本文選題：重疊 + 功能性胃腸病��； 參考：《北京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:功能性胃腸病(Functional Gastrointestinal Disorders,FGIDs),即腸-腦互動(dòng)障礙,是一組常見(jiàn)的消化科疾病。臨床上,患者常存在多種癥狀重疊,甚至有兩類或兩類以上疾病重疊的現(xiàn)象,概括為功能性胃腸病重疊綜合征,根據(jù)近些年臨床流行病學(xué)調(diào)查顯示,功能性胃腸病重疊綜合征中功能性消化不良重疊腸易激綜合征較為常見(jiàn)。功能性胃腸病重疊綜合征歸屬于中醫(yī)脾胃系疾病的范圍,目前暫無(wú)與之相對(duì)應(yīng)的病名,現(xiàn)將其歸于"胃胺痛"、"嘈雜"、"痞滿"、"吐酸"、"嘔吐"、"泄瀉"、"便秘"等病范圍,各個(gè)疾病有各自的標(biāo)準(zhǔn)證型分類,但重疊征臨床上證型繁多,存在主觀因素,目前缺乏統(tǒng)一的辨證分型標(biāo)準(zhǔn),一定程度上影響了中醫(yī)對(duì)其的認(rèn)識(shí)和臨床治療。故本研究擬以功能性消化不良重疊腹瀉型腸易激綜合征為例,探索總結(jié)功能性胃腸病重疊綜合征的常見(jiàn)癥狀及中醫(yī)證候,為建立證候要素、辨證論治體系奠定一定的流行病學(xué)基礎(chǔ),以期規(guī)范功能性胃腸病重疊綜合征的中醫(yī)辨證分型標(biāo)準(zhǔn)。方法:本研究病例均來(lái)源于2016年3月至2016年12月首都醫(yī)科大學(xué)附屬北京中醫(yī)醫(yī)院脾胃病科和北京中醫(yī)醫(yī)院延慶醫(yī)院,共210例患者,且符合功能性消化不良重疊腹瀉型腸易激綜合征診斷標(biāo)準(zhǔn)。按照橫斷面調(diào)查方法,運(yùn)用擬定的臨床病例信息采集表收集資料,包括患者的一般資料及中醫(yī)四診信息等,運(yùn)用SPSS 21.0統(tǒng)計(jì)軟件對(duì)病例一般資料及癥狀進(jìn)行構(gòu)成比分析,采用聚類分析方法,探索總結(jié)功能性胃腸病重疊綜合征中醫(yī)證候的分布規(guī)律。結(jié)果:(1)一般資料:210例病人中,男性96例(45.71%),女性114例(54.29%),女性是男性的1.19倍。年齡最小的為18歲,最大的為85歲,青年人59例(28.10%),中年人75例(35.71%),老年人76例(36.19%),平均年齡為53.04± 15.17歲。(2)基于經(jīng)驗(yàn)的中醫(yī)證候類型,210例患者中,脾虛濕阻證76例,占36.19%,肝郁脾虛證69例,占32.86%,脾腎陽(yáng)虛證24例,占11.43%,脾胃氣虛證16例,占7.62%,寒熱錯(cuò)雜證15例,占7.14%,脾胃濕熱證7例,占3.33%,肝氣郁結(jié)證3例,占1.43%。(3)聚類分析結(jié)果:210例患者,納入出現(xiàn)頻率25%以上中醫(yī)四診信息,剔除對(duì)辨證無(wú)明顯意義的信息,最終納入43條癥狀體征變量,運(yùn)用系統(tǒng)聚類方法,得到三種證候類型:寒熱錯(cuò)雜、脾胃虛弱、肝郁脾虛證。結(jié)論及意義:基于聚類分析,功能性胃腸病重疊綜合征臨床常見(jiàn)的證候類型為寒熱錯(cuò)雜、脾胃虛弱、肝郁脾虛證。本研究運(yùn)用聚類分析的方法,以功能性消化不良重疊腹瀉型腸易激綜合征為例,客觀分析了功能性胃腸病重疊綜合征的中醫(yī)證候規(guī)律,避免了主觀因素對(duì)辨證分型的影響,為臨床規(guī)范化治療功能性胃腸病重疊綜合征提供了一定的理論基礎(chǔ)。
[Abstract]:Objective: functional Gastrointestinal disordersFGIDsD, or intestinal-brain interaction disorder, is a group of common digestive diseases.Clinically, patients often have multiple symptoms overlap, or even two or more types of diseases overlap phenomenon, summarized as functional gastrointestinal overlapping syndrome, according to recent clinical epidemiological surveys show,Functional dyspepsia overlapping irritable bowel syndrome is more common in functional gastrointestinal overlapping syndrome.Functional gastroenteropathy overlap syndrome belongs to the scope of spleen and stomach diseases in traditional Chinese medicine. At present, it has no corresponding disease name. It is now classified as "stomach amine pain", "noise", "ruffiness", "acid vomiting", "vomiting", "diarrhea", "constipation" and other diseases, such as "stomach pain", "noise", "fullness", "vomiting", "diarrhea", "constipation" and so on.Each disease has its own standard classification of syndromes, but there are many clinical syndrome types of overlap syndrome, there are subjective factors, the lack of unified criteria of syndrome differentiation and classification, to a certain extent, affect the understanding and clinical treatment of TCM.Therefore, this study intends to take functional dyspepsia overlapping diarrhea type irritable bowel syndrome as an example, to explore and summarize the common symptoms and TCM syndromes of functional gastrointestinal overlapping syndrome, so as to establish syndromes.The system of syndrome differentiation and treatment lays a foundation for epidemiology in order to standardize the criteria of TCM syndrome differentiation and classification of functional gastrointestinal overlapping syndrome.Methods: from March 2016 to December 2016, 210 patients were involved in this study, including the Department of spleen and stomach Diseases of Beijing Medical University affiliated to Beijing Medical University and the Yanqing Hospital of Beijing traditional Chinese Medicine Hospital.It is in accordance with the diagnostic criteria of functional dyspepsia overlapping diarrhea irritable bowel syndrome.According to the method of cross-sectional investigation, the general data of cases and symptoms were analyzed by SPSS 21.0 software, including the general data of patients and the information of four diagnoses of TCM.Cluster analysis was used to explore the distribution of functional gastroenteric overlap syndrome (FGDS) in traditional Chinese medicine (TCM).Results of the 210 patients, 96 were male (45.71) and 114 were female (54.29). The number of female was 1.19 times that of male.The youngest was 18 years old, the largest was 85 years old, 59 young people (28.1010), 75 middle-aged people (35.71), 76 elderly (36.1919), the average age (53.04 鹵15.17). Among the 210 patients with experience based TCM syndrome type, 76 cases were spleen deficiency dampness obstruction syndrome, 76 cases were spleen deficiency dampness obstruction syndrome.The information of four diagnoses of TCM appeared more than 25% frequently, eliminated the information which had no obvious meaning to the differentiation of symptoms and signs, and finally included 43 variables of symptoms and signs, and obtained three types of syndromes: cold and heat disorder, spleen and stomach weakness, liver stagnation and spleen deficiency.Conclusion and significance: based on cluster analysis, the common syndromes of functional gastroenteropathy overlap syndrome are cold and heat disorder, spleen and stomach weakness, liver stagnation and spleen deficiency.In this study, cluster analysis was used to analyze objectively the TCM syndromes of functional gastroenteric overlapping syndrome by taking functional dyspepsia overlapping diarrhea irritable bowel syndrome as an example, thus avoiding the influence of subjective factors on syndrome differentiation.It provides a theoretical basis for the standardized treatment of functional gastrointestinal overlap syndrome.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 蔡旭華;郝操;金曼;;大學(xué)生功能性胃腸病的流行病學(xué)調(diào)查及認(rèn)知療法干預(yù)研究[J];健康研究;2016年05期

2 徐三榮;;功能性胃腸道疾病羅馬診斷標(biāo)準(zhǔn)的歷史變遷及標(biāo)準(zhǔn)Ⅳ[J];中華診斷學(xué)電子雜志;2016年03期

3 陳笑騰;馬偉明;康年松;韓旭豐;;三辨一和方治療功能性消化不良重疊腹瀉型腸易激綜合征24例[J];浙江中醫(yī)雜志;2016年08期

4 杜佩鳳;陳繼彬;;腸易激綜合征重疊功能性消化不良患者與心理因素關(guān)系及療效分析[J];中國(guó)預(yù)防醫(yī)學(xué)雜志;2016年06期

5 呂林;唐旭東;王鳳云;王靜;黃穗平;陳婷;馬祥雪;程正義;田亞欣;;從“脾主運(yùn)化”理論探討論治功能性胃腸病[J];時(shí)珍國(guó)醫(yī)國(guó)藥;2016年01期

6 洪彩娟;;脾陰虛理論在功能性胃腸病中的運(yùn)用[J];中醫(yī)臨床研究;2016年01期

7 蘇清敏;蘇凌瑞;;伊托必利聯(lián)合穴位注射治療功能性消化不良重疊便秘型腸易激綜合征的臨床觀察[J];醫(yī)學(xué)綜述;2015年23期

8 葉冬梅;;生物反饋療法在治療功能性胃腸病方面的臨床意義[J];當(dāng)代醫(yī)藥論叢;2015年23期

9 于惠玲;魯素彩;王陽(yáng)陽(yáng);常穎;;老年功能性消化不良重疊腹瀉型腸易激綜合征的胃腸激素水平變化[J];中國(guó)老年學(xué)雜志;2015年21期

10 李西梅;陳平;高瑞萍;于小兵;王鐵武;;不同類型功能性胃腸病患者焦慮與抑郁情況的比較[J];寧夏醫(yī)學(xué)雜志;2015年11期

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