痞满的中医证型和中医体质相关性研究

发布时间：2019-07-06 20:31

【摘要】：研究目的：通过对痞满患者基本资料收集,对中医证型和中医体质的辩别,了解痞满发病的特点,将中医体质学说与临床结合,运用临床调查方法,分析痞满中医证型与中医体质类型的分布情况,并进行统计分析,探讨它们之间的相关性,为从中医体质学角度预防和治疗本病提供新的思路,以提高痞满的中医药治疗效果。研究方法：采用临床流行病学观察性横断面研究的方法,由两名不同的中医师对2015年1月-2016年3月来广东省中医院门诊、广州中医药大学附属南海妇产儿童医院中医门诊就诊的患者,根据严格的纳入标准与排除标准,将符合332例痞满患者进行中医辨证分型,并指导患者完成《中医体质量表》,比较痞满不同证型中不同体质类型所占比率,将所得数据采用SPSS13.0统计软件分析,从而研究它们之间可能存在的相关性。研究结果：1.332例痞满患者其中女性为224例(67.47%),男性为108例(32.53%)。痞满患者不同性别在各年龄层有统计学意义。2.痞满发病诱因上与饮食不洁相关频数最高,频率为32.56%,其次为情志不畅；而饮食偏嗜中,肥甘油腻最多,其次为浓茶；吸烟、饮酒情况上,其不吸烟的痞满患者为277人,占83.43%,不喝酒为290人,占87.34%；从运动情况上,几乎不锻炼的痞满为185人,占55.06%,其次为平均每天锻炼1小时为82人,占24.69%。3.痞满中医证型分布与性别、年龄、饮食偏嗜均具有统计学意义(P0.05),而与运动情况无统计学意义(P0.05)；中医体质分布同样与患者的性别、年龄差异、饮食偏嗜有关(P0.05),不认为与运动情况有关。4.332例痞满患者中医证型出现的频率依次为脾胃虚弱证(24.09%))肝胃不和证(18.98%)=痰湿中阻证(18.98%))湿热阻胃证(17.17%))饮食内停证(11.44%))胃阴不足证(9.34%)。5.332例痞满患者中平和质53例,占15.96%:偏颇质245例,占73.80%:兼夹质34例,占10.24%。在298例单一体质中出现的体质类型构成比为阳虚质(42.50%))气郁质(17.79%)=平和质(17.09%)〉气虚质(11.09%))阴虚质(7.72%))湿热质(7.38%))痰湿质(7.05%))血瘀质(5.03%))特禀质(1.68%),以阳虚质最多见。6.298例单一体质的痞满患者中,脾胃虚弱证,阳虚质多见,占33.80%,其次为气虚质(19.72%)；肝胃不和证,气郁质(46.43%)多见；痰湿中阻证,阳虚质多见,占36.84%,其次为痰湿质(19.30%) ；湿热阻胃证,湿热质多见,占32.65%,其次为平和质(24.49%)7.298例单一体质的痞满患者阳虚质中医证型中,脾胃虚弱证(32.88%)最多,其次为痰湿中阻证(28.71%)；平和质中饮食内停证多见,占32.08%；气郁质以肝胃不和证最多,占49.06%；气虚质中脾胃虚弱证最多,占42.42%,其次为痰湿中阻证(21.21%)：阴虚质中胃阴不足证多见,占60.87%：湿热质中,湿热阻胃证多见,占72.73%；痰湿质中痰湿中阻证最多,占52.38%,其次为湿热阻胃证(28.57%)。8.痞满的中医证型与中医体质具有统计学意义,P0.05。研究结论：痞满患者中医证型以脾胃虚弱证、肝胃不和证、痰湿中阻证、湿热阻胃证最多见。中医体质类型主要为阳虚质、气郁质、平和质、气虚质。本研究通过对痞满患者中医证型与中医体质相关性研究得出,中医体质与中医证型具有显著相关性,阳虚质、气虚质患者发病后易患脾胃虚弱证,湿热质患病后易患湿热阻胃证,阴虚质患者易患胃阴不足证。同时,临床治疗中,应注意辨病、辩证的同时结合辨体质,通过干预及调整患者体质,降低其发病率,并提高中医药治疗痞满效果及降低复发率。
[Abstract]:Objective: To study the characteristics of the syndrome of TCM and the constitution of Chinese medicine by collecting the basic data of the patients with full-time and to understand the characteristics of the disease, and to use the clinical investigation method to analyze the distribution of the syndrome of TCM and the type of the constitution of the Chinese medicine. In order to improve the curative effect of the traditional Chinese medicine, this paper makes a statistical analysis and discusses the correlation between them and provides a new way to prevent and treat the disease from the angle of the constitution of Chinese medicine. Methods: The clinical and epidemiological cross-sectional study was adopted, and two different Chinese doctors from January 2015 to March,2016, the outpatient of Guangdong Central Hospital, the Affiliated South China Medical University of Guangzhou University of Traditional Chinese Medicine, and the patients in the clinic of the Chinese medicine clinic of the children's hospital of the South China Sea, According to the strict inclusion criteria and exclusion criteria, the syndrome differentiation of 332 patients with Richmond will be met, and the proportion of the different types of body constitution in the different types of TCM is compared, and the data obtained will be analyzed by the SPSS13.0 statistical software. So as to study the possible correlation between them. The results of the study: 1.332 cases of full-filled patients were 224 (67.47%) and 108 (32.53%). The different sex of the patients with Richmond had a statistical significance in all ages. The frequency was the highest, the frequency was 32.56%, the second was the unsmooth feeling, while the diet was in the middle, the fat and the fat were the most, the second was the thick tea, smoking, alcohol consumption, the non-smoking, full of the patients was 277, accounting for 83.43%, the non-drinking was 290, accounting for 87.34%; In the exercise, almost no exercise was full of 185, accounting for 55.06%, followed by an average of 82 people per day for an average of 24.69%. There was no significant difference in the distribution of TCM syndrome type and sex, age and diet (P0.05). The physical distribution of Chinese medicine was similar to that of the patients (P <0.05). The physical distribution of the Chinese medicine was also related to the sex, age and diet of the patients (P0.05). The frequency of TCM syndrome of 4.332 patients with Richmond was found to be the weakness of the spleen and stomach (24.09%), the liver and stomach syndrome (18.98%), the damp-heat resistance (18.98%), the damp-heat resistance (17.17%), the deficiency of the stomach (11.44%), and the deficiency of the stomach (9.34%). There were 53 cases of moderate and moderate quality, 15.96%, and 245 cases, 73.80% and 10.24%, respectively. The type of body constitution in 298 cases of single body constitution is deficiency of yang (42.50%), Qi stagnation (17.79%), Qi deficiency (11.09%), yin deficiency (7.72%), damp-heat quality (7.38%), damp-heat quality (7.05%), blood stasis (5.03%), and blood stasis (1.68%). The deficiency of the spleen and the stomach was more common, accounting for 33.80%, followed by Qi deficiency (19.72%), liver and stomach syndrome, and Qi stagnation (46.43%), and the syndrome of phlegm and dampness was more common, accounting for 36.84%. The second was the phlegm-dampness (19.30%), the damp-heat resistance and the stomach syndrome, the heat and heat were more common, accounting for 32.65%, followed by a moderate (24.49%) of 7.298 patients with single body constitution, the spleen and stomach weakness syndrome (32.88%) was the most, followed by phlegm-dampness obstruction (28.71%); It was more common in the middle and middle diet, accounting for 32.08%, most of which accounted for 32.08%, the most of which were the liver and stomach, accounting for 49.06%, and the deficiency of the spleen and stomach in the Qi-deficiency was the most common, accounting for 42.42%, followed by phlegm-dampness obstruction (21.21%): the deficiency of the stomach and yin in the yin-deficiency mass was more common, accounting for 60.87%: the damp-heat quality and the damp-heat resistance of the stomach were more common. 72.73% of phlegm-dampness, 52.38% of phlegm-dampness, followed by damp-heat-resistance (28.57%). The TCM syndrome type of Richmond is of statistical significance with the constitution of Chinese medicine, P0.05. Conclusion: The syndrome of traditional Chinese medicine in Richmond is the most common syndrome in the spleen and stomach, the syndrome of liver and stomach, the syndrome of phlegm and dampness, and the syndrome of damp-heat resistance. The type of physical constitution of the Chinese medicine is mainly yang-deficiency, qi-stagnation, mild, and Qi-deficiency. According to the study of the correlation between the TCM syndrome type and the constitution of the traditional Chinese medicine, the TCM constitution of the Chinese medicine has a significant correlation with the TCM syndrome types, and the deficiency of the spleen and the stomach in the patients with the deficiency of the spleen and the stomach after the onset of the deficiency of the spleen and the stomach and the heat and heat resistance of the patients after the heat and heat are affected, The patients with yin deficiency have the syndrome of deficiency of the stomach and yin. At the same time, in the clinical treatment, attention should be paid to the identification of the disease, the dialectical and simultaneous combination of the physical constitution, the intervention and the adjustment of the patient's body constitution, the reduction of its morbidity, and the improvement of the full-filling effect of the traditional Chinese medicine and the reduction of the recurrence rate.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R256.32

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