發(fā)布時(shí)間：2018-03-02 07:28

  本文關(guān)鍵詞： 老年人 AAD 菌群失調(diào) 流行病學(xué)調(diào)查 苦寒傷胃　出處：《山東中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:運(yùn)用流行病學(xué)方法對老年人抗生素相關(guān)性腹瀉發(fā)病的危險(xiǎn)因素、證候分布等方面進(jìn)行調(diào)查研究,探討其發(fā)病規(guī)律,以期對今后老年人抗生素相關(guān)性腹瀉的診斷和治療提供指導(dǎo)。方法:選擇我院2014年10月—2015年12月符合老年人抗生素相關(guān)性腹瀉納入標(biāo)準(zhǔn)的80例患者,對其臨床資料進(jìn)行調(diào)研分析。觀察內(nèi)容包括患者人口學(xué)特征,基礎(chǔ)疾病,抗生素應(yīng)用的原因、種類及時(shí)間,腹瀉次數(shù)、大便性狀及相關(guān)癥狀和體征,舌苔脈象以及輔助檢查等,采用EXCEL 2003進(jìn)行數(shù)據(jù)管理,運(yùn)用SPSS 21.0統(tǒng)計(jì)軟件對計(jì)數(shù)資料進(jìn)行χ2檢驗(yàn)及秩和檢驗(yàn)。結(jié)果:1.老年人抗生素相關(guān)性腹瀉的發(fā)病率與性別無關(guān)。2.老年人抗生素相關(guān)性腹瀉患者以70-79歲居多,占51.2%。3.老年人抗生素相關(guān)性腹瀉患者中83.75%患有基礎(chǔ)病,排前3位的依次是心腦血管疾病(38.98%)、呼吸系統(tǒng)疾病(22.03%)、糖尿病(17.8%)。4.老年人抗生素相關(guān)性腹瀉患者使用抗生素的原因主要為呼吸系統(tǒng)感染(53.75%)、尿路感染(12%)和預(yù)防應(yīng)用(13.75%)。5.引起老年人抗生素相關(guān)性腹瀉的抗生素,以三代頭孢(22.96%)、廣譜青霉素類(19.26%)和碳青霉烯類(14.81%)居多。6.當(dāng)抗生素使用時(shí)間14天,腹瀉發(fā)病率明顯升高。7.老年人抗生素相關(guān)性腹瀉各證型中,脾腎陽虛證最多,占56.25%,其次為脾胃虛弱證,占23.75%。結(jié)論:老年人抗生素相關(guān)性腹瀉的危險(xiǎn)因素主要有:使用廣譜抗生素、患有基礎(chǔ)疾病、抗生素使用時(shí)間長等。老年人抗生素相關(guān)性腹瀉有寒濕困脾證、濕熱內(nèi)蘊(yùn)證、脾胃虛弱證、脾腎陽虛證4種證型,尤以脾腎陽虛證、脾胃虛弱證常見。
[Abstract]:Objective: to investigate the risk factors and syndromes distribution of antibiotic associated diarrhea in the elderly by means of epidemiological method. Methods: from October 2014 to December 2015, 80 patients who met the criteria of antibiotic associated diarrhea in our hospital were selected. The clinical data were investigated and analyzed. The observation included demographic characteristics of patients, basic diseases, causes, types and time of antibiotic use, number of diarrhea, stool traits and related symptoms and signs, tongue coating pulse and auxiliary examination, etc. Using EXCEL 2003 for data management, The statistical software SPSS 21.0 was used to test the count data by 蠂 2 test and rank sum test. Results: 1. The incidence of antibiotic associated diarrhea in the elderly was not related to sex. 2. The majority of elderly patients with antibiotic associated diarrhea were 70-79 years old. 83.75% of the elderly patients with antibiotic associated diarrhea had basic diseases, The top three were cardio-cerebrovascular diseases (38.98), respiratory diseases (22.03) and diabetes (17.8). The main reasons for the use of antibiotics in elderly patients with antibiotic associated diarrhea were respiratory infection (53.75g) and urinary tract infection (12g) and preventive use of 13.75g. Antibiotics for antibiotic associated diarrhea in the elderly, Among the three generations of cephalosporium 22.96m, broad-spectrum penicillin 19.26) and carbapenem 14.81), the incidence of diarrhea increased significantly when antibiotics were used for 14 days. The incidence of diarrhea in the elderly patients with antibiotic associated diarrhea was the most in all the syndrome types, spleen and kidney yang deficiency syndrome was the most. Conclusion: the main risk factors of antibiotic associated diarrhea in the elderly are: the use of broad-spectrum antibiotics, suffering from basic diseases, the second is deficiency of spleen and stomach, the second is deficiency of spleen and stomach, and the second is deficiency of spleen and stomach. The antibiotics were used for a long time. There were four syndrome types of antibiotic associated diarrhea in the elderly, including cold and dampness syndrome, damp-heat accumulation syndrome, spleen and stomach deficiency syndrome, spleen and kidney yang deficiency syndrome, especially spleen and kidney yang deficiency syndrome, and spleen and stomach deficiency syndrome.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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