慢性胃炎湿郁脾胃辨证的临床研究

发布时间：2018-11-22 09:05

【摘要】：目的:慢性胃病是临床常见病和多发病,属于中医的“胃痛”、“痞满”、“嘈杂”等。本研究通过计算机检索、手工检索的方式、古籍的查阅,对慢性胃炎与中医的“湿证”相关的文献进行统计学分析,得出慢性胃炎与“湿”有关的主症有泄泻、便溏,口淡、纳少,烦躁易怒,汗多,心慌,出汗,失眠,胁肋胀痛、情绪影响,胃院痛、嘈杂,胃胀,脘腹怕冷,反酸,头晕,面色萎黄,大便不爽,舌红苔黄,小便黄,口粘腻,口苦,恶心、呕吐,胸闷,肢体困重,嗳气,四肢乏力,口臭,神疲懒言,失眠多梦,善太息,口干,口渴28个症状,舌象有舌暗,舌红,淡红舌,胖大舌,舌有齿痕,苔薄白,苔白腻,苔黄腻,苔厚如积粉;脉象有弦脉、沉脉、细脉、涩脉、滑脉,总共42个要素。以中医诊断学辨证要素为基础,结合多元数理统计方法,以期确定慢性胃炎湿郁脾胃证宏观辨证标准,探讨建立中医证候辨证标准的方法和手段。方法:选择2014年9月至2015年12月间,就诊于广西中医药大学附属瑞康医院消化科门诊患者,经内窥镜及病理组织学检查,确诊为慢性非萎缩性胃炎患者200例。并设计的方法对200例慢性胃炎患者进行临床流行病学调查,符合中医的湿证,给予排行气健脾,化湿解郁的安胃二号方服用后好转的患者,除兼有其它脏器严重疾病者,其中90例患者符合探究慢性胃炎湿郁脾胃这一证型临床症状特点。对90例资料进行聚类分析、两次SPSS回归分析,以此筛选出对慢性胃炎湿郁脾胃证辨证有意义的主要症状、体征。其中男性38例,女性52例。平均年龄45.5岁,标准差为12.24岁。患者性别、年龄、身高、体重无显著性差异(P0.05)。结果与结论:1、通过对临床流行病学调查数据进行了中医理论的辩证要素的分类、聚类分析、主成分分析以及回归分析,发现对于诊断为慢性胃炎的患者,如果有胃脘部不适伴有口淡、纳少,失眠多梦,胃脘痛、嘈杂,胃胀,大便不爽,恶心、呕吐,肢体困重,烦躁易怒,舌红苔黄腻这些症状,则中医诊断为湿郁脾胃证的可能性较大。2、湿郁脾胃证可以概括临床上慢性胃病湿邪郁阻的患者,但是湿郁脾胃证的患者是否具有中医郁证或西医相关的焦虑与抑郁症有待进一步的考究。3、通过对中医学理论与多元统计方法的结合,可以筛选出中医证型诊断中有意义的辩证要素。
[Abstract]:Objective: chronic gastropathy is a common and frequent clinical disease, which belongs to traditional Chinese medicine (TCM), such as "stomach pain", "ruffian fullness", "noise" and so on. This research through the computer retrieval, the manual retrieval way, the ancient books consult, carries on the statistical analysis to the chronic gastritis and the traditional Chinese medicine "dampness syndrome" related literature, obtains the chronic gastritis and the "wet" related main symptom to have the diarrhea, the stool is loose, the mouth is light, Little, irritable, sweaty, nervous, sweating, insomnia, flank pain, emotional influence, stomach pain, noise, stomach distension, stomach pain, stomach distension, stomach ache, regurgitation, dizziness, yellow complexion, bad stool, yellow tongue, yellow urination, sticky mouth, bitter mouth, Nausea, vomiting, chest tightness, body drowsiness, belching, limb fatigue, bad breath, tired talk, insomnia and dreams, good breath, dry mouth, 28 symptoms of thirst, tongue with dark tongue, red tongue, pale red tongue, fat tongue, teeth mark on tongue, thin white fur, White and greasy fur, yellow greasy fur, thick as powder; Pulse has chord pulse, deep vein, thin vein, astringent vein, slippery vein, total 42 elements. Based on the dialectical elements of TCM diagnostics and the multivariate mathematical statistical method, this paper aims to determine the macro syndrome differentiation standard of chronic gastritis with dampness depression and spleen and stomach syndrome, and to discuss the methods and means of establishing TCM syndrome differentiation standard. Methods: from September 2014 to December 2015, 200 cases of chronic non-atrophic gastritis were diagnosed by endoscopy and histopathology. The designed method was used to investigate the clinical epidemiology of 200 patients with chronic gastritis. According to the traditional Chinese medicine's dampness syndrome, the patients who got better after taking Anwei No. 2, which ranked qi to strengthen the spleen and dissipated dampness and relieve depression, except for those with serious diseases of other organs, were given. 90 of them were in accordance with the clinical symptoms of chronic gastritis with dampness depression and spleen-stomach syndrome. By cluster analysis and SPSS regression analysis of 90 cases, the main symptoms and signs of chronic gastritis with dampness depression and spleen and stomach syndrome differentiation were screened out. There were 38 males and 52 females. The average age was 45.5 years and the standard deviation was 12.24 years old. There was no significant difference in sex, age, height and weight (P0.05). Results & conclusion: 1. Through the classification of dialectical elements of TCM theory, cluster analysis, principal component analysis and regression analysis, we found that the patients with chronic gastritis were diagnosed as chronic gastritis. If there are stomach discomfort accompanied by light mouth, Na Shao, insomnia, many dreams, epigastric pain, noise, stomach distension, stool upset, nausea, vomiting, limb sleepy, irritable and irritable, tongue red fur yellow greasy these symptoms, The TCM diagnosis of dampness stagnation spleen and stomach syndrome is more likely. 2. Dampness stagnation spleen and stomach syndrome can be summarized in clinical patients with chronic stomach disease dampness and evil stagnation. However, whether the patients with dampness depression spleen and stomach syndrome have TCM depression syndrome or western medicine related anxiety and depression need further study. 3. Through the combination of traditional Chinese medicine theory and multivariate statistical methods, We can screen out the dialectical elements in the diagnosis of TCM syndromes.
【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

【参考文献】