胚胎停育發(fā)病相關因素及中醫(yī)證候、體質(zhì)類型的調(diào)查研究
發(fā)布時間：2018-08-26 08:18
【摘要】：目的:通過收集胚胎停育患者資料,探討引起胚胎停育的相關高危因素;統(tǒng)計分析該病的中醫(yī)證候特點及體質(zhì)類型,為胚胎停育的中醫(yī)藥防治提供參考依據(jù),據(jù)此通過對孕前體質(zhì)進行辨識,調(diào)節(jié)易感體質(zhì),以減少胚胎停育的發(fā)生發(fā)展,體現(xiàn)中醫(yī)"治未病"的理念和優(yōu)勢,為中醫(yī)藥認識和防治胚胎停育提供了新的思路和方法。方法：以就診于北京中醫(yī)藥大學東方醫(yī)院婦科門診及病房的有過胚胎停育病史的患者為研究對象,設計胚胎停育一般情況調(diào)查表、中醫(yī)體質(zhì)自測表,通過收集患者一般情況、輔助檢查結(jié)果、中醫(yī)四診資料、體質(zhì)類型,運用Excel軟件及SPSS 19.0統(tǒng)計學軟件對數(shù)據(jù)進行分析,探討與胚胎停育發(fā)病相關的不良因素,探究中醫(yī)證型特點及體質(zhì)類型。結(jié)果:1.胚胎停育以31-35歲發(fā)病率最高,比例為43%,平均年齡31.49土0.372歲。2.胚胎停育患者文化程度以大學及以上者最多見,高中以其以下的人群所占比例較小,并且隨著文化程度的增高,發(fā)病率隨之增高。高發(fā)人群多集中在職業(yè)緊張程度大、腦力勞動為主的職業(yè)中,包括:醫(yī)藥類、教育文化類、金融貿(mào)易、文員相關、設計相關、國營公務等。3.胚胎停育發(fā)生的次數(shù)最少為1次,最多為4次,范圍為1-4次;發(fā)病時孕周以6-8周多見。4.本次調(diào)查中,諸多與胚胎停育發(fā)生有關的危險因素中,熬夜、接觸噪音、被動吸煙占據(jù)前三位。5.本次調(diào)查的患者每日接觸電腦及手機的時間,最短為2小時,最長為16小時。其中以每日接觸電腦及手機的時間在11h-14h之間最多見。6.本次調(diào)查中,有36%的胚胎停育患者的飲食偏好辛辣。7.胚胎停育患者月經(jīng)情況以經(jīng)色紫黯、有血塊、量少為主要表現(xiàn);帶下情況以帶下量少,質(zhì)粘稠,色黃白為主要表現(xiàn);全身狀況以以腰膝酸軟最多見,其次為經(jīng)前乳房脹痛、神疲乏力、畏寒肢冷。提示該病虛實夾雜,虛證以腎虛、脾虛、氣血虛弱為主、實證以氣滯、血瘀、痰濕為主。8.本次調(diào)查,實驗室檢查異常項目中,以孕激素偏低最為常見,比例約為21.1%,其次為亞臨床甲減,比例為15.2%;患者的血型以B型最多,共54人,比例為31.6%;其次為A型、0型,比例均為23.4%;AB型的比例最少,為21.6%;有148位患者的愛人進行過精液檢查,在這148位中,異常項主要包括精子活力低,比例為10.5%;另一項為精子形態(tài)異常:畸形率高,比例為3.5%。9.常見中醫(yī)證型分布:腎虛肝郁型(34.5%),腎虛血瘀(17.5%)、腎虛痰濕(15.8%)、脾腎兩虛(13.5%)、腎陽虛(10.5%)、氣血虛弱(8.2%)10.體質(zhì)分布特點:陽虛質(zhì)所占比例最高,為26.3%,其次為氣郁質(zhì),比例為22.2%,再者為平和質(zhì)(18.1%),接下來依次為濕熱質(zhì)(8.2%)、痰濕質(zhì)(4.1%)、特稟質(zhì)和陰虛質(zhì)(均為3.5%)、血瘀質(zhì)(2.9%)結(jié)論:1.胚胎停育患者的年齡多集中在31歲以上。2.胚胎停育以文化程度高、職業(yè)緊張程度大的腦力勞動工作者較為多見,高發(fā)職業(yè)有:醫(yī)藥類、教育文化類、金融貿(mào)易、文員相關、設計相關、國營公務。3.胚胎停育發(fā)生時的孕周以6-8周之間常見。4.辨證分型中,腎虛肝郁型最多,依次為腎虛血瘀、腎虛痰濕、脾腎兩虛、腎陽虛、氣血虛弱。5.體質(zhì)類型以陽虛質(zhì)、氣郁質(zhì)最多見。6.相關檢查項目中,以TORCH的未檢查率最高,其次支原體、衣原體的檢測,提示患者對這三項檢測的重要性認識不足。7.相關疾病中,以孕激素偏低、亞臨床甲減、子宮肌瘤占調(diào)查結(jié)果的前三位。
[Abstract]:Objective: To investigate the high risk factors of embryonic cessation by collecting the data of patients with embryonic cessation, analyze the characteristics of TCM syndromes and constitution types of embryonic cessation, and provide reference for the prevention and treatment of embryonic cessation. The concept and advantages of "treating pre-disease" in traditional Chinese medicine (TCM) provide a new idea and method for TCM to recognize and prevent embryo cessation.Methods: Taking the patients who had been diagnosed with embryo cessation in the gynecological clinic and ward of Oriental Hospital of Beijing University of Traditional Chinese Medicine as the research object, the general situation questionnaire of embryo cessation was designed, and the self-test table of TCM constitution was adopted. After collecting the general situation of patients, the results of auxiliary examination, the four diagnostic materials of traditional Chinese medicine, the type of constitution, using Excel software and SPSS 19.0 statistical software to analyze the data, to explore the adverse factors associated with embryo cessation, to explore the characteristics of TCM syndrome types and constitutional types. The average age was 31.49 Tu 0.372.2. Most of the patients with embryo cessation were college or above. The proportion of the people below high school was small, and the incidence increased with the increase of education level. 3. Embryo cessation occurs at least once, at most four times, ranging from 1 to 4 times; the gestational age at onset is more than 6-8 weeks. 4. In this survey, many risk factors related to embryo cessation, such as staying up late, exposure to noise, passive smoking occupied the top three.5. This survey In this survey, 36% of the embryonic cessation patients had a spicy diet preference. 7. The menstrual state of the embryonic cessation patients was characterized by purple menstruation, blood clots and low dosage. The main manifestations of the disease are less bandage, viscous texture and yellowish-white color; the most common general condition is soreness and weakness of the waist and knee, followed by pain and distention of the breast before menstruation, fatigue of the mind, fear of cold and limbs. Among them, low progesterone was the most common, accounting for 21.1%, followed by subclinical hypothyroidism, accounting for 15.2%; 54 patients with B blood type, accounting for 31.6%; followed by A, 0, accounting for 23.4%; AB, accounting for the least proportion, accounting for 21.6%; 148 patients with a loved one had semen examination, of which the abnormal items mainly included sperm. The abnormal sperm morphology rate was 3.5%. 9. Distribution of common TCM syndrome types: kidney deficiency and liver depression (34.5%), kidney deficiency and blood stasis (17.5%), kidney deficiency and phlegm dampness (15.8%), spleen and kidney deficiency (13.5%), kidney yang deficiency (10.5%) and Qi and blood deficiency (8.2%) was the highest, followed by Yang deficiency and blood deficiency (26.3%). Qi depression (22.2%) was found in 22.2% of the patients, and then was calm (18.1%), followed by dampness-heat (8.2%), phlegm-dampness (4.1%), special temperament and yin deficiency (3.5%) and blood stasis (2.9%). Conclusion: 1. Most of the patients with embryo cessation were over 31 years old. 2. Brain workers with high educational level and high occupational stress were more likely to have embryo cessation. See, the high-incidence occupations are: medicine, education and culture, finance and trade, clerk-related, design-related, state-owned public affairs.3. Embryo cessation occurs in the gestational week between 6-8 weeks common.4. Syndrome differentiation, kidney deficiency and liver depression type is the most, followed by kidney deficiency and blood stasis, kidney deficiency and phlegm-dampness, spleen and kidney deficiency, kidney-yang deficiency, Qi and blood deficiency.5. Among the related examinations, TORCH had the highest rate of non-examination, followed by the detection of Mycoplasma and chlamydia, suggesting that the importance of these three examinations was not well understood. 7. Among the related diseases, low progesterone, subclinical hypothyroidism and hysteromyoma accounted for the first three.
【學位授予單位】：北京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R271.9
本文編號：2204274
[Abstract]:Objective: To investigate the high risk factors of embryonic cessation by collecting the data of patients with embryonic cessation, analyze the characteristics of TCM syndromes and constitution types of embryonic cessation, and provide reference for the prevention and treatment of embryonic cessation. The concept and advantages of "treating pre-disease" in traditional Chinese medicine (TCM) provide a new idea and method for TCM to recognize and prevent embryo cessation.Methods: Taking the patients who had been diagnosed with embryo cessation in the gynecological clinic and ward of Oriental Hospital of Beijing University of Traditional Chinese Medicine as the research object, the general situation questionnaire of embryo cessation was designed, and the self-test table of TCM constitution was adopted. After collecting the general situation of patients, the results of auxiliary examination, the four diagnostic materials of traditional Chinese medicine, the type of constitution, using Excel software and SPSS 19.0 statistical software to analyze the data, to explore the adverse factors associated with embryo cessation, to explore the characteristics of TCM syndrome types and constitutional types. The average age was 31.49 Tu 0.372.2. Most of the patients with embryo cessation were college or above. The proportion of the people below high school was small, and the incidence increased with the increase of education level. 3. Embryo cessation occurs at least once, at most four times, ranging from 1 to 4 times; the gestational age at onset is more than 6-8 weeks. 4. In this survey, many risk factors related to embryo cessation, such as staying up late, exposure to noise, passive smoking occupied the top three.5. This survey In this survey, 36% of the embryonic cessation patients had a spicy diet preference. 7. The menstrual state of the embryonic cessation patients was characterized by purple menstruation, blood clots and low dosage. The main manifestations of the disease are less bandage, viscous texture and yellowish-white color; the most common general condition is soreness and weakness of the waist and knee, followed by pain and distention of the breast before menstruation, fatigue of the mind, fear of cold and limbs. Among them, low progesterone was the most common, accounting for 21.1%, followed by subclinical hypothyroidism, accounting for 15.2%; 54 patients with B blood type, accounting for 31.6%; followed by A, 0, accounting for 23.4%; AB, accounting for the least proportion, accounting for 21.6%; 148 patients with a loved one had semen examination, of which the abnormal items mainly included sperm. The abnormal sperm morphology rate was 3.5%. 9. Distribution of common TCM syndrome types: kidney deficiency and liver depression (34.5%), kidney deficiency and blood stasis (17.5%), kidney deficiency and phlegm dampness (15.8%), spleen and kidney deficiency (13.5%), kidney yang deficiency (10.5%) and Qi and blood deficiency (8.2%) was the highest, followed by Yang deficiency and blood deficiency (26.3%). Qi depression (22.2%) was found in 22.2% of the patients, and then was calm (18.1%), followed by dampness-heat (8.2%), phlegm-dampness (4.1%), special temperament and yin deficiency (3.5%) and blood stasis (2.9%). Conclusion: 1. Most of the patients with embryo cessation were over 31 years old. 2. Brain workers with high educational level and high occupational stress were more likely to have embryo cessation. See, the high-incidence occupations are: medicine, education and culture, finance and trade, clerk-related, design-related, state-owned public affairs.3. Embryo cessation occurs in the gestational week between 6-8 weeks common.4. Syndrome differentiation, kidney deficiency and liver depression type is the most, followed by kidney deficiency and blood stasis, kidney deficiency and phlegm-dampness, spleen and kidney deficiency, kidney-yang deficiency, Qi and blood deficiency.5. Among the related examinations, TORCH had the highest rate of non-examination, followed by the detection of Mycoplasma and chlamydia, suggesting that the importance of these three examinations was not well understood. 7. Among the related diseases, low progesterone, subclinical hypothyroidism and hysteromyoma accounted for the first three.
【學位授予單位】：北京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R271.9
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