(14次,6.48%)、肝肾阴虚证(13次,6.02%)、气滞血瘀证(11次,5.09%)、肝郁化火证(10次,4.63%)、肝气逆证(10次,4.63%)、肝郁脾虚证(10次,4.63%)。1.2文献研究结果显示:本病涉及的脏腑包括肝、脾、肾,其中主要以肝为主,构成比为53.13%,其次为脾,构成比为20.54%,再次为肾,构成比为18.30%,三者累计频率为91.97%。1.3文献研究结果显示:病性要素频次频率排在前3位由高到低,依次分别是气滞(85次,28.81%)、火/热(43次,14.58%)和阴虚(37次,12.54%)。实性证候要素以气滞为主,虚性证候要素以阴虚为主。2.临床研究2.1调查山西中医学院女大学生972人,发现PMS患者406人,PMS的患病率为41.77%。2.2女大学生经前期综合征高发年龄为23-25岁,高发年级为大五,与所在专业无关。2.3临床证型研究结果显示:主证由多到少,依次为肝气逆证168例(45.16%),肝气郁结证96例(25.81%),肝郁化火证63例(16.94%),肝郁脾虚证30例(8.06%),气滞血瘀证15例(4.03%),肝肾阴虚证0例,脾肾阳虚证0例。次证由多到少,依次为肝郁脾虚证88例,约占33.72%;肝郁化火证53例,约占20.31%;肝气郁结证35例,约占13.41%;脾肾阳虚证29例,约占11.11%;气滞血瘀证28例,约占10.73%;肝气逆证21例,约占8.05%;肝肾阴虚证7例,约占2.68%。本病各种证候的主证及次证分布有显著性差异(P0.05)。2.4临床症状研究结果显示:此次调查的经前期综合征症状共36项,精神症状频数居前两位的是:急躁易怒262例(70.43%)、情绪抑郁143例(38.98%);行为改变症状频数居前两位的是:注意力不集中278例(77.73%)、学习能力下降236例(63.44%);躯体症状频数居前10位统计的是:小腹胀痛293例(78.76%)、疲乏256例(68.82%)、乳房胀痛242例(65.05%)、失眠多梦203例(54.57%)、脘腹胀满196例(52.69%)、头痛188例(50.54%)、胸闷176例(47.31%)、胸胁胀痛167例(44.89%)、心烦137例(36.83%)、纳呆125例(33.60%)。本病各种症状轻度、中度、重度程度分布有显著性差异(P0.05)。研究结论1.文献研究资料经过规范化地提取,本病证型以肝气郁滞证、脾肾阳虚证、肝肾阴虚证、气滞血瘀证、肝郁化火证、肝气逆证、肝郁脾虚证为主。本病病位在肝、脾、肾等脏腑,主要以肝为主。病理性质虚实错杂。实证以气滞为主;虚证以阴虚为主。2.本次调查结果显示:所调查人群PMS的发病率为41.77%,与文献资料相符合。3.本次调查结果显示:本病主证主要以肝气逆证(45.16%)和肝气郁结证(25.81%)为主,故主证以肝失疏泄的证型为主,次证主要以肝郁脾虚证(33.72%)、肝郁化火证(20.31%)和肝气郁结证(13.41%)为主,故次证中肝郁的变证是出现最多的证型。4.本次调查结果显示:小腹胀痛(78.76%)、注意力不集中(77.73%)、急躁易怒(70.43%)是该人群PMS患者最常见的症状。
[Abstract]:Objective To explore the distribution of symptoms of premenstrual syndrome (PMS) in the literature of traditional Chinese medicine (TCM) in the past 10 years, and to provide a reference for the preparation of the questionnaire; to explore the incidence of PMS and the distribution of clinical symptoms of TCM among female college students in Shanxi University of Traditional Chinese Medicine, and to lay a foundation for the standardized treatment and clinical diagnosis of female college students. Research methods: By searching the literature of PMS in the past 10 years, according to the inclusion and exclusion criteria, select the suitable literature, make statistics and Analysis on its syndrome, combine with the etiology and pathogenesis of PMS, etiology and pathology of Western medicine, summarize the diagnostic data needed for TCM syndrome differentiation and clinical diagnosis, and design the questions needed. A questionnaire survey was conducted among female college students aged 18-25 in Shanxi College of Traditional Chinese Medicine. The subjects who met the diagnostic criteria of PMS were screened. The symptoms and signs of premenstrual syndrome were filled out in the questionnaire. The results of the questionnaire were carefully examined and entered into EpiData 3.1 software. SPSS17.0 statistical software was used to analyze the data and analyze whether the relevant data were statistically significant. Results 1. Literature research 1.1 After standardized extraction of literature research data, the main syndrome types (frequency < 10), a total of 7; its frequency from more to less in turn is: liver qi stagnation syndrome (35 times, 1. 6.2%, spleen and kidney yang deficiency syndrome (14 times, 6.48%), liver and kidney yin deficiency syndrome (13 times, 6.02%), qi stagnation and blood stasis syndrome (11 times, 5.09%), liver depression and fire (10 times, 4.63%), liver Qi reversal syndrome (10 times, 4.63%) and liver depression and spleen deficiency syndrome (10 times, 4.63%). 1.3 The results of literature study showed that the frequency of the disease factors ranked the top three from high to low, followed by qi stagnation (85 times, 28.81%), fire / heat (43 times, 14.58%) and yin deficiency (37 times, 12.54%). Clinical research 2.1 Investigation of 972 female college students in Shanxi College of Traditional Chinese Medicine, found that 406 patients with PMS, the prevalence of PMS was 41.77%. 2.2 Female college students with premenstrual syndrome high-incidence age of 23-25 years old, high-incidence grade for the fifth, and their major has nothing to do. 2.3 Clinical syndrome type research results show that the main syndrome from more to less, followed by liver-qi syndrome 168. Cases (45.16%), 96 cases (25.81%), 63 cases (16.94%), 30 cases (8.06%) of liver depression and spleen deficiency, 15 cases (4.03%) of qi stagnation and blood stasis, 0 cases of liver and kidney yin deficiency, and 0 cases of spleen and kidney yang deficiency. 29 cases of kidney yang deficiency syndrome, accounting for 11.11%; 28 cases of qi stagnation and blood stasis syndrome, accounting for 10.73%; 21 cases of liver qi deficiency syndrome, accounting for 8.05%; 7 cases of liver and kidney yin deficiency syndrome, accounting for 2.68%. The distribution of various syndromes and sub-syndromes of this disease has significant differences (P The first two were impatience and irritability in 262 cases (70.43%) and emotional depression in 143 cases (38.98%); behavioral changes in 278 cases (77.73%), learning ability in 236 cases (63.44%) and physical symptoms in 293 cases (78.76%), fatigue in 256 cases (68.82%) and breast swelling pain in 242 cases (65.05%). 203 cases (54.57%), 196 cases (52.69%), 188 cases (50.54%) of headache, 176 cases (47.31%) of chest tightness, 167 cases (44.89%), 137 cases (36.83%) of anxiety, 125 cases (33.60%) of dementia. There were significant differences in the distribution of mild, moderate and severe symptoms (P 0.05). Conclusion 1. The main syndrome types are stagnation of liver-qi, deficiency of spleen-kidney yang, deficiency of liver-kidney yin, stagnation of Qi and blood stasis, stagnation of Liver-qi to dissipate fire, reversion of liver-qi, and deficiency of liver-qi and spleen. The incidence of the disease was 41.77%, which was consistent with the literature. 3. The results showed that the main syndromes of the disease were liver-qi inverse syndrome (45.16%) and Liver-qi Stagnation Syndrome (25.81%). So the main syndromes were liver-qi loss and discharge syndrome, the secondary syndromes were liver-qi stagnation and spleen-deficiency syndrome (33.72%), Liver-qi Depression and fire-removing syndrome (20.31%) and Liver-qi Stagnation Syndrome (13.41%). The results of this survey showed that abdominal distention and pain (78.76%), inattention (77.73%) and irritability (70.43%) were the most common symptoms of PMS.
【学位授予单位】：山西中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.115
本文编号：2193075
[Abstract]:Objective To explore the distribution of symptoms of premenstrual syndrome (PMS) in the literature of traditional Chinese medicine (TCM) in the past 10 years, and to provide a reference for the preparation of the questionnaire; to explore the incidence of PMS and the distribution of clinical symptoms of TCM among female college students in Shanxi University of Traditional Chinese Medicine, and to lay a foundation for the standardized treatment and clinical diagnosis of female college students. Research methods: By searching the literature of PMS in the past 10 years, according to the inclusion and exclusion criteria, select the suitable literature, make statistics and Analysis on its syndrome, combine with the etiology and pathogenesis of PMS, etiology and pathology of Western medicine, summarize the diagnostic data needed for TCM syndrome differentiation and clinical diagnosis, and design the questions needed. A questionnaire survey was conducted among female college students aged 18-25 in Shanxi College of Traditional Chinese Medicine. The subjects who met the diagnostic criteria of PMS were screened. The symptoms and signs of premenstrual syndrome were filled out in the questionnaire. The results of the questionnaire were carefully examined and entered into EpiData 3.1 software. SPSS17.0 statistical software was used to analyze the data and analyze whether the relevant data were statistically significant. Results 1. Literature research 1.1 After standardized extraction of literature research data, the main syndrome types (frequency < 10), a total of 7; its frequency from more to less in turn is: liver qi stagnation syndrome (35 times, 1. 6.2%, spleen and kidney yang deficiency syndrome (14 times, 6.48%), liver and kidney yin deficiency syndrome (13 times, 6.02%), qi stagnation and blood stasis syndrome (11 times, 5.09%), liver depression and fire (10 times, 4.63%), liver Qi reversal syndrome (10 times, 4.63%) and liver depression and spleen deficiency syndrome (10 times, 4.63%). 1.3 The results of literature study showed that the frequency of the disease factors ranked the top three from high to low, followed by qi stagnation (85 times, 28.81%), fire / heat (43 times, 14.58%) and yin deficiency (37 times, 12.54%). Clinical research 2.1 Investigation of 972 female college students in Shanxi College of Traditional Chinese Medicine, found that 406 patients with PMS, the prevalence of PMS was 41.77%. 2.2 Female college students with premenstrual syndrome high-incidence age of 23-25 years old, high-incidence grade for the fifth, and their major has nothing to do. 2.3 Clinical syndrome type research results show that the main syndrome from more to less, followed by liver-qi syndrome 168. Cases (45.16%), 96 cases (25.81%), 63 cases (16.94%), 30 cases (8.06%) of liver depression and spleen deficiency, 15 cases (4.03%) of qi stagnation and blood stasis, 0 cases of liver and kidney yin deficiency, and 0 cases of spleen and kidney yang deficiency. 29 cases of kidney yang deficiency syndrome, accounting for 11.11%; 28 cases of qi stagnation and blood stasis syndrome, accounting for 10.73%; 21 cases of liver qi deficiency syndrome, accounting for 8.05%; 7 cases of liver and kidney yin deficiency syndrome, accounting for 2.68%. The distribution of various syndromes and sub-syndromes of this disease has significant differences (P The first two were impatience and irritability in 262 cases (70.43%) and emotional depression in 143 cases (38.98%); behavioral changes in 278 cases (77.73%), learning ability in 236 cases (63.44%) and physical symptoms in 293 cases (78.76%), fatigue in 256 cases (68.82%) and breast swelling pain in 242 cases (65.05%). 203 cases (54.57%), 196 cases (52.69%), 188 cases (50.54%) of headache, 176 cases (47.31%) of chest tightness, 167 cases (44.89%), 137 cases (36.83%) of anxiety, 125 cases (33.60%) of dementia. There were significant differences in the distribution of mild, moderate and severe symptoms (P 0.05). Conclusion 1. The main syndrome types are stagnation of liver-qi, deficiency of spleen-kidney yang, deficiency of liver-kidney yin, stagnation of Qi and blood stasis, stagnation of Liver-qi to dissipate fire, reversion of liver-qi, and deficiency of liver-qi and spleen. The incidence of the disease was 41.77%, which was consistent with the literature. 3. The results showed that the main syndromes of the disease were liver-qi inverse syndrome (45.16%) and Liver-qi Stagnation Syndrome (25.81%). So the main syndromes were liver-qi loss and discharge syndrome, the secondary syndromes were liver-qi stagnation and spleen-deficiency syndrome (33.72%), Liver-qi Depression and fire-removing syndrome (20.31%) and Liver-qi Stagnation Syndrome (13.41%). The results of this survey showed that abdominal distention and pain (78.76%), inattention (77.73%) and irritability (70.43%) were the most common symptoms of PMS.
【学位授予单位】：山西中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.115
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