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子宫腺肌病患者中医证候、体质及发病相关因素的研究

发布时间:2019-04-08 16:29
【摘要】:研究目的:通过对子宫腺肌病患者病因、中医证候及体质的调查,统计调查研究的数据,运用流行病学研究方法,对子宫腺肌病的发病影响因素、中医证候分布及体质分布做出初步研究,并且探讨他们之间的相关性,为临床实践上中医个体化防治子宫腺肌病提供临床依据。研究方法:采用问卷调查方法,选择2015年4月-2016年3月期间在成都中医药大学附属医院妇科门诊就诊的患者,共102例,收集患者的一般情况、体质、中医证候等信息,用Excel表格录入基本数据后,运用SPSS17.0软件中的频数分析、聚类分析及非参数检验等统计方法分析患者的病因、中医证候、体质分布规律及相关性。研究结果:(1)收集的102例子宫腺肌病患者中,35-50岁年龄阶段的患者占总数的72.55%。喜食辛辣的占48.04%、喜食豆制品的占38.24%。有过3次及以上宫腔手术操作史的占42.15%。(2)子宫腺肌病患者的血清CA125升高者占80.39%,CA199升高者占25.69%。主要病况以经行腹痛最多,占总数的91.17%,程度以重度痛经占多数,约42.16%。(3)子宫腺肌病的中医证型聚类分析后分为四类:肾虚气滞血瘀(占37.25%)、气滞血瘀(占27.54%)、气虚血瘀(占18.63%)、湿热瘀结(占16.67%),其中单证型中血瘀型最多,占70.59%。(4)子宫腺肌病的中医体质类型中阳虚质占总数的22.55%,气郁质占总数的19.61%,气虚质占总数的1 3.73%,血瘀质占总数的12.75%。有兼夹体质的占61.76%。(5)调查的子宫腺肌病患者中各中医证型与年龄、学历、流产次数、血清CA125、痛经程度等因素均无统计学意义(P0.05)。各中医体质与年龄、学历、痛经程度、宫腔手术或操作次数等因素均无统计学意义(P0.05)。(6)调查的子宫腺肌病患者中各中医证型与宫腔手术或操作次数有统计学意义(P0.05)。不同中医体质与不同证型分布有统计学意义(P0.05)。结论:(1)年龄、饮食习惯、多次宫腔手术操作史均是子宫腺肌病发病的重要影响因素。(2)中医证型分布与宫腔手术或操作次数有相关性。随着次数的增加,患者证型中出现肾虚证的比例亦随之增加。(3)中医体质与证型之间有相关性。气郁质与气滞血瘀证有一定的相关性,阳虚质与肾虚血瘀证有一定的相关性。
[Abstract]:Objective: to investigate the etiology, TCM syndrome and physique of patients with adenomyosis of uterus, to investigate the data of statistical investigation, and to use epidemiological methods to study the factors affecting the pathogenesis of adenomyosis. The distribution of TCM syndromes and physique were studied, and the correlation between them was discussed, which could provide clinical basis for individualized prevention and treatment of adenomyosis in traditional Chinese medicine (TCM) in clinical practice. Methods: a total of 102 patients from the gynecological outpatient department of Chengdu University of traditional Chinese Medicine from April 2015 to March 2016 were selected by questionnaire survey. The general situation, physique, TCM syndrome and other information of the patients were collected, and the results showed that there were 102 patients in the gynecological outpatient department of Chengdu University of traditional Chinese Medicine. After inputting the basic data with Excel form, using the statistical methods of frequency analysis, cluster analysis and non-parameter test in SPSS17.0 software to analyze the etiology, TCM syndrome, physique distribution rule and correlation of the patients. Results: (1) of 102 cases of adenomyosis, 35% of 50-year-olds accounted for 72.55% of the total. Spicy food accounted for 48.04%, soybean products accounted for 38.24%. (2) Serum CA125 was elevated in 80.39% of patients with adenomyosis and 25.69% of patients with adenomyosis. The main diseases were abdominal pain (91.17%) and severe dysmenorrhea (42.16%). (3) the syndrome types of adenomyosis were classified into four categories: deficiency of kidney, qi stagnation and blood stasis (37.25%). Qi stagnation and blood stasis (27.54%), Qi deficiency and blood stasis (18.63%), dampness-heat stasis (16.67%), among which the blood stasis type was the most. (4) among the types of traditional Chinese medicine constitution of adenomyosis, yang deficiency accounted for 22.55%, qi depression 19.61%, qi deficiency 13.73% and blood stasis 12.75%. (5) there was no significant difference in TCM syndrome type and age, academic background, abortion times and dysmenorrhea degree of serum CA125, among the investigated patients with adenomyosis of uterus (P0.05). Chinese medicine constitution and age, education, dysmenorrhea degree, There was no statistical significance in the frequency of uterine surgery or operation (P0.05). (6) among the patients with adenomyosis (P0.05), there was significant difference between the types of TCM syndrome and the frequency of uterine surgery or operation (P0.05). Different TCM constitution and distribution of different syndrome types have statistical significance (P0.05). Conclusion: (1) Age, diet habit, multiple operation history of uterine cavity are all important influencing factors of adenomyosis of uterus. (2) the distribution of TCM syndrome type is related to the frequency of uterine cavity operation or operation. With the increase of times, the proportion of patients with kidney deficiency syndrome also increased. (3) there is a correlation between TCM constitution and syndrome type. There is a certain correlation between qi stagnation and blood stasis, Yang deficiency and kidney deficiency and blood stasis.
【学位授予单位】:成都中医药大学
【学位级别】:硕士
【学位授予年份】:2016
【分类号】:R271.9

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