本文關(guān)鍵詞： 干燥綜合征 證候特點(diǎn) 證型分布 用藥規(guī)律　出處：《南京中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過(guò)對(duì)近年來(lái)中西醫(yī)治療干燥綜合征的相關(guān)文獻(xiàn)進(jìn)行整理、分析,并根據(jù)對(duì)本病臨床病例的收集及統(tǒng)計(jì)學(xué)分析,對(duì)其辨治規(guī)律進(jìn)行總結(jié),為本病的科研及臨床治療提供幫助。方法：采用回顧性研究的方法,對(duì)140例中老年女性干燥綜合征患者的年齡、舌脈、其他癥狀、辨證用藥信息逐份錄入Microsoft office Excel 2010中,同時(shí)使用IBM SPSS Statistics22.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)學(xué)分析,并采用頻數(shù)分析及聚類分析的方法,以期初步總結(jié)中老年女性干燥綜合征各證型的證候特點(diǎn)、治法及用藥規(guī)律。結(jié)果：1.證候規(guī)律：在140例患者中出現(xiàn)頻率較多的證候類型中舌質(zhì)舌形為紅舌60.71%；舌苔為少苔26.43%；脈象主要為細(xì)脈相兀關(guān)的脈象(包括細(xì)、細(xì)沉、細(xì)滑、細(xì)緩、細(xì)弱、細(xì)澀、細(xì)數(shù)、細(xì)弦共8種脈象),占比共為88.5%；其他癥狀中較為普遍存在的癥狀(出現(xiàn)頻率≥25%)有口干、限干或異物感、關(guān)節(jié)疼痛、齲齒、夜寐不安、乏力以及食欲不振,其中口干最常見,占97.14%。最常見的證型為陰虛內(nèi)熱型,占22.86%,其余依次為氣陰兩虛型、肝腎陰虛型、陰虛濕阻型、陰虛血瘀型及陰虛濕熱型。陰虛內(nèi)熱型證候特點(diǎn)為口干,眼干或異物感,齲齒,干咳少痰,皮膚干燥,關(guān)節(jié)疼痛,舌紅少津,或有裂紋舌,少苔或無(wú)苔,脈細(xì)或細(xì)數(shù),或有發(fā)熱、頭昏,夜寐不安,其中較典型的癥狀當(dāng)屬發(fā)熱；氣陰兩虛型占20.71%,特征性證候?yàn)榉αγ黠@,自汗,大便干,舌紅少津,少苔或薄白苔,脈細(xì)、細(xì)數(shù)或細(xì)弱,食欲不振,夜寐不安；肝腎陰虛型占18.57%,主要證候特點(diǎn)為口干,眼干或異物感,視物模糊,齲齒,舌紅少津,少苔,裂紋舌,脈細(xì)弦,夜寐不安,關(guān)節(jié)疼痛,大便干；陰虛濕阻型占17.14%,其證候突出表現(xiàn)為苔白膩及齒痕舌；陰虛血瘀型占14.29%,其突出證候?yàn)樯喟导t,關(guān)節(jié)疼痛明顯,皮膚紫癜,腮腺腫大,雷諾現(xiàn)象等；陰虛濕熱型僅占6.43%,突出證候表現(xiàn)為苔黃膩,大便溏及食欲不振。2.用藥規(guī)律：對(duì)140例患者總體而言,被使用頻率排在前10位的藥物分別是麥冬72.14%、生地黃69.29%、南沙參66.43%、甘草62.14%、北沙參57.14%、石斛52.14%、枸杞子42.86%、白芍37.86%、丹參37.14%、陳皮32.86%,對(duì)藥物按功效進(jìn)行分類發(fā)現(xiàn)使用頻率較高的藥物種類依次為補(bǔ)陰藥35.44%、清熱藥18.84%、補(bǔ)氣藥12.05%、補(bǔ)血藥7.37%、活血化瘀藥5.73%。陰虛內(nèi)熱型患者主要用藥為以養(yǎng)陰生滓、清熱涼血滋陰、滋補(bǔ)肝腎為主;氣陰兩虛型用藥為以滋陰潤(rùn)燥、健脾益氣、行氣布津?yàn)橹鳎桓文I陰虛型用藥主要以養(yǎng)陰生津、補(bǔ)益肝腎、健脾益氣、清熱養(yǎng)血活血為主；陰虛濕阻型患者主要用藥以燥濕健脾、益氣生津、滋補(bǔ)陰津?yàn)橹�；陰虛血瘀型主要用藥以活血化瘀、清熱涼血、養(yǎng)陰生津、通絡(luò)止痛為主；陰虛濕熱型患者主要用藥以燥濕健脾、清熱燥濕、清熱養(yǎng)陰、養(yǎng)血活血為主。結(jié)論：1.中老年女性干燥綜合征總體證候表現(xiàn)以口干、眼干或異物感、關(guān)節(jié)疼痛、齲齒、夜寐不安、乏力、食欲不振、舌紅、少苔或無(wú)苔、脈細(xì)為主,治以養(yǎng)陰生津潤(rùn)燥為根本。本病共分為六型,出現(xiàn)頻率依次為陰虛內(nèi)熱型氣陰兩虛型肝腎陰虛型陰虛濕阻型陰虛血瘀型陰虛濕熱型。2.其中陰虛內(nèi)熱型主要證候特點(diǎn)為皮膚干燥,舌紅少津,或有裂紋舌,或有發(fā)熱、頭昏,夜寐不安,治以滋陰生津、清熱涼血為主,方用一貫煎去川楝子合芍藥甘草湯加減；氣陰兩虛型主要證候特點(diǎn)突出體現(xiàn)在乏力明顯,自汗,治以滋陰潤(rùn)燥、健脾益氣布津,方用益胃湯合補(bǔ)中益氣湯加減：肝腎陰虛型主要證候特點(diǎn)突出表現(xiàn)為視物模糊,齲齒,裂紋舌,脈細(xì)弦,治以補(bǔ)益肝腎、養(yǎng)陰生津、健脾益氣、清熱養(yǎng)血活血為主,方用益胃湯合杞菊地黃丸及二至丸加減；陰虛濕阻型證候特點(diǎn)突出表現(xiàn)為舌紅或淡,苔白膩或伴齒痕舌,食欲不振,治以燥濕健脾、滋陰生津?yàn)橹?方用益胃湯合參苓白術(shù)散加減；陰虛血瘀型證候特點(diǎn)突出表現(xiàn)為關(guān)節(jié)疼痛明顯,皮膚紫癜,腮腺腫大,雷諾現(xiàn)象,齲齒,舌暗紅等,治以養(yǎng)陰清熱涼血、活血化瘀通絡(luò)為主,方用沙參麥冬湯合桃紅四物湯加減；陰虛濕熱型主要證候特點(diǎn)為食欲不振,舌紅,或有裂紋舌,苔黃膩,脈細(xì)數(shù),大便溏等,治以健脾益氣、清熱燥濕、活血養(yǎng)陰為主,方用四妙丸合四君子湯并佐以益胃湯加減為宜。
[Abstract]:Objective: through the relevant literature of Western medicine in recent years in the treatment of Sjogren syndrome were collected, analyzed, and according to the statistics collection and analysis of clinical cases of this disease, the treatment rules were summarized, to provide help for the scientific research and clinical treatment of the disease. Methods: a retrospective study of elderly patients, 140 cases of female Sjogren syndrome age, tongue and pulse, other symptoms, medication information by a Microsoft office entry in Excel 2010, and analyzed by using the IBM SPSS Statistics22.0 software, and the method of frequency analysis and cluster analysis, in order to preliminarily summarize the syndrome characteristics of elderly women Sjogren syndrome syndrome the treatment and medication rules. Results: 1. syndromes: tongue tongue red tongue 60.71% syndrome types frequently appeared in 140 patients in the coating is 26.43% less moss; 鑴夎薄涓昏涓虹粏鑴夌浉鍏，

本文編號(hào)：1548719