發(fā)布時(shí)間：2018-03-06 03:03

  本文選題：慢性萎縮性胃炎　切入點(diǎn)：腸上皮化生　出處：《河南中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過對(duì)近10年與慢性萎縮性胃炎(Chronic Atrophic Gastritis,以下簡(jiǎn)稱CAG)腸上皮化生(Intestinal Metaplasia,以下簡(jiǎn)稱IM)相關(guān)文獻(xiàn)的研究,以及對(duì)導(dǎo)師治療CAG伴IM經(jīng)驗(yàn)的總結(jié),歸納出CAG伴IM的證治規(guī)律。方法：檢索相關(guān)期刊論文(CNKI).重慶維普(VIP)、萬方等中文數(shù)據(jù)庫中2006年1月-2016年1月收錄的所有相關(guān)文獻(xiàn)資料,以證候要素-靶位-應(yīng)證組合規(guī)律理論為指導(dǎo),對(duì)檢索到的文獻(xiàn)進(jìn)行統(tǒng)計(jì)學(xué)分析,總結(jié)出CAG伴IM近10年相關(guān)文獻(xiàn)中辨證論治文獻(xiàn)中證候、證候要素、對(duì)應(yīng)靶位出現(xiàn)的規(guī)律和證候要素之間、靶位與靶位之間以及證候要素與靶位之間的應(yīng)證組合規(guī)律；對(duì)納入的以固定方加減的文獻(xiàn)進(jìn)行統(tǒng)計(jì)學(xué)分析,得出各類藥物的用藥規(guī)律；結(jié)合臨床實(shí)踐,對(duì)導(dǎo)師論治CAG伴IM的經(jīng)驗(yàn)進(jìn)行歸納總結(jié),對(duì)導(dǎo)師常用方藥及驗(yàn)案進(jìn)行剖析,進(jìn)一步闡釋本病的證治規(guī)律。結(jié)果：1)符合納入標(biāo)準(zhǔn)的近10年文獻(xiàn)中辨證治療CAG伴IM的共63篇,規(guī)范后的證型36個(gè),出現(xiàn)的證候頻次為：胃陰虧虛證脾胃濕熱證肝胃不和證脾胃氣虛證瘀阻胃絡(luò)證脾胃虛寒證氣滯血瘀證氣陰兩虛證肝脾不和證寒熱錯(cuò)雜證；2)頻次大于10的證候要素分別為內(nèi)熱、氣虛、陰虛、氣郁、血瘀、內(nèi)濕、陽虛、氣滯,證候要素組合有單證、兩證、三證和四證組合,其中兩證組合出現(xiàn)頻次最高,兩證組合中又以“氣郁+內(nèi)熱”和“內(nèi)濕+內(nèi)熱”頻次最高；對(duì)應(yīng)的靶位為胃、脾、肝、心、膽,以胃、脾、肝為主,靶位-靶位組合中脾-胃,胃-胃,肝-胃組合最多；證素-靶位組合中胃-內(nèi)熱,脾-氣虛,胃-陰虛,胃-血瘀,肝-氣郁,胃-氣虛,脾-內(nèi)熱,肝-內(nèi)熱,脾-內(nèi)濕居前9位；3)以固定方加減治療CAG伴IM的224篇文獻(xiàn)中共出現(xiàn)198種藥物,頻數(shù)為2534次,補(bǔ)虛藥、理氣藥、清熱藥、活血化瘀藥、化濕藥、消食藥、化痰藥出現(xiàn)頻次居于前7位,使用頻次居前10位的藥物分別為甘草、白術(shù)、白芍、黨參、黃芪、丹參、茯苓、半夏、白花蛇舌草、黃連。補(bǔ)虛藥中補(bǔ)氣藥、補(bǔ)血藥出現(xiàn)最多,補(bǔ)氣藥以甘草、白術(shù)、黨參、黃芪為主；補(bǔ)血藥以白芍、當(dāng)歸為主；理氣藥以陳皮、枳殼、柴胡、佛手、木香為首；清熱藥中清熱解毒藥、清熱燥濕藥最多,代表藥為白花蛇舌草、黃連、蒲公英、黃芩；活血化瘀藥以丹參、莪術(shù)、延胡索為主；化痰藥中半夏出現(xiàn)最多。結(jié)論：1.通過基于證素-靶位-應(yīng)證組合規(guī)律的CAG伴IM近10年中醫(yī)文獻(xiàn)的研究,可以得出CAG伴IM證候以胃陰虧虛證、脾胃濕熱證、肝胃不和證、脾胃氣虛證、瘀阻胃絡(luò)證、脾胃虛寒證六個(gè)證型居多,辨證時(shí)可以上述六個(gè)證型為主,病位主要在胃,與脾、肝、心、膽等臟腑相關(guān)；2.固定方加減治療CAG伴IM的224篇文獻(xiàn)中補(bǔ)虛藥、理氣藥、清熱藥、活血化瘀藥、化濕藥、消食藥、化痰藥出現(xiàn)頻次居前七位,補(bǔ)虛藥中補(bǔ)氣藥頻次最高,其次為補(bǔ)血藥、補(bǔ)陰藥、補(bǔ)陽藥,說明現(xiàn)代醫(yī)家治療CAG伴IM時(shí)以補(bǔ)虛為基礎(chǔ),尤以補(bǔ)氣為重,且出現(xiàn)氣郁(包括氣滯)、內(nèi)熱、瘀血、內(nèi)濕、食積、痰飲的可能性較大。根據(jù)用藥規(guī)律可推出CAG伴IM的病機(jī)是以正虛為主、兼以邪實(shí),正虛主要為脾胃氣虛、脾胃陰虛、脾胃虛寒,邪實(shí)主要為氣郁(包括氣滯)、內(nèi)熱、瘀血、內(nèi)濕、食積、痰濁等。3.根據(jù)聚類方,在辨證治療時(shí)可將本病分為脾胃氣虛證、脾胃虛寒證、胃陰虧虛證、寒熱錯(cuò)雜證、瘀阻胃絡(luò)證、肝氣郁滯證、脾胃濕熱證七個(gè)證型,分別運(yùn)用類六君子湯；類小建中湯；類沙參麥冬湯；類半夏瀉心湯；類丹參飲合百合烏藥湯、類失笑散以及類桃紅四物湯；類四逆散合金鈴子散等方。
[Abstract]:Objective: through in the past 10 years with chronic atrophic gastritis (Chronic Atrophic Gastritis, hereinafter referred to as CAG) of intestinal metaplasia (Intestinal Metaplasia, hereinafter referred to as IM) the study of relevant literature, and a summary of CAG treatment with IM experience, summed up the law of CAG with IM syndrome. Methods: Chinese Retrieval Periodicals Full Text Database (CNKI). Chongqing VIP (VIP), Wanfang database Chinese January 2006 -2016 year in January included all the relevant literature on syndrome elements - target - theory combination rules as the guidance, the statistical analysis of the retrieved literature, summed up the CAG with the IM syndrome related literature 10 in the literature on the treatment of syndromes, syndrome elements, between the corresponding target occurrence rules and syndrome factors between the target and the target as well as between syndrome elements and target should permit the combination rule; the included fixed Decoction of the literature For statistical analysis, the drug laws of various drugs; combined with clinical practice, the tutor on the treatment of CAG with IM experience are summarized, the tutor of common prescriptions and case analysis, further explained the ill treatment of the law. Results: 1) met the inclusion criteria of the literature for nearly 10 years in the differentiation and treatment of CAG a total of 63 patients with IM syndrome type, specification after the 36, the frequency of syndrome: stomach yin deficiency syndrome of spleen stomach damp heat syndrome of disharmony between liver and stomach spleen qi deficiency and blood stasis syndrome of spleen deficiency syndrome of stomach qi stagnation and blood stasis syndrome of disharmony between liver and spleen yin two deficiency syndrome ofintermingled; 2) greater than the frequency of syndrome the 10 elements were heat, Qi, yin deficiency, qi stagnation, blood stasis, wet, Yang deficiency, qi stagnation, syndrome factor combination with documents, two cards, cards and the four card combination, the highest frequency of occurrence of two card combination, two card combination in "Qi + heat" and "wet + internal frequency 鏈，

本文編號(hào)：1573027