142例免疫性血小板减少症中医辨证分型相关因素分析

发布时间：2019-03-17 16:09

【摘要】：目的:探讨142例免疫性血小板减少症(immune thrombocytopenic purpura ITP)的中医证型分布特征,及中医证型与性别、年龄、病程、出血倾向、血小板计数、巨核细胞数之间的关系。方法:将142例ITP患者进行中医辨证分型,同时对142例ITP患者的性别、年龄、病程、出血倾向、血小板计数、巨核细胞数进行统计分析,探讨中医证型分布特征,分析中医证型与性别、年龄、病程、出血倾向、血小板计数、巨核细胞数之间的关系。结果:1.142例ITP中医证型分布特征:阴虚火旺型(62.0%)、气不摄血型(21.1%)、血热妄行型(9.2%)、瘀血阻络型(7.7%),其中阴虚火旺型最为常见;2.142例ITP患者中男女比例为1:1.33,性别差异有统计学意义(P0.05),而四种证型间性别差异无统计学意义(P0.05);3.142例ITP患者年龄以19-39岁年龄段最多(41.6%),四型中血热妄行组患者年龄均值最小;4.中医证型与病程的关系:阴虚火旺型、血热妄行型病程相对较短,气不摄血型、血热妄行型病程相对较长。5.中医证型与出血倾向的关系:阴虚火旺型、气不摄血型的出血倾向评分均值低于血热妄行型和瘀血阻络型(P0.05);6.中医证型与血小板计数的关系:阴虚火旺型、气不摄血型的血小板计数均值高于血热妄行型和瘀血阻络型(P0.05);7.27例ITP患者中医证型与巨核细胞数关系:阴虚火旺型、气不摄血型的巨核细胞均值高于血热妄行型和瘀血阻络型(P0.05)。结论:1.142例ITP患者中医证型以阴虚火旺型最多;2.142例ITP患者发病以女性多见,四种证型间无明显性别差异;3.ITP可见于各个年龄段,以19-39岁年龄段最多,四型中血热妄行组患者年龄均值最小,提示可能与小儿纯阳体质有关;4.各证型在病程长短方面存在不同,提示病程的长短是影响中医证型分布的因素之一,而中医证型在一定程度上可反应病程的长短;5.中医证型与出血倾向评分、血小板计数、巨核细胞有统计学意义,阴虚火旺、气不摄血两组出血倾向评分均值较低,而血小板计数均值、巨核细胞均值均较高,可推测考虑将出血倾向评分、血小板计数、巨核细胞数做为ITP中医辨证分型客观指标的参考依据。
[Abstract]:Aim: to investigate the distribution characteristics of TCM syndrome type of (immune thrombocytopenic purpura ITP) and the relationship between TCM syndrome type and sex, age, course of disease, bleeding tendency, platelet count and megakaryocyte count in 142 cases of immune thrombocytopenia. Methods: a total of 142 patients with ITP were divided into two groups: sex, age, course of disease, bleeding tendency, platelet count and megakaryocyte count, and the distribution characteristics of TCM syndrome type were discussed. To analyze the relationship between TCM syndrome type and sex, age, course of disease, bleeding tendency, platelet count, megakaryocyte count. Results: the distribution characteristics of TCM syndrome types of 1.142 cases of ITP were as follows: Yin deficiency and fire type (62.0%), Qi not ingestion type (21.1%), blood-heat delusion type (9.2%), blood stasis type (7.7%), the most common type was Yin-deficiency and fire-abatement type (62.0%), blood-heat delusion type (9.2%) and blood stasis type (7.7%). In 2.142 patients with ITP, the ratio of male to female was 1 / 1.33, the gender difference was statistically significant (P0.05), but there was no significant difference among the four types of syndrome (P0.05). The age of 3.142 patients with ITP was the most (41.6%) in the 19-39-year-old group, and the mean age in the delusional group of type 4 blood fever was the lowest. The relationship between TCM syndrome type and the course of disease: Yin deficiency fire type, blood-heat delusional type is relatively short, qi is not blood type, blood-heat delusional type is relatively long. 5. The relationship between TCM syndrome type and bleeding tendency: Yin deficiency and fire flourishing type, the mean value of bleeding tendency score of Qi not ingestion blood type was lower than that of blood-heat delusion type and blood stasis obstruction type (P0.05); 6. The relationship between TCM syndrome type and platelet count: the mean value of blood platelet count of Yin-deficiency-fire-prosperous type was higher than that of blood-heat delusion type and stasis-blood blocking collaterals type (P0.05); 7. The relationship between TCM syndrome type and megakaryocyte count in 27 patients with ITP: the mean value of megakaryocyte in the type of yin deficiency and fire was higher than that in type of blood-heat delusion and stagnation of collaterals (P0.05). Conclusion: 1.142 patients with ITP have the most syndrome types of yin deficiency and fire, 2.142 patients with ITP are female, and there is no significant gender difference among the four syndrome types. 3.ITP can be found in all ages, the most in the 19-39-year-old age group and the smallest in the 4-type delusional blood fever group, suggesting that it may be related to the pure masculine constitution of children; 4. It is suggested that the length of the disease course is one of the factors affecting the distribution of TCM syndrome type, and the TCM syndrome type can reflect the duration of the disease to a certain extent. 5. TCM syndrome type and bleeding tendency score, platelet count, megakaryocyte have statistical significance, Yin deficiency fire is prosperous, qi does not absorb blood the two groups bleeding tendency score average value is lower, but platelet count mean value, megakaryocyte mean value is higher. It can be inferred that the score of bleeding tendency, platelet count and megakaryocyte count should be considered as the reference basis for the objective index of TCM syndrome differentiation and classification of ITP.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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