發(fā)布時(shí)間：2018-03-23 11:25

  本文選題：兒童哮喘　切入點(diǎn)：先天稟賦　出處：《成都中醫(yī)藥大學(xué)》2012年碩士論文

【摘要】：目的 以數(shù)據(jù)和資料來驗(yàn)證和探索兒童哮喘先天稟賦因素的科學(xué)內(nèi)涵,豐富哮喘病因,推動(dòng)兒童哮喘中醫(yī)病因研究的發(fā)展及豐富兒童哮喘的治療。 方法 本次研究以“第三次全國兒童哮喘流行病學(xué)調(diào)查”為依托,采用橫斷面篩查法,進(jìn)行分層隨機(jī)整群抽樣。在成都市約抽取12000人。將12000份資料錄入Epi_Info軟件,篩選出病例組504例,對照組223例(對照組為隨機(jī)整群抽樣中非哮喘、無慢性呼吸系統(tǒng)炎癥的兒童。對照的選擇要求與病例兒童的年齡、性別及民族相匹配,年齡要求相差±1歲)。將所有問卷中涉及先天稟賦的問題進(jìn)行賦值處理,采用spss17.0統(tǒng)計(jì)軟件分析,單因素分析采用X2檢驗(yàn),計(jì)算P值。再將單因素分析中有統(tǒng)計(jì)學(xué)意義的問題帶入多因素非條件Logistic回歸分析,計(jì)算OR值及95%置信區(qū)間,綜合分析哮喘先天稟賦因素。 結(jié)果 單因素卡方分析示母親孕期患疾病、孕期有不良習(xí)慣、母親多胎或多產(chǎn)史、有家族過敏史、兒童被診斷過敏性鼻炎、兒童被診斷蕁麻疹、兒童被診斷濕疹、非母乳喂養(yǎng)、孕期寒熱偏嗜、孕期五味偏嗜、肺虛質(zhì)、脾虛質(zhì)、腎虛質(zhì)、出生前后家中有裝修的P值0.05,有統(tǒng)計(jì)學(xué)意義。多因素非條件Logistic回歸分析示母親孕期患疾病、家族過敏史、兒童被診斷過敏性鼻炎、兒童被診斷蕁麻疹、兒童被診斷濕疹、孕期嗜食辛辣、嗜食生冷、酸味偏嗜、辛味偏嗜、兒童體質(zhì)瘦弱、易感冒、腹脹納差、夜間盜汗、便溏、出生前后家中有裝修的OR值分別為1.123、1.959、4.039、1.356、2.411、1.480、3.141、3.514、1.007、4.952、5.254、1.981、2.174、2.516、4.624,為哮喘的危險(xiǎn)因素。 結(jié)論 經(jīng)單因素卡方檢驗(yàn)及多因素非條件Logistic回歸分析,結(jié)果提示稟賦的主要內(nèi)容即父母基質(zhì)、胎育保養(yǎng)、天時(shí)地利、體質(zhì)因素與哮喘的發(fā)生關(guān)系密切。結(jié)果提示我們在平時(shí)的生活調(diào)護(hù)中,應(yīng)加強(qiáng)上述因素的干預(yù),做到未病先防、既病防變。稟賦為中醫(yī)學(xué)的特有概念,有廣義與狹義之分。狹義的稟賦與現(xiàn)代醫(yī)學(xué)的遺傳相似,其基礎(chǔ)是基因和染色體。而在臨床中,應(yīng)用更多的稟賦是廣義的,包括文中所述父母基質(zhì)、胎育保養(yǎng)、天時(shí)地利、體質(zhì)因素等相關(guān)內(nèi)容。常見的稟賦不足類疾病,未必都能在基因的層面得到反映。故廣義的稟賦概念更能真實(shí)地反映人與疾病的關(guān)聯(lián),這也正是中醫(yī)稟賦學(xué)說的優(yōu)勢所在。哮喘是一種多基因遺傳病,由遺傳因素及環(huán)境因素共同作用,在本文中也得到證實(shí)。
[Abstract]:Purpose. To verify and explore the scientific connotation of congenital endowment factors of childhood asthma with data and data, to enrich the etiology of asthma, to promote the development of TCM etiology research of children's asthma and to enrich the treatment of children's asthma. Method. Based on the third National Epidemiology Survey of Childhood Asthma, this study used cross-sectional screening method to carry out stratified random cluster sampling. About 12000 people were sampled in Chengdu. 12000 data were entered into Epi_Info software, and 504 cases were selected from the case group. Control group (control group: random cluster sampling of non-asthmatic children without chronic respiratory inflammation. Control group selection requirements were matched with age, sex and nationality of the children. The difference in age requirement was 鹵1 year old. All the questions related to innate endowment in all questionnaires were assigned and analyzed by spss17.0 statistical software, and X2 test was used for single factor analysis. The P value was calculated, and then the statistical significance in univariate analysis was introduced into the multivariate Logistic regression analysis, OR value and 95% confidence interval were calculated, and the congenital endowment factors of asthma were comprehensively analyzed. Results. Univariate chi-square analysis showed that the mother was ill during pregnancy, had bad habits during pregnancy, had a history of multiple births or multiple births, had a family history of allergies, diagnosed allergic rhinitis in children, diagnosed urticaria in children, diagnosed eczema in children, and was not breast-fed. There were significant differences in cold and heat during pregnancy, five flavors in pregnancy, lung deficiency, spleen deficiency, kidney deficiency, P value of decoration at home before and after birth (P = 0.05). Multivariate Logistic regression analysis showed that the mother was suffering from diseases during pregnancy and family allergies. Children are diagnosed with allergic rhinitis, children are diagnosed with urticaria, children are diagnosed with eczema, pregnant women are spicy, cold, sour, pungent, weak, susceptible to colds, abdominal distension and anorexia, night sweating, loose stools, The OR values of decorated home before and after birth were 1.123 / 1.959 / 4.039 / 1.356/ 1.356/ 2.4111.80/ 3.141/ 3.5141/ 1.007 / 4.952 / 5.2541.981/ 2.174/ 2.516 / 4.624, respectively, which were risk factors of asthma. Conclusion. By univariate chi-square test and multivariate unconditioned Logistic regression analysis, the results showed that the main contents of endowment were parental matrix, fetal maintenance, timing and geographical location. The results suggest that we should strengthen the intervention of the above factors in our daily life and nursing, so as to prevent the disease before we get sick and prevent the change of the disease, and the endowment is a special concept of traditional Chinese medicine. There is a broad sense and a narrow sense. The narrow endowment is similar to the inheritance of modern medicine and is based on genes and chromosomes. In clinical practice, the application of more endowments is broad, including the parental matrix mentioned in the article, fetal maintenance, timing, geographical location, The general concept of endowment can reflect the relationship between human beings and diseases more truly, so the general concept of endowment can reflect the relationship between human beings and diseases more realistically, so the general concept of endowment can not always be reflected at the level of gene, so the concept of endowment in a broad sense can reflect the relationship between human and disease. This is the advantage of the endowment theory of traditional Chinese medicine. Asthma is a polygenetic disease, which is combined by genetic factors and environmental factors, which is also confirmed in this paper.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R272

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