本文關鍵詞： 氣虛證 升陷湯 臨床觀察　出處：《北京中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

【摘要】：背景:氣虛證廣泛見于各種疾病的不同階段或亞健康人群,表現(xiàn)為乏力、自汗、氣短、神疲、懶言、脈虛、舌淡等一系列癥候群,中醫(yī)治療氣虛證有獨特的優(yōu)勢。臨床上遇氣虛證患者,多數(shù)中醫(yī)工作者辨證用藥習慣從傳統(tǒng)的調(diào)整陰陽、調(diào)理臟腑之氣、營衛(wèi)之氣入手,我們基于宗氣在人體的獨特地位試從調(diào)補宗氣入手治療氣虛證。歷代醫(yī)家認為宗氣能統(tǒng)攝全身諸氣,是諸氣的綱領,具有"貫心脈、行呼吸,總行氣血,撐持全身、振作精神,維持神思腦力,溫養(yǎng)四肢官骸'"等功能[1]。宗氣虧虛推動無力,氣血斡旋失暢,全身諸氣均受影響,表現(xiàn)為營衛(wèi)之氣、臟腑之氣、經(jīng)絡之氣不能正常運行,臟腑功能得不到正常的發(fā)揮。所以運用升陷湯益氣升提、調(diào)補宗氣,可以作為治療氣虛證的一個思路。研究目的:通過觀察升陷湯加減治療氣虛證患者的中醫(yī)癥狀改善情況,綜合評價升陷湯加減治療氣虛證的臨床療效,為進一步擴大升陷湯的適應范圍,為使升陷湯被更多中醫(yī)工作者重視和認識盡一份力。研究方法:本臨床研究采用自身前后對照的方法,根據(jù)氣虛證診斷標準、納入標準、排除標準,共納入氣虛證患者89例,脫落5例。84例氣虛證患者按照疾病種類分為6組:糖尿病、心血管疾病、甲狀腺疾病、腎系病、慢性疲勞綜合征、其他疾病組。對符合納入標準的患者予升陷湯加減治療。觀察周期為4周,分別于治療前0天和治療后第28天進行證候?qū)W記錄,根據(jù)中醫(yī)證候積分來評價癥狀的改善情況。采用SPSS21.0統(tǒng)計分析軟件進行統(tǒng)計學處理。研究結(jié)果:①經(jīng)過治療后,84例氣虛證患者的臨床療效顯示:痊愈0例,顯效10例,有效74例,無效0例,總有效率100%。結(jié)果:說明在臨床應用升陷湯加減治療氣虛證患者有顯著的療效。②84例患者分病種治療前后差值進行組間比較,P值0.05,比較差異有統(tǒng)計學意義,組間差值大小順序為:甲狀腺疾病慢性疲勞綜合征其他疾病腎系疾病心血管疾病糖尿病。結(jié)果:說明升陷湯加減對甲狀腺疾病的治療有較好的療效。③將84例氣虛證患者的兼夾證按照中醫(yī)證候分型分為血瘀證、血虛證、陰虛證、陽虛證、濕濁證、濕熱證、肝郁證,比較各證證候積分治療前后的差異均有統(tǒng)計學意義。結(jié)果:表明升陷湯加減治療上述各兼夾證均有效。④對各證的癥狀改善情況分析,其中神疲、乏力、氣短、自汗、肢體麻木、胸悶、心悸、咽干口渴、手足心熱、潮熱、頭暈眼花、潮熱、肢體困重、便溏不爽、苔黃膩、善太息、煩躁易怒等癥狀治療前后積分比較,P值0.05,比較差異有統(tǒng)計學意義。結(jié)果:說明升陷湯加減能明顯改善患者的上述臨床癥狀,提高患者生活質(zhì)量。⑤所有患者治療前后無不良反應。結(jié)論:升陷湯加減治療氣虛證患者在改善中醫(yī)癥狀方面有顯著的療效,能緩解患者的臨床癥狀,且未出現(xiàn)不良反應,安全有效,值得臨床推廣應用。
[Abstract]:Background: different stages of qi deficiency syndrome is common in a variety of diseases or sub-health, manifested as fatigue, sweating, shortness of breath, lassitude, lazy words, weak pulse, pale tongue and a series of TCM syndrome, Qi deficiency syndrome has a unique advantage. The clinical syndrome of Qi in TCM syndrome patients, most workers from drug habits the adjustment of the traditional conditioning organs of yin and Yang, Qi, Ying and Wei Qi of our gas tries to tune up the gas in the treatment of qi deficiency in the unique position of human body. Based on the ancient physicians that can control all the cases of gas gas, the gas is the program, with "through the heart pulse, respiratory, blood bank support, body, spirits, maintain spiritual mental, warm and nourish the limbs' function of [1]., the skeleton of Zong Qi deficiency promote weakness, blood mediated loss of smooth body of the gas are affected, manifested as Ying and Wei Qi, viscera Qi, Qi of meridians can not operate normally, viscera function is not positive Often play. So the use of Shengxian Decoction Yiqi Shengti, Tiaobu cases of gas, can be used as a way of treating qi deficiency. Objective: through the observation of TCM symptoms in Sheng Decoction in the treatment of qi deficiency syndrome patients to improve the clinical curative effect, comprehensive evaluation of Shengxian Decoction in the treatment of Qi deficiency, in order to further expand Shengxian Decoction range for Shengxian Decoction by more and more Chinese workers, attention and awareness as a force. Methods: This clinical study using self-control method, according to the standard, Qi deficiency syndrome diagnosis and inclusion criteria, exclusion criteria, a total of 89 cases of patients with Qi deficiency syndrome, 5 cases of.84 patients with syndrome of Qi off according to the types of diseases were divided into 6 groups: diabetes mellitus, cardiovascular disease, thyroid disease, kidney disease, chronic fatigue syndrome and other diseases. The patients who met the inclusion criteria for Shengxian decoction treatment. The observation period was 4 weeks, respectively before treatment 0 days and twenty-eighth days after treatment of TCM syndrome, the symptoms evaluation according to TCM syndrome integral. Using SPSS21.0 statistical analysis software was used for statistical analysis. Results: after treatment, the clinical curative effect of 84 cases showed Qi deficiency syndrome patients: 0 cases were cured, 10 cases markedly effective, effective in 74 cases, 0 cases were invalid, the total efficiency of 100%. results: in the clinical application of L has obvious curative effect in decoction treating qi deficiency patients. The 84 patients were divided into disease difference between before and after treatment were compared between the two groups, the P value is 0.05, the difference was statistically significant, the difference between the groups value order: chronic fatigue of thyroid diseases the other kidney disease syndrome disease cardiovascular disease diabetes. Results: Shenxian Decoction on the treatment of thyroid disease has good curative effect. The 84 cases of patients with Qi deficiency syndrome and syndrome according to TCM syndrome type is divided into blood stasis syndrome, blood deficiency syndrome , yin deficiency, Yang deficiency, turbid dampness, damp heat syndrome, liver stagnation syndrome, the syndrome integral comparison before and after treatment were statistically significant. Results: the results showed that Shengxian Decoction in the treatment of the complicated syndromes are effective. The analysis of improvement of symptoms to the card, the lassitude, weakness shortness of breath, sweating, numbness, palpitations, chest tightness, dry throat, thirst, hot feeling, fever, dizziness, fever, body, loose stool, yellow greasy, deep sigh, irritability and other symptoms integral comparison before and after treatment, the P value is 0.05, the difference was statistically significant. Results: the clinical symptoms Shengxian decoction can significantly improve the patients, improve the quality of life of patients. All patients with adverse reactions before and after treatment. Conclusion: Shengxian Decoction Treatment of qi deficiency syndrome patients had significant therapeutic effects in improvement of TCM symptoms, can alleviate the clinical symptoms of the patients, and no adverse reaction It is safe and effective and is worthy of clinical application.

【學位授予單位】：北京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R255

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