本文關(guān)鍵詞： 反流性食管炎 中醫(yī)證型 心理因素　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的:本次研究是以反流性食管炎(reflux esophagitis,RE)為研究對(duì)象,分為文獻(xiàn)研究和臨床研究?jī)刹糠帧Ｎ墨I(xiàn)研究部分,通過(guò)收集、分析既往中醫(yī)研究RE的文獻(xiàn),總結(jié)文獻(xiàn)中RE中醫(yī)的證型名稱與分布特征。臨床研究部分,通過(guò)統(tǒng)計(jì)學(xué)方法對(duì)RE患者的臨床相關(guān)資料進(jìn)行分析、處理,對(duì)RE患者中醫(yī)證型與心理因素相關(guān)性進(jìn)行研究,并以此為基礎(chǔ),探討RE中醫(yī)證型與精神心理因素的關(guān)系。從而進(jìn)一步加深中醫(yī)對(duì)RE的認(rèn)識(shí),為該病的中醫(yī)辨證標(biāo)準(zhǔn)化的建立提供參考依據(jù),使中醫(yī)辨證論治能更加客觀化、標(biāo)準(zhǔn)化,為臨床預(yù)防、治療RE提供理論支持。研究方法:1.文獻(xiàn)研究人工檢索包括中國(guó)學(xué)術(shù)期刊全文數(shù)據(jù)庫(kù)(CNKI)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)(SinoMed)、中文科技期刊數(shù)據(jù)庫(kù)(VIP,重慶維普)、萬(wàn)方數(shù)據(jù)庫(kù)在內(nèi)的截至2015年12月所有有關(guān)RE中醫(yī)研究文獻(xiàn)。下載、閱讀、篩選文獻(xiàn),整理歸納中醫(yī)藥學(xué)對(duì)RE的研究文獻(xiàn),并進(jìn)行文獻(xiàn)分析評(píng)價(jià)。2.臨床研究①對(duì)99例RE患者的臨床相關(guān)資料進(jìn)行調(diào)查、整理,運(yùn)用統(tǒng)計(jì)學(xué)方法分析其中醫(yī)證候的分布特點(diǎn)。②通過(guò)Z氏焦慮與抑郁自評(píng)量表對(duì)99例RE患者心理因素進(jìn)行評(píng)價(jià),進(jìn)而運(yùn)用統(tǒng)計(jì)學(xué)方法進(jìn)行處理,進(jìn)而分析患者中醫(yī)證型分布與心理因素的相關(guān)性。結(jié)果:1.文獻(xiàn)研究結(jié)果:本次文獻(xiàn)研究一共納入91篇文獻(xiàn)報(bào)道,共計(jì)10258例病例,所載共32種中醫(yī)證型,其中尤以肝胃郁熱證、肝胃不和證為多。2.臨床研究結(jié)果:本次臨床研究,一共收集病例數(shù)為99例。①患者中醫(yī)證型的所占比例由高到低依此為:肝胃不和證(20.2%)脾胃虛弱證(19.2%)肝胃郁熱證(17.2%)=脾胃濕熱證(17.2%)痰氣郁結(jié)證(14.1%)胃陰虧虛證(12.1%)。②99例RE患者焦慮程度情況分布為:無(wú)焦慮(50.5%)輕度焦慮(41.4%)中度焦慮(8.1%),無(wú)重度焦慮患者。無(wú)焦慮患者中,脾胃濕熱證和脾胃虛弱證人數(shù)相等,且患者數(shù)最多;輕度焦慮患者中,肝胃不和證患者數(shù)最多;中度焦慮患者中,無(wú)胃陰虧虛證、肝胃郁熱證及脾胃虛弱證。經(jīng)卡方檢驗(yàn),中醫(yī)證型分布與焦慮程度具有統(tǒng)計(jì)學(xué)差異(χ2=21.519,P=0.0180.05)。③99例RE患者中抑郁程度情況分布為:無(wú)抑郁(79.8%)輕度抑郁(15.1%)中度抑郁(5.1%),無(wú)重度抑郁患者。無(wú)抑郁患者中證型分布依次為:脾胃虛弱證18(18.2%)脾胃濕熱證16(16.2%)肝胃不和證13(13.1%)=肝胃郁熱證13(13.1%)胃陰虧虛證10(10.1%)痰氣郁結(jié)證9(9.1%);輕度抑郁患者中肝胃郁熱證和痰氣郁結(jié)證最多;中度抑郁患者中只出現(xiàn)肝胃不和證和痰氣郁結(jié)證。經(jīng)卡方檢驗(yàn),中醫(yī)證型分布與抑郁程度具有統(tǒng)計(jì)學(xué)差異(χ2=1 8.896,P=0.0420.05)。結(jié)論:1.文獻(xiàn)研究:RE的中醫(yī)證候類型多以肝胃郁熱證和肝胃不和證為主,其病變部位在胃、肝及脾,病理屬性以實(shí)證或虛實(shí)夾雜證為多,單純虛證可見但相對(duì)較少;病理性質(zhì)實(shí)證多見熱、氣滯及痰濕,虛證多見陰虛。2.臨床研究:①RE中醫(yī)的6個(gè)證型中以肝胃不和證和脾胃虛弱證多見。②RE患者焦慮程度與中醫(yī)證型分布具有一定的相關(guān)性,其中肝胃不和證的焦慮患者最多。③RE患者抑郁程度與中醫(yī)證型分布具有一定相關(guān)性,其中肝胃不和證的抑郁患者最多。
[Abstract]:Objective: the purpose of this study is to reflux esophagitis (reflux esophagitis RE) as the research object, is divided into two parts: literature research and clinical research. The literature research part, through the collection, analysis of the previous RE traditional Chinese medicine research literature, summarizes the references of RE in Chinese name and distribution. The part of clinical study through statistical methods, the related clinical data of RE patients were analyzed, to study the correlation of RE with TCM syndrome type and psychological factors, and on this basis, to explore the relationship between RE and the TCM syndrome type of psychological factors. In order to further deepen the understanding of RE in traditional Chinese medicine, and provide the reference for the standards of TCM syndrome of the disease the establishment of the TCM can be more objective, standard for clinical prevention and treatment of RE, to provide theoretical support. Research methods: 1. literature research of artificial retrieval including China academic journals full text database (CNKI), China biomedical literature database (SinoMed), Chinese scientific journal database (VIP, Chongqing VIP, Wanfang database), as of December 2015 all about RE Chinese medicine research literature. Download, reading, screening literature, summarizing TCM of RE research literature, and literature analysis and evaluation of the.2. clinical research 1. Investigation on 99 cases of patients with RE related clinical data, using statistical methods to analyze the distribution characteristics of TCM syndromes. Through Z's anxiety and depression self rating scale for the evaluation of the psychological factors of RE patients in 99 cases, and the use of statistical methods for processing, analysis of the correlation between patients with TCM syndromes and psychological factors then. Results: 1. literature research results: the literature study included 91 reported, a total of 10258 cases, contained a total of 32 kinds of TCM syndrome type, especially in the heat stagnation of liver and stomach, liver and stomach And as a multi.2. clinical research results: the clinical study, collected a total number of cases was 99 cases. The patients with TCM syndrome type proportion from high to low: according to the syndrome of disharmony between liver and stomach (20.2%) stomach syndrome (19.2%) heat stagnation of liver and stomach (17.2%) = 17.2% (spleen stomach damp heat syndrome gas phlegm stagnation syndrome) (14.1%) the stomach yin deficiency syndrome 99 cases (12.1%). The degree of anxiety in patients with RE distribution: (50.5%) no anxiety and mild anxiety (41.4%) moderate anxiety (8.1%), no patients with severe anxiety. The anxiety of patients, and the number of spleen stomach damp heat syndrome of spleen stomach deficiency and equal. The maximum number of patients with mild anxiety; patients, patients with liver stomachdisharmony number; moderate anxiety in patients without stomach yin deficiency, stagnation of liver and stomach heat syndrome and spleen stomach deficiency. By chi square test, type distribution and degree of anxiety syndrome has a statistically significant difference (x 2=21.519, P= 0.0180.05) in 99 cases of depression. The degree distribution for RE patients: No depression (79.8%) mild depression (15.1%) moderate depression (5.1%), no patients with severe depression. Depression in patients with syndrome type distribution is as follows: the weakness of the spleen and stomach syndrome 18 (18.2%) 16 (16.2%) of spleen stomach damp heat syndrome of disharmony between liver and stomach 13 (13.1% = 13) heat stagnation of liver and stomach (13.1%) stomach yin deficiency of 10 (10.1%) sputum stagnation syndrome (9.1%); 9 patients with mild depression of liver stomach heat syndrome and gas stagnation syndrome; liver stomach disharmony syndrome and gas stagnation syndrome appear only moderate depression patients. By chi square test, the distribution of TCM syndromes and the degree of depression has a statistically significant difference (2=1 8.896, P=0.0420.05 1.). Conclusion: the literature research: TCM syndrome types of RE with heat stagnation of liver and stomach and liver stomach disharmony, the lesions in the stomach, liver and spleen, pathological properties to empirical or the actual card is more visible but relatively simple deficiency; the pathological nature of empirical heat, qi stagnation and phlegm dampness, deficiency of yin deficiency.2. Clinical study: 6 syndromes of RE in TCM syndrome of disharmony between liver and stomach and spleen and stomach syndrome. The degree of anxiety has a certain correlation with the distribution of TCM Syndromes of RE patients, the disharmony between liver and stomach in patients with anxiety most. The degree of depression is a relationship between the RE and the distribution of TCM syndromes, including disharmony between liver and stomach depression were the most.

【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

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本文編號(hào)：1526147