本文選題：斑禿　切入點：中醫(yī)體質(zhì)學(xué)　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過對240例斑禿患者一般情況及發(fā)病相關(guān)因素的搜集以及運用皮膚鏡觀察患者脫發(fā)部鏡下征象,分析探討斑禿中醫(yī)體質(zhì)類型的分布規(guī)律及其與發(fā)病相關(guān)因素、中醫(yī)證型和黑點征之間的關(guān)系。方法:選擇切合納入標(biāo)準(zhǔn)的AA患者共240例,且這些病例全部收集于在江蘇省中醫(yī)院的皮膚科,時間限定為2016.4-2016.12。以填寫調(diào)查問卷表、使用皮膚鏡鏡下觀察的形式進行資料收集。調(diào)查問卷選用王琦等擬定的《中醫(yī)體質(zhì)量表》(該表目前在我國中醫(yī)體質(zhì)學(xué)研究中最具權(quán)威性)。原始數(shù)據(jù)采用EXCEL處理,用spsaa16.0對進行統(tǒng)計分析。結(jié)果:1.共調(diào)查患者240例,其中男女比例為1.03:1;年齡在15～40歲之間的人最多,病程在1年以下者最多,達到55%。小學(xué)及以下者36例(15%),初高中學(xué)歷64例(26.7%),大專學(xué)歷42例(17.5%),本科學(xué)歷78例(32.5%)。研究生及以上20例(8.3%);活動期占58.33%。局限型176例,占73.33%,普禿30例占12.5%,全禿34例,占14.17%。證型分布中肝腎不足證比重最高(31.67%);其次為脾腎兩虛證(25.83%)。主要偏頗體質(zhì)類型為氣虛質(zhì)、陰虛質(zhì)、氣郁質(zhì),比重為12.92%、12.01%、11.88%。單一體質(zhì)有14例,占4.83%,復(fù)合質(zhì)共226例,其中四種以上復(fù)雜性復(fù)合體質(zhì)比重最高,達79.33%。男性患者氣虛體質(zhì)最高,其次為濕熱質(zhì);女性患者中,血疲質(zhì)及陰虛質(zhì)相同且比重最大。2.對所有計數(shù)資料采用卡方檢驗,AA體質(zhì)類型不受性別影響(X~2=10.217,P=0.2500.05);AA體質(zhì)類型分布不受年齡影響(X~2=16.197,P=0.4390.05);體質(zhì)分布類型不受AA病程階段的影響(X~2=6.549,P=0.9810.05);體質(zhì)類型分布不受AA臨床分期影響(X~2=8.951,P=0.9510.05)。學(xué)歷高低對體質(zhì)的影響不大(X~2=16.681,P=0.9880.05)。AA體質(zhì)類型與臨床嚴(yán)重度未見明顯相關(guān)性(X~2=11.816,P=0.7570.05),體質(zhì)不受證型影響(X~2=19.028,P=0.9660.05);體質(zhì)與黑點征之間不存在相關(guān)性(X~2=5.305,P=0.7250.05);黑點征檢出率與性別分布無關(guān)(X~2=3.229,P=0.0720.05)。黑點征不受年齡影響(X~2=1.777,P=0.4110.05)。黑點征的分布不受病程長短影響(X~2=0.846,P=0.6550.05)。黑點征與受教育程度無關(guān)(X~2=3.164,P=0.5310.05),黑點征隨AA臨床分期的不同而不同(X~2 =9.933,P=0.0090.05)。不能認為黑點征與AA臨床嚴(yán)重度相關(guān)(X~2=4.052,P=0.1320.05)。黑點征不受AA中醫(yī)證候影響(X~2=2.319,P=0.6770.05)。結(jié)論:本次調(diào)查AA體質(zhì)類型中最常見的是:氣虛質(zhì)、陰虛質(zhì)、氣郁質(zhì),提示我們在進行臨床診療的時候一方面要準(zhǔn)確辨病,辨證,同時還要考量患者的體質(zhì)類型,針對各自體制特征,有的放矢,綜合用藥,補正糾偏,增強療效。體質(zhì)類型與中醫(yī)證型、黑點征、和AA相關(guān)因素之間沒有明顯相關(guān)性。黑點征是本病的特征性表現(xiàn),其分布不受體質(zhì)、證型、性別、年齡、病程等影響,但與本病的臨床分期相關(guān)�？筛鶕�(jù)該征象開展相應(yīng)臨床活動,輔佐臨床診治鑒別及療效判定,提高臨床效率。
[Abstract]:Objective: to analyze the distribution of TCM physique types of alopecia areata and its related factors by collecting the general situation and the related factors of the disease in 240 patients with alopecia areata and observing the signs of alopecia areata under dermatoscope. Methods: 240 patients with AA were selected and collected in the dermatology department of Jiangsu Provincial traditional Chinese Medicine Hospital for a limited period of time from June 4 to June 12, 2016.12 to fill out the questionnaire. The questionnaire was composed of the TCM physique scale developed by Wang Qi et al. (this form is currently the most authoritative in the research of TCM physique in our country. The raw data are processed by EXCEL. Results: 1. A total of 240 patients were investigated, of whom the ratio of male to female was 1.03: 1; the number of people aged between 15 and 40 was the highest, and the course of disease was the most in less than one year. There are 36 cases of primary school and below, 64 cases of junior and senior middle school education, 42 cases of junior high school degree, 42 cases of junior college degree, 78 cases of undergraduate degree and 32.5g. The number of graduate students and over 20 cases is 8.3. The active period is 58.33. There are 176 cases of localized type, accounting for 73.33 cases, 30 cases of general alopecia, 12.5 cases of total alopecia, 34 cases of total alopecia. The proportion of deficiency of liver and kidney was the highest in the distribution of syndromes, followed by deficiency of spleen and kidney in 25.83 cases. The main types of physical bias were deficiency of qi, deficiency of yin, stagnation of qi, and specific gravity of 12.920.01 and 11.88.The single constitution was 14 cases (4.833%), and the compound was 226 cases. Among them, the proportion of more than four complex complex constitutions was the highest, reaching 79.33.The male patients with qi deficiency had the highest constitution, followed by dampness and heat; among the female patients, Blood fatigue and yin deficiency were the same and the proportion was the largest. 2. All counting data were tested by chi-square test. The physical type of AA was not affected by sex. The distribution of physical type of AA was not affected by age. The distribution of constitution type was not affected by age. The type of constitution distribution was not affected by the disease course stage of AA, and the type of constitution distribution was not affected by the disease course of AA. The distribution of physique type was not affected by the clinical stage of AA. The influence of educational level on constitution was not significant. There was no obvious correlation between the constitution type and clinical severity. There was no significant correlation between the constitution type and clinical severity, and the constitution was not affected by the syndrome type. The relationship between physique and black spot sign was not significant (P = 0.9660.05), and there was no significant correlation between physique and black spot sign (P = 0.9660.05, P = 0.9660.05, P = 0.9660.05, P = 0.9660.05, P = 0.9660.05, P = 0.9660.05, P = = =. The detection rate of the black spot sign was not related to the sex distribution. The black spot sign was not affected by age. The distribution of the black spot sign was not affected by the duration of the disease. The distribution of the black spot sign was not affected by the duration of the disease. There was no relationship between the black spot sign and the education level. The black spot sign was not related to the educational level. The black spot sign was different with the clinical stage of AA. The black spot sign was different with the clinical stage of AA. The distribution of the black spot sign was not affected by the duration of the disease. The distribution of the black spot sign was not affected by the duration of the disease. There was no correlation between the black spot sign and the education level. The black spot sign was not related to the degree of education, and the black spot sign varied with the clinical stage of AA. It can be considered that the black spot sign is related to the clinical severity of AA. The black spot sign is not affected by the TCM syndrome of AA. Conclusion: the most common type of AA constitution is deficiency of qi. Yin deficiency and qi stagnation suggest that we should, on the one hand, accurately identify diseases and syndrome differentiation, and at the same time consider the physical types of patients, in accordance with their respective institutional characteristics, with a view to their respective institutional characteristics, comprehensively use drugs, and correct and correct errors. There was no significant correlation between physique type and TCM syndrome type, blackspot sign, and AA related factors. Black dot sign was the characteristic manifestation of the disease, and its distribution was not affected by constitution, syndrome type, sex, age, course of disease, etc. But it is related to the clinical stage of the disease. According to this sign, we can carry out corresponding clinical activities, assist in clinical diagnosis and treatment, and evaluate the curative effect, and improve the clinical efficiency.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R275.9

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