本文選題：Hp感染者　切入點：證侯特點　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:分析Hp感染的相關(guān)因素,為預(yù)防提供方向;研究Hp感染者的證侯特點,為盡早診斷提供依據(jù);探討Hp感染者的證型分布規(guī)律,為治療提供思路。方法:本次研究模擬采用大數(shù)據(jù)與臨床研究相結(jié)合的方法,搜集符合研究目標(biāo)的人群,形成研究分析的全數(shù)據(jù)集,探索分析在實際情況下Hp感染者的相關(guān)特點。通過參考權(quán)威書籍綜合臨床經(jīng)驗,設(shè)計出相應(yīng)臨床研究觀察表;收集2016年4月-2016年6月就診于南京市中醫(yī)院,并行13C尿素呼氣試驗或胃鏡檢查的患者201例,根據(jù)檢查結(jié)果將患者分為兩組,其中Hp陽性患者共104例,為Hp陽性組;Hp陰性患者97例,為Hp陰性組;根據(jù)患者的臨床研究資料,建立數(shù)據(jù)庫。應(yīng)用相關(guān)統(tǒng)計學(xué)方法,分析Hp感染的相關(guān)因素及其證侯特點,Hp感染者的證型分布規(guī)律。結(jié)果:(1)不同性別、年齡、婚姻狀況的人群中,Hp陽性率不能認(rèn)為有差異(P0.05);Hp感染在外出就餐、飲酒方面無統(tǒng)計學(xué)差異(P0.05);而與分餐,吸煙存在顯著差異(P0.05),不分餐人群的Hp陽性率明顯高于分餐人群,吸煙人群的Hp陽性率明顯高于不吸煙人群;(2)Hp感染者主要的證侯出現(xiàn)頻次由多至少依次為:胃脘脹滿、噯氣、口臭、大便稀溏、反酸;舌象以舌紅,苔黃、膩為主,脈象以弦、滑為主。胃脘脹滿、噯氣、口臭、大便稀溏、苔膩在Hp陽性組與Hp陰性組中分布有統(tǒng)計學(xué)差異(P0.05),而反酸、舌紅、苔黃在兩組間分布無統(tǒng)計學(xué)差異(P0.05)。進一步將有統(tǒng)計學(xué)差異(P0.05)的癥狀結(jié)合不分餐、吸煙相關(guān)因素分析,得出噯氣、口臭、大便稀溏的人群,Hp感染率較高;(3)Hp感染者的證型分布:以脾胃濕熱證為主,占比為37.5%,其次分別為肝胃不和證(26.0%)脾胃虛弱證(18.3%)寒熱錯雜證(8.7%)胃陰不足證(7.7%)胃絡(luò)瘀阻證(1.9%)。結(jié)論:(1)Hp感染與性別、年齡、婚姻狀況,外出就餐、飲酒無明顯相關(guān)性;與分餐,吸煙存在相關(guān)性。(2)噯氣、口臭、大便稀溏對判斷是否感染Hp具有較好的診斷價值,結(jié)合分餐及吸煙相關(guān)因素,得出如果就診人群有噯氣、口臭、大便稀溏、吸煙、不分餐這些信息,建議應(yīng)盡早行Hp相關(guān)檢查,這樣可以提高人群Hp感染的檢出率,提高臨床診斷Hp的篩檢能力。(3)Hp感染者證型分布規(guī)律為:脾胃濕熱證肝胃不和證脾胃虛弱證寒熱錯雜證胃陰虧虛證胃絡(luò)瘀阻證。
[Abstract]:Objective: to analyze the related factors of HP infection, to provide the direction for prevention, to study the syndrome characteristics of HP infection, to provide the basis for early diagnosis, to explore the distribution pattern of HP infection. Methods: in this study, big data was used in combination with clinical research to collect people who were in line with the objectives of the study and to form a complete data set of research and analysis. To explore and analyze the relevant characteristics of HP infection in the actual situation. By referring to authoritative books to synthesize clinical experience, to design the corresponding clinical research observation table, to collect from April 2016 to June 2016 to visit Nanjing traditional Chinese Medicine Hospital, 201 patients who underwent 13C urea breath test or gastroscopy were divided into two groups according to the results of the examination, including 104 patients with HP positive, 97 patients with HP negative, who were HP negative, according to the clinical data of the patients. To establish the database, to analyze the related factors of HP infection and its syndromic characteristics, and to analyze the distribution pattern of HP infection by using the relevant statistical method. Results: different sex, age, and age. There was no significant difference in HP positive rate between the two groups, but there was no significant difference in drinking, but there was a significant difference in smoking between the two groups, and the HP positive rate in the non-meal group was significantly higher than that in the meal group. The positive rate of HP in smoking population was obviously higher than that in non-smoking population. The frequency of HP infection was at least in the following order: full stomach, belching, halitosis, loose stool, acid regurgitation, red tongue, yellow fur, greasy tongue, string pulse. The gastric distension, belching, halitosis, loose stools, clothiness in HP positive group and HP negative group were significantly different (P 0.05), but regurgitated, tongue red, and so on. There was no statistical difference in the distribution between the two groups (P0.05). Further, the symptoms with statistical difference (P0.05) were combined with non-meal, smoking related factors were analyzed, and the results showed that there was belching and bad breath. The prevalence of HP infection in the population with dilute stools was higher. The distribution of the syndrome types of HP infection was mainly spleen and stomach dampness and heat syndrome. The proportion was 37.5, followed by liver and stomach disharmony (26.0) spleen and stomach weakness syndrome and 18.3C) cold and heat disorder syndrome 8.7m) stomach yin deficiency syndrome 7.7. conclusion there is no significant correlation between sex, age, marital status, dining out, alcohol consumption, sex, age, marital status, dining out and drinking. Smoking has correlation. 2) belching, bad breath and loose stools have good diagnostic value in judging whether or not infected with HP. Combined with meal and smoking related factors, it is concluded that if there are belching, halitosis, loose stools, smoking, and smoking, In order to improve the detection rate of HP infection in the population, it is suggested that HP related examination should be carried out as soon as possible. To improve the screening ability of clinical diagnosis of HP. The distribution rule of syndrome type of HP infection is: spleen and stomach dampness heat syndrome liver and stomach disharmony syndrome spleen and stomach deficiency syndrome cold heat disorder syndrome stomach yin deficiency syndrome stomach deficiency syndrome stomach collaterals stasis syndrome.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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