發(fā)布時間：2018-01-24 16:34

  本文關(guān)鍵詞： 頑固性功能性便秘 軀體癥狀 規(guī)律研究 頑固性功能性便秘 軀體癥狀 治療　出處：《成都中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：本研究通過對頑固性功能性便秘患者軀體癥狀分類的規(guī)律研究來指導(dǎo)臨床上伴有多種軀體癥狀的頑固性功能性便秘患者的診斷問題。方法：將2015年6月1日—2016年2曰1日期間在成都肛腸專科醫(yī)院門診就診或在便秘科住院并符合納入標(biāo)準(zhǔn)的頑固性功能性便秘患者進行相關(guān)量表的調(diào)查,包括《一般情況調(diào)查表》、《便秘癥狀評分量表》、《軀體癥狀分類量表》。分析患者一般情況、軀體癥狀分類特點、軀體癥狀與便秘相關(guān)癥狀的相關(guān)性,找出頑固性功能性便秘患者的一般規(guī)律基軀體癥狀分類規(guī)律結(jié)果：54例頑固性功能性便秘伴多種軀體癥狀的患者中,性別分布呈現(xiàn)女性明顯超過男性患者趨勢;年齡構(gòu)成中患者人群主要分布在40-59歲這個年齡段;受教育程度分布,患者人群處于小學(xué)、初高中文化水平占了大部分比例;職業(yè)分布中,農(nóng)民和無業(yè)人員占了人部分比例;軀體癥狀對社會功能有嚴(yán)重影響,患者對軀體癥狀的肯定的關(guān)注度;臨床癥狀以排便不盡感、肛門墜脹最為突出;軀體癥狀分類主要以抑制性軀體癥狀為主;抑制性軀體癥狀與排便困難、排便不盡感、排便時間呈正相關(guān);患者激惹性軀體癥狀與腹痛、腹脹呈正相關(guān);生物性軀體癥狀與病程、排便頻率呈正相關(guān).結(jié)論：本課題通過研究表明中年女性、文化水平不高、從事農(nóng)業(yè)及無業(yè)人員在頑固性功能性便秘患者比例較高,頑固性功能性便秘患者所表現(xiàn)出的軀體癥狀對社會功能有嚴(yán)重影響,患者對軀體癥狀有肯定的關(guān)注度,提示臨床醫(yī)師應(yīng)重視此類便秘患者。頑固性功能性便秘患者臨床表現(xiàn)特征主要為排便不盡感和排便時間長。對于以肛門墜脹感,排便不盡感、排便時間長為主要癥狀前來就診的便秘患者應(yīng)格外重視。頑固性功能性便秘患者以抑制性軀體癥狀為主,不同軀體癥狀與不同的便秘癥狀有關(guān)聯(lián)。用軀體癥狀分類量表評估患者精神心理狀態(tài)簡單易操作,適用于所有臨床工作者。目的：本研究通過對頑固性功能性便秘伴隨軀體癥狀患者進行個體化治療,以觀察軀體癥狀分類治療的臨床療效。方法：本研究對20例頑固性功能性便秘患者,明確軀體癥狀類型后,采取相應(yīng)的推薦治療方案。采用自身前后對照的方法,比較治療前后患者便秘相關(guān)癥狀量表評分及軀體癥狀量表評分,同時觀察藥物副反應(yīng)。結(jié)果：20例患者完成3個月隨訪,均無明顯不良反應(yīng)發(fā)生。1個月治療后有效率為60%,3個月治療后總有效率為75%�；颊呋�與治療4周軀體癥狀總分比較(56.80±9.96VS43.5±7.87),雙側(cè)近似P1值=0.0000.05,差異有統(tǒng)計學(xué)意義�；颊呋�與治療12周軀體癥狀總分比較(56.80±9.96VS37,70±8.52),雙側(cè)近似P2值=().0000.05,差異有統(tǒng)計學(xué)意義�；颊呋�與治療4周便秘總分比較(15.10±2.75VS10.50±3.24),雙側(cè)近似P1值=0.0000.05,差異有統(tǒng)計學(xué)意義�；颊呋�與治療12周便秘總分比較(15.10±2.75VS8.00±3.93),雙側(cè)近似P2值=0.0000.05,差異有統(tǒng)計學(xué)意義。結(jié)論：根據(jù)病人軀體癥狀的分類具體情況而采用個體化的治療方案,能顯著改善患者消化道癥狀及焦慮抑郁情緒,療效滿意,且無明顯不良反應(yīng)發(fā)生。
[Abstract]:Objective: through the study on the regularity of obstinate functional constipation patients symptoms classification to guide the diagnosis of obstinate functional constipation patients with multiple somatic symptoms in clinic. Methods: from June 1, 2015 to 2016 2, 1 days during hospitalization of constipation in Chengdu anorectal Hospital outpatient or with intractable patients with functional constipation were investigated into the standard scale, including the general situation questionnaire < >, < > constipation symptom score, "analysis of the general condition of the patient body symptoms. Classification scale, characteristics of somatic symptoms, physical symptoms and related constipation symptoms, find a general rule based classification of somatic symptoms the results of patients with obstinate functional constipation: 54 cases of patients with obstinate functional constipation with somatic symptoms of various, gender distribution showed women significantly more than men suffering from Age structure trend; people were mainly distributed in the 40-59 year old age; education distribution, patients in the primary school, junior high school and senior high school educational level accounted for most of proportion; occupation distribution, farmers and the unemployed accounted for the proportion of people; physical symptoms have serious impact on the social function of patients with somatic symptoms the positive attention; clinical symptoms with endless defecation, anal bulge is most prominent; somatic symptoms classification mainly inhibited somatic symptoms; inhibition of somatic symptoms and defecation difficulties, endless defecation, defecation time was positively correlated with somatic symptoms; irritability and abdominal pain, abdominal distension was positively related to biology; of course with somatic symptoms, defecation frequency was positively correlated. Conclusion: through the study showed that middle-aged women, cultural level is not high, engaged in agriculture and the unemployed in obstinate functional constipation patients compared with High in patients with obstinate functional constipation showed somatic symptoms have serious impact on the social function of patients with somatic symptoms have certain degree of concern, suggesting that clinicians should pay more attention to such patients with constipation. Obstinate functional constipation in patients with clinical features included defecation imcompletely and defecation time for anal bulge long. The sense of endless defecation, defecation time as the main symptoms of constipation patients come to treatment should be paid special attention. Patients with obstinate functional constipation by inhibition of somatic symptoms, different somatic symptoms. Associated with different symptoms of constipation with somatic symptoms classification scale to assess mental state with simple and easy to operate, suitable for all clinical workers. Objective: This study of obstinate functional constipation in patients with somatic symptoms of individual treatment, to observe clinical curative effect of physical symptoms classification treatment. Methods: the study of 20 cases of obstinate functional constipation, clear body symptom type, take the recommended treatment accordingly. By self-control method, comparison of patients before and after treatment of constipation related symptoms score and physical symptoms scale score, and observe the adverse drug reaction. Results: 20 patients completed 3 months of follow-up, there were no.1 months after treatment of adverse reaction rate was 60%, 3 months after treatment, the total efficiency of 75%. patients at baseline and after 4 weeks of treatment, body symptom scores (56.80 + 9.96VS43.5 + 7.87), bilateral approximate P1 value of =0.0000.05, there were statistically significant differences in baseline and treatment in 12. Week of somatic symptoms scores (56.80 + 9.96VS37,70 + 8.52), bilateral P2 =.0000.05 (approximate), the difference was statistically significant. The baseline and 4 weeks of treatment in patients with constipation scores (15.10 + 2.75VS10.50 + 3.24), bilateral approximate P1 value =0 .0000.05, the difference was statistically significant. The baseline and 12 weeks of treatment in patients with constipation scores (15.10 + 2.75VS8.00 + 3.93), bilateral approximate P2 value =0.0000.05, the difference was statistically significant. Conclusion: the individualized treatment according to the patient's specific situation and classification of physical symptoms with emotional symptoms and anxiety, depression in patients with digestive tract significantly to improve the curative effect, with no obvious adverse reactions.

【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】：2016
【分類號】：R256.35

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