本文選題：臺灣地區(qū) + 特發(fā)性中樞性性早熟��； 參考：《廣州中醫(yī)藥大學(xué)》2015年博士論文

【摘要】：目的：研究臺灣北部女童特發(fā)性中樞性性早熟(ICPP)的中醫(yī)證型分布特點,分析誘發(fā)該病的危險因素及兩者之間的相關(guān)性,收集陰虛火旺型ICPP女童病例,探討滋陰降火類中藥對此證型的療效,為臺灣中醫(yī)治療性早熟建立一遵循規(guī)范。方法：本研究采用橫斷面調(diào)查病例方法結(jié)合現(xiàn)代數(shù)理統(tǒng)計方法,通過文獻考證、專家咨詢、早期預(yù)調(diào)查等,設(shè)計病歷調(diào)查表,采集臺灣北部女童ICPP患者一般資料及中醫(yī)四診信息。將量化后的癥狀、舌、脈作為證候變量輸入計算機,建立SPSS數(shù)據(jù)庫。一般資料采用描述性統(tǒng)計分析,對整理后的證候變量進行系統(tǒng)聚類法變量聚類分析,依據(jù)專業(yè)知識結(jié)合《證素辨證學(xué)》診斷標準確定聚類類別的證型,然后得出各證型的分布情況。同時以問卷調(diào)查的形式研究性早熟發(fā)病相關(guān)因素中的危險因素,根據(jù)調(diào)查結(jié)果使用SPSS19.0統(tǒng)計軟件進行統(tǒng)計分析。最后,根據(jù)臨床的問卷研究調(diào)查、專家提問及聚類型統(tǒng)計分析的結(jié)果,確定受試患兒中陰虛火旺型的例數(shù),采用自身前后對照的方法來研究滋陰降火類中藥治療這一個證型的臨床效果。結(jié)果：1.對92例患者癥狀體征及舌脈統(tǒng)計頻數(shù)、積分,SPSS19.0統(tǒng)計軟件進行聚類分析,依據(jù)專業(yè)知識結(jié)合《證素辨證學(xué)》診斷標準確定聚類類別的證型,得出三個主要證型：陰虛火旺型：占52%,主證：乳房異常發(fā)育、月經(jīng)來潮、舌質(zhì)紅、苔少、脈細數(shù);兼證：五心煩熱、口干咽燥、潮熱盜汗、夜寐不安、大便秘結(jié)、消瘦。肝郁化火型：占25%,主證：乳房脹滿或有硬結(jié)、月經(jīng)來潮、舌質(zhì)紅、苔黃、脈弦;兼證：情緒抑郁或煩躁易怒、胸悶善太息、胸脅脹痛、口苦咽干、小便短赤。脾虛痰結(jié)型：占15%,主證：乳房脹滿有硬結(jié)有壓痛、月經(jīng)來潮、白帶增多、舌質(zhì)淡紅、苔白膩、脈滑;兼證：倦怠乏力懶言、形體偏胖、時腹痛便溏、口淡、痰多易咳。2.Logistic回歸分析結(jié)果表明,服用營養(yǎng)滋補品,成人洗漱護膚品,食用含激素食物3類因素與ICPP的致病密切相關(guān)(P0.01或P0.05),其他研究因一素未進入回歸方程。3.滋陰降火類中藥治療治療陰虛火旺型ICPP女童療效確切,采用獨立樣本t檢驗,結(jié)果顯示,治療前后臨床癥狀各項積分P值均小于0.05,具有統(tǒng)計學(xué)意義。結(jié)論：根據(jù)聚類分析、調(diào)查量表、專家提問的方式,得出的結(jié)論為：臺灣北部女童ICPP可辨證為陰虛火旺型、肝郁化火型、脾虛痰結(jié)型,沒有其他型病例,各組所占比例為陰虛火旺型肝郁化火型脾虛痰結(jié)型。調(diào)查的10類危險因素中6類與性早熟的發(fā)病相關(guān),其中經(jīng)常服用營養(yǎng)滋補品、使用含激素食品和使用成人洗漱護膚品與性早熟的致病關(guān)系密切,并且對各型ICPP女童疾病的發(fā)生均有一定作用,家長、社會、政府應(yīng)該增加重視程度,并采取相關(guān)有效地措施,如相關(guān)食品安全的政策的出臺等,以期做好全面的預(yù)防工作。滋陰降火類中藥治療治療陰虛火旺型ICPP女童療效非常確切,采用獨立樣本t檢驗,結(jié)果顯示,治療前后臨床癥狀各項積分P值均小于0.05,具有統(tǒng)計學(xué)意義,但其作用機理還沒有被大家弄清楚,需要進一步去探索和證實。
[Abstract]:Objective: To study the distribution characteristics of TCM syndrome type of idiopathic central sexual precocious puberty (ICPP) in northern Taiwan, analyze the risk factors of the disease and the correlation between them, collect the cases of ICPP girls with Yin deficiency and fire type, and discuss the effect of the traditional Chinese medicine of nourishing yin and reducing fire on this type of syndrome, and establish a standard for the treatment of precocious puberty in Taiwan. Method: in this study, a cross-sectional case method combined with modern mathematical statistics was used. Through literature examination, expert consultation, early pre investigation and so on, a medical record questionnaire was designed to collect the general information of ICPP patients in northern Taiwan and the information of four diagnosis of traditional Chinese medicine. The quantified symptoms, tongue and veins were used as the syndrome variables to enter the computer, and the SPSS data were set up. The general data are analyzed by descriptive statistics, and the cluster analysis of the syndrome variables after the arrangement is analyzed by systematic clustering method. According to the combination of professional knowledge and the diagnostic criteria of syndrome differentiation, the pattern of cluster classification is determined, and then the distribution of each type of syndrome is obtained. According to the results of the survey, the SPSS19.0 statistical software was used to analyze the risk factors. Finally, according to the clinical questionnaire investigation, expert questions and the results of various types of statistical analysis, the number of yin deficiency and fire type in the children was determined. Results: 1. of the 92 cases of symptoms and signs and the statistical frequency of tongue and vein statistics, integral, SPSS19.0 statistical software for clustering analysis, according to professional knowledge combined with "syndrome differentiation" and diagnostic criteria to determine the type of cluster of syndrome, get three main syndrome types: Yin deficiency fire type: 52%, main syndrome: abnormal development of the breast, menstrual flow, lingual red, Little moss, pulse fine number, and syndrome: five heart trouble heat, dry mouth dry sweat, hot tide and night sweats, night and sleep, constipation, thin. Liver depression fire type: 25%, the main syndrome: breast swollen or hardened, menstrual tide, tongue red, yellow moss, pulse chords; and syndrome: emotional depression and irritability, chest tightness, flank pain, mouth and throat, stool swynch, short stool. Spleen asthenia sputum knot Type: account for 15%, main evidence: the breast is filled with hard knot and tenderness, menstrual flow, leucorrhea increase, tongue light red, white and greasy, pulse slippery; and syndrome: tired lassitude laziness, body fat, abdominal pain and loose stool, palate, sputum.2.Logistic regression analysis results show, take camp nourishing tonic, adult wash and skin care products, and eat hormone food containing hormone food 3 factors and The pathogenicity of ICPP is closely related (P0.01 or P0.05). Other studies are effective for the treatment of yin deficiency and fire flourishing ICPP girls because one vegetarian is not entering the regression equation,.3. Yin reducing fire type Chinese medicine. The independent sample t test is adopted. The results show that the integral P values of clinical symptoms before and after treatment are less than 0.05, with statistical significance. Conclusion: according to cluster analysis The results of the questionnaire and experts' questions were as follows: ICPP in the northern part of Taiwan can be divided into yin deficiency and fire type, liver depression fire type, spleen deficiency phlegm junction type, and no other type of cases. The proportion of each group is Yin deficiency and fire type liver depression and spleen deficiency phlegm type. The 6 types of 10 types of risk factors are related to the onset of precocious puberty, among which the patients are related to the onset of precocious puberty. The use of nutritious tonics, the use of hormone foods and the use of adult wash and skin care products is closely related to the pathogenesis of precocious puberty, and has a certain role in the occurrence of diseases of the various types of ICPP girls. Parents, society, the government should increase the degree of attention, and take relevant effective measures, such as the policy of related food safety, in order to do so. Good comprehensive prevention work. The effect of nourishing yin and reducing fire in the treatment of ICPP girls of yin deficiency and fire flourish is very accurate. The results of independent sample t test show that the P values of the clinical symptoms before and after treatment are less than 0.05, but the mechanism of its action has not been made clear, and it needs to be further explored and confirmed.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2015
【分類號】：R272

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