本文關(guān)鍵詞： 小兒腦癱 證候 證素 分布 組合　出處：《遼寧中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討小兒腦癱中醫(yī)證候及證素規(guī)律,加深對本病的中醫(yī)認(rèn)識,規(guī)范其中醫(yī)辯證,為指導(dǎo)臨床提高辨證準(zhǔn)確性及治療效果提供參考。方法:通過對89例腦癱患兒進行病歷資料調(diào)查,采集中醫(yī)四診信息,編制填寫《小兒腦癱中醫(yī)證素臨床調(diào)查表》,建立證候證素研究數(shù)據(jù)庫,并通過SPSS19.0統(tǒng)計分析軟件,利用頻數(shù)統(tǒng)計及聚類分析等方法,對提取的小兒腦癱中醫(yī)證素進行統(tǒng)計描述。結(jié)果:1.證候分布特征:89例患兒共分為6個證型,分別為肝腎不足證(55.06%)、脾腎虛弱證(16.85%)、痰瘀阻滯證(8.99%)、心脾兩虛證(7.87%)、脾虛肝亢證(6.74%)、陰虛風(fēng)動證(4.49%)。2.證素分布規(guī)律:本研究提取小兒腦癱中醫(yī)證素12個,其中病位證素4個,病性證素8個。病位證素中,腎出現(xiàn)頻率(占全部病例數(shù)的百分比,下同)最高,為71.91%,余下依次為肝(61.80%)、脾(31.46%)、心(7.87%);病性證素包括精虧(71.91%)、血虛(62.92%)、陰虛(59.55%)、氣虛(31.46%)、痰(8.99%)、瘀血(8.99%)、陽亢(6.74%)和動風(fēng)(4.49%)。病性組合中,虛性組合占79.78%,遠(yuǎn)高于虛實夾雜組合和實性組合。3.證素組合規(guī)律:證素組合有五證素組合(55.06%)、四證素組合(31.46%)和兩證素組合(13.48%)3種類型,分別對應(yīng)一種證素組合形式,即兩病位證素+三病性證素組合(55.06%)、兩病位證素+兩病性證素(31.46%)和兩病性證素(13.48%)。4.證素聚類分析:聚類分析結(jié)合中醫(yī)理論,認(rèn)為可分4類:腎與精虧一類、肝與陰虛、血虛一類、脾與氣虛一類,余下證素為一類。結(jié)論:研究結(jié)果顯示,腦癱患兒多于學(xué)齡前期(3~7歲)入院診治,且男性患兒多于女性患兒。納入病例中醫(yī)辯證共分六個證型,其中以肝腎不足證最為多見。腦性癱瘓中醫(yī)病位主要在腎、肝、脾三臟,與心相關(guān);病性證素包括精虧、血虛、陰虛、氣虛、痰、瘀血、陽亢、動風(fēng)。其中,腎、肝為主要的病位證素,二者的組合為分布最多的病位證素組合;精虧、血虛、陰虛為主要的病性證素,三者的組合為分布最多的病性證素組合。病性方面,小兒腦癱具有以本虛為主、或見虛實夾雜的特點。證素組合,包括兩證素、四證素、五證素組合三種,尤以五證素組合(即兩病位證素+三病性證素)為多,這種組合即為肝+腎+陰虛+血虛+精虧的組合。聚類分析結(jié)果提示腎精虧損、肝陰血虛和脾氣虛弱為本病重要病機,而痰、瘀血等病理產(chǎn)物亦與本病關(guān)系密切。
[Abstract]:Objective: to probe into the law of TCM syndromes and syndromes in children with cerebral palsy, to deepen the understanding of TCM on this disease, and to standardize the dialectical of TCM in children with cerebral palsy. Methods: 89 cases of cerebral palsy were investigated by medical records, and the information of four diagnoses of TCM was collected. To compile and fill out the clinical questionnaire of TCM syndromes in children with cerebral palsy, to establish the research database of syndromes syndromes, and to use the methods of frequency statistics and cluster analysis through SPSS19.0 statistical analysis software. The extracted TCM syndromes of children with cerebral palsy were statistically described. Results: 1. The characteristics of syndrome distribution in 89 children were divided into 6 syndromes. They were liver and kidney deficiency syndrome, spleen and kidney deficiency syndrome, spleen and kidney deficiency syndrome, spleen and kidney deficiency syndrome, phlegm and blood stasis block syndrome, phlegm and blood stasis block syndrome, phlegm and blood stasis block syndrome, phlegm and blood stasis block syndrome, phlegm and blood stasis syndrome, phlegm and spleen deficiency syndrome, Qi 7.87g, spleen deficiency and liver hyperactivity syndrome, liver hyperactivity syndrome, Yin deficiency and wind movement syndrome, respectively. The distribution of syndromes: 12 syndromes of children with cerebral palsy were extracted in this study, among which 4 syndromes were found in the position of disease. The frequency of kidney appearance (percentage of total cases, the same below) was the highest. For 71.91, the rest is the liver with 61.80m, the spleen with 31.46m, the heart with 7.87s and the heart with 7.87s. The syndrome elements of the disease include the essence deficiency 71.91g, the blood deficiency 62.92o, the yin deficiency 59.555am, the deficiency of qi 31.46x, the phlegm 8.9999, the blood stasis 8.99m, the Yang hyperactivity 6.7445) and the moving-wind 4.4974. The combination of deficiency is 79.78, which is much higher than that of the combination of deficiency and reality and the combination of substance. 3. The law of combination of syndromes and elements: there are five combinations of syndromes and five elements, and the combination of four syndromes is 31.4646) and the combination of two syndromes is 13.48g, corresponding to one kind of combination of evidence elements, respectively. That is, the combination of syndrome factors of two diseases, syndrome factors of three diseases, factors of syndrome of three diseases (55.06g), factors of syndrome of two diseases of disease (31.46) and factors of syndrome of two diseases (13.4848.4.The cluster analysis of syndromes: cluster analysis combined with the theory of traditional Chinese medicine (TCM), it is believed that there are 4 kinds of syndromes: kidney and essence deficiency, liver and yin deficiency, blood deficiency, etc. Spleen and qi deficiency, the remaining syndromes belong to one class. Conclusion: the results of the study show that the number of children with cerebral palsy is more than that of pre-school children (37 years old), and the number of male children is more than that of women. The syndrome of deficiency of liver and kidney is the most common. The position of TCM disease of cerebral palsy is mainly in kidney, liver and spleen, which is related to heart; the factors of disease syndrome include essence deficiency, blood deficiency, yin deficiency, deficiency of qi, phlegm, blood stasis, hyperactivity of yang, moving wind. Among them, kidney, kidney, blood deficiency, yin deficiency, qi deficiency, phlegm, blood stasis, hyperactivity of yang, moving wind. Liver is the main syndrome element, the combination of the two is the most distributed syndrome element, the essence deficiency, blood deficiency and yin deficiency are the main syndromes of disease, the combination of the three is the most distributed combination of disease syndrome factors. The children's cerebral palsy is characterized by the deficiency of essence or the inclusion of deficiency and reality. The combination of syndromes is composed of two syndromes, four syndromes, and five syndromes, especially the combination of five syndromes (that is, two disease syndromes and three diseased syndromes), which is mainly composed of two syndromes, four syndromes and five syndromes. The results of cluster analysis indicated that deficiency of kidney essence, deficiency of liver yin and blood and deficiency of temper were important pathogenesis of this disease, and phlegm, blood stasis and other pathological products were closely related to this disease.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R277.7

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