本文關(guān)鍵詞：類(lèi)風(fēng)濕關(guān)節(jié)炎患者消化道（胃腸）癥狀臨床調(diào)查及證候特點(diǎn)研究　出處：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 類(lèi)風(fēng)濕關(guān)節(jié)炎 消化道癥狀 中醫(yī)辨證 半夏瀉心湯加味

【摘要】：目的:通過(guò)對(duì)確診為類(lèi)風(fēng)濕關(guān)節(jié)炎患者進(jìn)行問(wèn)卷調(diào)查的方式,篩選出其中伴有消化道癥狀的患者,并整合調(diào)查問(wèn)卷中的信息對(duì)其進(jìn)行辨證分型,總結(jié)出脾胃濕熱證的患者,對(duì)其使用半夏瀉心湯加味進(jìn)行治療并觀察療效。方法:收集2015年6月到2016年12月期間就診于中國(guó)人民解放軍第二一一醫(yī)院風(fēng)濕免疫科確診為類(lèi)風(fēng)濕關(guān)節(jié)炎的患者547例。通過(guò)采用自擬調(diào)查問(wèn)卷進(jìn)行問(wèn)卷調(diào)查的方式,在547例患者中篩選出182例合并消化道癥狀的患者。對(duì)問(wèn)卷調(diào)查中的信息進(jìn)行整理,統(tǒng)計(jì)出患者的用藥情況等病因?qū)W因素。并對(duì)具有消化道癥狀的患者進(jìn)行辨證分型。根據(jù)辨證分型的結(jié)果,選擇發(fā)病率最高的證候的患者進(jìn)行中醫(yī)辨證治療,并對(duì)其療效進(jìn)行臨床觀察。結(jié)果:試驗(yàn)一:類(lèi)風(fēng)濕關(guān)節(jié)炎患者用藥情況與合并消化道癥狀相關(guān)性的結(jié)果表明,服用雙氯芬酸鈉腸溶膠囊的患者出現(xiàn)消化道癥狀的幾率為45.45%,發(fā)病率最高,其次為塞來(lái)昔布(發(fā)病率為29.45%),使用依托考昔的患者發(fā)病率最低為27.91%。而服用慢作用抗風(fēng)濕藥的患者當(dāng)中,服用甲氨蝶呤片中有84.93%的患者出現(xiàn)不同程度的消化道癥狀。研究發(fā)現(xiàn)類(lèi)風(fēng)濕關(guān)節(jié)炎患者,出現(xiàn)最頻繁的消化道癥狀依次為:胃脘脹滿(mǎn)37.36%,噯氣反酸36.26%,胃中嘈雜31.32%,身重困倦25.82%其次所占比例較大的為惡心欲嘔18.68%,大便不暢18.68%等癥狀。RA患者胃腸道癥狀的中醫(yī)辨證分型結(jié)果表明,脾胃濕熱證的患者有68例(37.36%),人數(shù)最多,發(fā)病率由高到低,出現(xiàn)最多的另外兩個(gè)證型為寒熱錯(cuò)雜證(12.64%),肝胃不和證(10.99%),其余證候相對(duì)較少。試驗(yàn)二:試驗(yàn)一的結(jié)果表明,RA患者出現(xiàn)消化道癥狀表現(xiàn)為脾胃濕熱證的患者人數(shù)最多,因此,臨床觀察采用半夏瀉心湯加味治療脾胃濕熱證的RA合并消化道癥狀的患者,結(jié)果表明,治療組34例患者的臨床療效總有效率為94.12%,明顯高于對(duì)照組的85.29%,說(shuō)明半夏瀉心湯加味治療本病效果明確。結(jié)論:在類(lèi)風(fēng)濕關(guān)節(jié)炎患者消化道癥狀的調(diào)查中脾胃濕熱證患者比例較高,半夏瀉心湯加味可能有效減輕大部分類(lèi)風(fēng)濕關(guān)節(jié)炎患者的消化道癥狀。
[Abstract]:Objective: to screen out the patients with digestive tract symptoms by questionnaire survey on the patients with rheumatoid arthritis, and to combine the information in the questionnaire to classify them according to their syndrome differentiation. Summarizes the spleen and stomach damp-heat syndrome patients. The treatment and curative effect of Banxia Xiexin decoction were observed. A total of 547 patients with rheumatoid arthritis (RA) diagnosed in the Rheumatological Immunology Department of the 211 Hospital of the Chinese people's Liberation Army (PLA) from June 2015 to December 2016 were collected. The way of questionnaire survey. 182 patients with digestive tract symptoms were selected out of 547 patients. According to the results of syndrome differentiation, select the patients with the highest incidence of syndrome differentiation treatment. Results: test 1: the relationship between the drug use in patients with rheumatoid arthritis and the symptoms of digestive tract. Patients taking diclofenac sodium enteric-coated capsules had the highest incidence of gastrointestinal symptoms (45.45), followed by celecoxib (29.45%). The lowest incidence rate was 27.91 for those who took etoxib, while for those who took slow antirheumatic drugs. 84.93% of the patients taking methotrexate had different gastrointestinal symptoms. The study found that in patients with rheumatoid arthritis, the most frequent gastrointestinal symptoms occurred in the order: epigastric bloating over 37.36%. Belching and regurgitation 36.26, stomach noise 31.322.The proportion of heavy sleepiness 25.82% was 18.68%. TCM Syndrome differentiation of Gastrointestinal symptoms in RA patients: 68 patients with spleen and stomach dampness and Heat Syndrome have the highest number of patients, and the incidence rate is from high to low. The other two syndromes that appeared most frequently were cold and heat disorder syndrome (Y12.64), liver and stomach disharmony syndrome (10.99%), and the other syndromes were relatively less. Experiment 2: the result of experiment 1 showed that. The number of RA patients with symptoms of spleen and stomach dampness and heat is the most. Therefore, the clinical observation of patients with RA combined with digestive tract symptoms of spleen and stomach dampness heat syndrome treated with Banxia Xiexin decoction, the results show that. The total effective rate of 34 patients in the treatment group was 94.12, which was significantly higher than that in the control group (85.29%). Conclusion: in the investigation of digestive tract symptoms of patients with rheumatoid arthritis, the proportion of patients with spleen and stomach damp-heat syndrome is higher. Banxia Xiexin decoction may effectively alleviate the digestive tract symptoms of most rheumatoid arthritis patients.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張家棟;彭麗萍;朱迪;;半夏瀉心湯治療慢性胃炎臨床研究現(xiàn)狀[J];亞太傳統(tǒng)醫(yī)藥;2017年03期

2 郭金偉;葛惠男;;半夏瀉心湯合旋覆代赭湯及奧美拉唑治療反流性食管炎臨床觀察[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2017年02期

3 陳海娟;陳瑛;;塞來(lái)昔布治療類(lèi)風(fēng)濕關(guān)節(jié)炎的臨床療效[J];當(dāng)代醫(yī)學(xué);2017年02期

4 楊金良;鄭學(xué)軍;羅寰;任占芬;阮海玲;趙亞君;;類(lèi)風(fēng)濕性關(guān)節(jié)炎合并肺間質(zhì)病變相關(guān)因素分析[J];中國(guó)煤炭工業(yè)醫(yī)學(xué)雜志;2016年09期

5 李麗;徐東;張奉春;曾小峰;;類(lèi)風(fēng)濕關(guān)節(jié)炎伴血管炎22例臨床特征[J];中華臨床免疫和變態(tài)反應(yīng)雜志;2016年02期

6 陳慕芝;付強(qiáng);扶瓊;楊程德;李挺;;117例類(lèi)風(fēng)濕關(guān)節(jié)炎患者肺間質(zhì)病變臨床特點(diǎn)及危險(xiǎn)因素研究[J];上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2016年03期

7 呂婷婷;李羽;殷振杰;王鑫博;劉潔;張巖;;類(lèi)風(fēng)濕關(guān)節(jié)炎并發(fā)心血管損害的臨床特點(diǎn)與相關(guān)因素[J];心臟雜志;2016年04期

8 區(qū)志軍;;連樸飲合半夏瀉心湯加減治療脾胃濕熱證慢性淺表性胃炎的療效觀察[J];現(xiàn)代診斷與治療;2016年05期

9 李興;尹玉峰;馬斌;牛林;徐建華;;157例類(lèi)風(fēng)濕關(guān)節(jié)炎患者合并癥及并發(fā)癥的臨床研究[J];中華疾病控制雜志;2016年02期

10 王亞麗;趙慶華;史海立;;半夏瀉心湯合丹參飲加減治療慢性淺表性胃炎36例臨床療效觀察[J];中醫(yī)臨床研究;2015年27期

相關(guān)碩士學(xué)位論文 前1條

1 萬(wàn)志紅;451例住院類(lèi)風(fēng)濕關(guān)節(jié)炎患者臨床流行病學(xué)分析[D];廣西醫(yī)科大學(xué);2013年

，

本文編號(hào)：1434592