本文關(guān)鍵詞：慢性心力衰竭中醫(yī)證候及證候要素分布規(guī)律十年文獻分析　出處：《河南中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

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【摘要】：目的:通過檢索近10年有關(guān)慢性心衰的中醫(yī)或中西醫(yī)結(jié)合臨床研究文獻,充分收集、分析文獻中CHF原發(fā)病、辨證分型、癥狀、證候要素分布特點,探索慢性心力衰竭常見證型及證候要素的分布規(guī)律,為今后的心衰證候規(guī)范、發(fā)病原因預防、常見證型及證候要素的臨床研究提供文獻依據(jù)。方法:通過檢索中國知網(wǎng)、萬方、維普3個數(shù)據(jù)庫中近10年有關(guān)心力衰竭或心衰或心功能不全的中醫(yī)或中西醫(yī)結(jié)合的臨床研究文獻,借助Note Express 3.2軟件導入文獻題錄,然后閱讀題名、摘要、關(guān)鍵詞,按照排除標準初步篩選文獻。再運用“辨證論治”、“證候”、“證型”、“辨證分型”為檢索詞進行二次檢索,將初步篩選后文獻進行全文下載并閱讀全文,嚴格根據(jù)納入、排除標準再次進行篩選。對符合標準的文獻提取相關(guān)資料信息。運用EpiData3.1軟件建立數(shù)據(jù)庫進行數(shù)據(jù)錄入,最后將EpiData3.1軟件中量化處理的數(shù)據(jù)導出至Excel表格中,運用頻數(shù)、構(gòu)成比描述的方法的進行統(tǒng)計分析。結(jié)果:(1)本課題最終共篩選出符合要求的文獻206篇。具有明確的辨證分型其后有具體病例數(shù)的177篇,分型后具有癥狀描述的文89篇,分型后涉及原發(fā)病的文獻104篇,分型后涉及證型與心功能分級的關(guān)系60篇。(2)中醫(yī)辨證分型參考標準多達21種。(3)CHF原發(fā)病中冠心病所占比例最大,其次為高心病、擴心病。(4)CHF證型與心功能分級:虛證類證型心功能分級多分布在Ⅱ級~Ⅲ級,Ⅳ級、Ⅰ級亦有分布;實證類證型心功能分級多分布在Ⅲ級~Ⅳ級,Ⅱ級次之,Ⅰ級未見;虛實夾雜類證型中心功能分級多集中在Ⅲ級~Ⅳ級,Ⅱ級次之,Ⅰ級極少見。(5)CHF證候經(jīng)規(guī)范后排在前11位的分別是氣虛血瘀證、氣陰兩虛證、陽虛水泛證、心腎陽虛證、心肺氣虛證、血瘀水停證、痰飲阻肺證、陰竭陽脫證、痰瘀互阻證、心血瘀阻證、陽虛血瘀證,經(jīng)提取證候要素后發(fā)現(xiàn)CHF病性類證候要素排在前6位的分別是氣虛、血瘀、陽虛、陰虛、水停、痰濁,病位類證候要素排在前3位的分別是心、肺、腎。(6)CHF癥狀出現(xiàn)頻率在2%以上為心悸、氣短、脈細、神疲、舌色紅、苔白、舌色暗、水腫、乏力、舌色淡、脈結(jié)代、喘息、脈弱、脈數(shù)、胸悶、脈沉、口唇紫紺可認定為心衰的常見癥狀。結(jié)論:(1)通過文獻研究,初步明確了心衰的主要證候和證候要素的分布情況,其常見證型為氣陰兩虛證,氣虛血瘀證、陽虛水泛證、心腎陽虛證、心肺氣虛證等,常見病性要素為氣虛、血瘀、陽虛、陰虛、水停、痰濁,常見病位為心、肺、腎;(2)心衰最常見的病因為冠心病,其次為高心病和擴心病;(3)研究發(fā)現(xiàn)心功能分級與證型關(guān)系密切,心功能Ⅰ~Ⅱ級多見于心氣虛證、心肺氣虛證,Ⅱ~Ⅲ級多見于氣陰兩虧證,Ⅲ~Ⅳ級多見于痰瘀水停及虛實兼雜類證;(4)初步明確了心衰常見癥狀心悸、氣短、神疲、水腫、乏力、喘息、胸悶、口唇紫紺、脈沉細或結(jié)代或弱或數(shù)、舌色暗紅或淡紅、苔白。
[Abstract]:Objective: to collect and analyze the distribution characteristics of CHF primary disease, syndrome differentiation, symptoms and syndromes in the past 10 years by retrieving the literatures of TCM or combination of traditional Chinese medicine and western medicine on chronic heart failure (CHF). To explore the distribution of common syndromes and syndromes of chronic heart failure (CHF) in order to standardize the symptoms of CHF in the future and to prevent the pathogenesis of CHF. The clinical research of common syndromes and syndromes elements provides the literature basis. Methods: through the search of Chinese knowledge network, Wanfang. There are three databases of Weip in recent 10 years about heart failure or heart failure or heart failure or heart failure of traditional Chinese medicine or integrated western medicine clinical research literature. With the help of Note Express 3.2 software, the title, abstract and key words were read, and the documents were screened according to the exclusion criteria, and then "syndrome differentiation and treatment" and "syndromes" were used. "Syndrome type", "syndrome differentiation" for the second search of the key words, after the preliminary screening of the full text download and read the full text, strictly according to the inclusion. The exclusion criteria are screened again. The relevant information is extracted from the documents that meet the standard. The database is built by using EpiData3.1 software for data entry. Finally, the quantized data in EpiData3.1 software is exported to the Excel table, and the frequency is used. Results: a total of 206 documents were selected to meet the requirements. 177 of the specific cases followed by specific syndrome differentiation were selected. There were 89 articles with symptom description and 104 articles with primary disease after typing. The relationship between syndromes and cardiac function classification after classification is 60 parts. 2) there are 21 kinds of reference criteria of TCM syndrome differentiation and classification. Coronary heart disease (CHD) is the largest among the primary diseases of CHF, followed by high heart disease. Type of CHF and classification of cardiac function: the types of deficiency syndromes were mostly distributed in grade 鈪，

本文編號：1425100