本文關(guān)鍵詞： 脾虛 慢性病 全科醫(yī)學(xué) 證治規(guī)律　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本課題通過病歷回顧研究,初步探索門診3種常見慢性病包括2型糖尿病、冠心病、慢性胃炎脾虛證型特點及用藥規(guī)律,通過對慢性病脾虛證型的不同探討脾虛證的證治規(guī)律,根據(jù)各證型的不同篩選方藥,以期為社區(qū)常見慢性疾病防治提供新思路,為后續(xù)探討中醫(yī)脾胃保健與辨證施治在社區(qū)開展的可行性及經(jīng)濟效益提供參考。方法:收集門診慢性病病歷資料,搜集各慢性病與脾虛相關(guān)證型,對病案數(shù)據(jù)進行規(guī)范化處理,輸入并建立標(biāo)準(zhǔn)化數(shù)據(jù)庫,采用統(tǒng)計軟件SPSS 22.0版對數(shù)據(jù)進行頻數(shù)分析、因子分析,依據(jù)中醫(yī)理論對所得到的統(tǒng)計結(jié)果進行分析,總結(jié)各慢性病脾虛證特點及用藥規(guī)律。結(jié)果:1.本課題納入3種慢性病脾虛證病歷600份,男性260例,女性340例。其中,2型糖尿病病歷男性占43.5%,女性占56.5%;冠心病男性占47.0%,女性占53.0%;慢性胃炎男性占39.5%,女性占60.5%。臨床調(diào)查資料的統(tǒng)計結(jié)果為3種慢性病脾虛證總的男女比例差異無明顯統(tǒng)計意義。年齡方面,2型糖尿病、冠心病年齡段在60-75歲最多,分別占39.5%、42.0%,平均年齡分別是62.5歲、68.16歲,以老年人為主。慢性胃炎的調(diào)查中年齡段在30-45歲的患者最多,占40.5%,其次是46-60歲,占30.5%,以中年患者為主體。2.3種脾虛證慢性病高頻癥狀(10%)分布情況:2型糖尿病依次是疲倦乏力、口干、肢體麻木、睡眠障礙、胃部不適、食欲不振、頭暈頭痛;冠心病高頻癥狀依次是胸悶、乏力氣短、心悸、睡眠障礙、頭暈頭痛、胸痛、食欲不振、肢體麻木疼痛、口干、胃部不適;慢性胃炎高頻癥狀是上腹脹、上腹痛、噯氣、睡眠障礙、食欲不振、疲倦乏力、便溏、反酸、口干、便秘、口苦、燒心、惡心欲嘔。3種脾虛證慢性病證型分布情況:2型糖尿病脾虛證證型依次是脾虛濕瘀脾腎兩虛脾虛痰濕氣陰不足脾虛夾瘀脾胃氣虛脾虛濕阻化熱;冠心病的脾虛證型脾虛痰瘀脾虛夾瘀脾腎兩虛氣陰不足心脾兩虛脾胃氣虛脾虛氣滯;慢性胃炎脾虛證型是脾虛氣滯脾胃氣虛肝郁脾虛脾虛濕阻化熱脾虛濕滯氣陰不足。3.通過對3種慢性病中藥進行因子分析,得到幾類中藥群,即公因子。2型糖尿病提取出10個公因子,其中與脾氣虛相關(guān)的因子有3個,與陰虛相關(guān)的因子有2個;與濕相關(guān)的因子有6個;與痰相關(guān)的因子有2個;與血瘀相關(guān)的因子有6個;與氣滯相關(guān)的因子2個。冠心病中藥中提取出8個公因子,與脾氣虛相關(guān)的因子有3個;與痰濕相關(guān)的因子有3個;與血瘀相關(guān)的因子有3個;與陰虛相關(guān)的因子有2個;與氣滯相關(guān)的因子有3個。慢性胃炎共提取了 6個公因子,與脾虛氣滯相關(guān)的因子有3個,與脾氣(陽)虛相關(guān)的因子有2個;與脾虛痰濕相關(guān)的因子有3個。結(jié)論:脾虛在慢性病的發(fā)病中起重要作用,本研究中,3種慢性病均與脾虛證關(guān)系密切,對于慢性病具有病程長、反復(fù)發(fā)作的特點,病機錯綜復(fù)雜,虛實夾雜,須在辨證基礎(chǔ)上,重視健脾益氣扶正的治法。另外,重視脾胃保健在慢性病預(yù)防中的作用,避免損傷脾胃。
[Abstract]:Objective: This study by reviewing medical records, 3 outpatient preliminary exploration of common chronic diseases including type 2 diabetes, coronary heart disease, chronic gastritis of spleen deficiency syndrome characteristics and drug law, through the study of different type of chronic diseases of the spleen deficiency of spleen deficiency syndrome and treatment rules, according to the different screening prescription of each type, in order to provide new ideas for the community to provide reference for preventing and treating chronic disease, health care and TCM syndrome differentiation in the community to carry out the feasibility and economic benefits for the subsequent study. Methods: collected the chronic disease outpatient medical records, collecting various chronic diseases and spleen deficiency syndrome, to standardize the medical record data input, and establish a standardized database, using the the statistical software SPSS 22 version of the data were analyzed by frequency analysis, factor analysis, based on the theory of TCM statistics the results of analysis, summarizes the characteristics of spleen deficiency syndrome of chronic disease and drug law. Results: 1. the research included 3 kinds of chronic diseases of spleen deficiency syndrome 600 cases, male 260 cases, female 340 cases. Among them, type 2 diabetes cases accounted for 43.5% of men, women accounted for 56.5%; coronary heart disease accounted for 47% of men, women accounted for 53% of male patients with chronic gastritis; 39.5%, women accounted for 60.5%. clinical data statistics survey results 3 kinds of chronic diseases of spleen deficiency ratio of male and female differences had no obvious statistical significance. The age, type 2 diabetes, coronary heart disease, aged 60-75, accounted for 39.5%, 42%, the average age was 62.5 years old, 68.16 years old, mainly in the elderly age. Investigation of chronic gastritis in 40.5% in 30-45 the age of patients, the most, followed by 46-60 years old, accounting for 30.5%, with.2.3 as the main body of middle-aged patients with spleen deficiency syndrome of chronic disease symptoms (10%) high frequency distribution: type 2 diabetes are fatigue, dry mouth, numbness, sleep disorders, stomach discomfort, loss of appetite, dizziness and headache; Coronary heart disease high-frequency symptoms are fatigue and shortness of breath, chest tightness, heart palpitations, sleep disorders, dizziness and headache, chest pain, loss of appetite, limb pain and numbness, dry mouth, stomach discomfort and symptoms of chronic gastritis; high frequency is abdominal distension, abdominal pain, belching, sleep disorders, loss of appetite, fatigue fatigue, diarrhea, reflux, constipation, dry mouth, bitter taste. Heartburn, nausea.3 spleen deficiency syndrome of chronic disease syndromes: type 2 diabetes spleen deficiency syndrome in spleen wet stasis spleen kidney two empty spleen yin deficiency blood stasis phlegm damp spleen qi deficiency of spleen and stomach, spleen deficiency and dampness heat of spleen deficiency syndrome; coronary heart disease of the spleen deficiency phlegm and blood stasis of blood stasis due to spleen deficiency of spleen kidney two empty gas Yin deficiency of heart and spleen two deficiency of spleen qi and stomach qi deficiency of spleen qi stagnation; chronic gastritis of spleen deficiency type is spleen deficiency and qi stagnation of spleen qi and stomach qi stagnation and spleen deficiency of spleen dampness heat of spleen dampness Qi and yin deficiency.3. through factor analysis of 3 kinds of chronic diseases in traditional Chinese medicine, several classes of Chinese medicine group, i.e. 鍏洜瀛，

本文編號：1464086