本文選題：重癥肌無力 + 中醫(yī)　； 參考：《長春中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:通過對重癥肌無力中醫(yī)相關(guān)文獻(xiàn)研究,歸納總結(jié)重癥肌無力中醫(yī)證候、證素及不同時(shí)間段證候類型分布規(guī)律,為重癥肌無力的標(biāo)準(zhǔn)化治療提供依據(jù),同時(shí)有關(guān)MG的臨床隨機(jī)對照試驗(yàn)文獻(xiàn)進(jìn)行質(zhì)量評價(jià),為重癥肌無力中醫(yī)治療指南提供依據(jù)。方法:通過中國知識資源總庫(CNKI)、萬方學(xué)術(shù)期刊全文數(shù)據(jù)庫、維普中文期刊數(shù)據(jù)庫(VIP)、中國生物醫(yī)學(xué)文獻(xiàn)服務(wù)系統(tǒng)電子數(shù)據(jù)庫檢索,一方面搜集近30年(1986年1月-2015年12月)所有國內(nèi)期刊發(fā)表的關(guān)于重癥肌無力中醫(yī)中文文獻(xiàn)。從中按照納入標(biāo)準(zhǔn)及排除標(biāo)準(zhǔn)篩選文獻(xiàn),從篩選后的文獻(xiàn)中提取重癥肌無力中醫(yī)各證候類型及病例基本信息等建立數(shù)據(jù)庫,采用Microsoft Excel頻數(shù)統(tǒng)計(jì)方法對證候類型、證候因素及不同時(shí)間段中醫(yī)證候類型分布規(guī)律等進(jìn)行分析統(tǒng)計(jì);另一方面收集近20年(1996年1月-2015年12月)中文期刊中所有關(guān)于重癥肌無力隨機(jī)對照試驗(yàn)研究的文獻(xiàn)。根據(jù)納入及排除標(biāo)準(zhǔn)篩選文獻(xiàn),并采用國際公認(rèn)的臨床試驗(yàn)報(bào)告的統(tǒng)一標(biāo)準(zhǔn)CONSORT聲明的條評價(jià)標(biāo)準(zhǔn)及改良Jadad評分量表的4個(gè)標(biāo)準(zhǔn)對納入的文獻(xiàn)報(bào)告進(jìn)行質(zhì)量評價(jià)。結(jié)果:1.文獻(xiàn)研究共納入27篇文獻(xiàn),重癥肌無力患者2403例。共整理出中醫(yī)證候類型分別為:脾氣虛證、脾腎兩虛證、奇經(jīng)虛損證、脾腎陽虛證、脾胃氣虛證、大氣下陷證、肝腎陰虛證、絡(luò)脈虛滯證、脾肺虛損證、氣虛血瘀證、濕熱浸淫證、腎虛血瘀證、脾腎陰虛證、脾虛濕困證、陰虛血熱證。其中主要的證候類型(比例≥10%)為脾氣虛證、脾腎兩虛證、奇經(jīng)虛損證、脾腎陽虛證、脾胃氣虛證。2.脾氣虛證及脾肺虛損證2006-2015年所占的比例較1986-1995年明顯減少;而大氣下陷證及肝腎陰虛證2006-2015年所占的比例則比1986-1995年增多;奇經(jīng)虛損證2006-2015年所占比例較1996-2005年明顯減少;而脾胃氣虛證及大氣下陷證2006-2015年所占比例較1996-2005年明顯增多。3.共提取出16項(xiàng)證素。包括病位證素(脾、腎、奇經(jīng)、胃、肝、胞絡(luò)、肺)7項(xiàng);病性證素(氣虛、陰虛、陽虛、血瘀、熱、血虛、濕、氣陷、津虧)9項(xiàng)。本病的病位多在脾、腎、奇經(jīng)(比例≥5%),病性多為氣虛、陰虛、陽虛(比例≥5%)。4.文獻(xiàn)評價(jià)研究:納入的70篇RCT文獻(xiàn)中,沒有1篇嚴(yán)格遵循CONSORT聲明條目規(guī)范報(bào)告,Jadad評分均為低質(zhì)量研究。結(jié)論：1.通過對重癥肌無力中醫(yī)證候、證候因素及不同時(shí)間段證候分布規(guī)律的研究,可見重癥肌無力辯證分型多以臟腑辨證為主,并與病因辨證和氣血陰陽辨證相結(jié)合。本病的病位以脾、腎、奇經(jīng)為主,病性則多以氣虛、陰虛、陽虛為多見。近年來肝腎陰虛、濕熱浸淫等證候類型在重癥肌無力證候中所占的比例明顯增多,所以提示我們,治療中在辨證論治、標(biāo)本兼顧的基礎(chǔ)上,病位上應(yīng)重視肝腎,病性上多注重濕熱等實(shí)證的防治。2.通過對MG隨機(jī)對照試驗(yàn)研究的文獻(xiàn)的評價(jià),發(fā)現(xiàn)目前隨機(jī)對照試驗(yàn)報(bào)告質(zhì)量偏低,有必要在相關(guān)期刊上大力推廣并采用CONSORT聲明規(guī)范隨機(jī)對照試驗(yàn)的報(bào)告。
[Abstract]:Objective: To summarize the TCM Syndromes of myasthenia gravis, syndrome factors and the distribution of syndrome types in different time periods, and to provide the basis for the standardized treatment of myasthenia gravis for myasthenia gravis. At the same time, the quality evaluation of MG's clinical randomized controlled trial literature was carried out for the treatment guide of myasthenia gravis. Methods: through the general database of Chinese knowledge resources (CNKI), the full text database of Wanfang academic periodicals, the database of VP Chinese Journal (VIP), and the electronic database retrieval of the Chinese biomedical literature service system. On the one hand, the Chinese literature on myasthenia gravis published in the domestic periodicals of nearly 30 years (December January 1986, -2015) has been collected. According to the inclusion criteria and exclusion criteria, a database was established to extract the types of TCM syndromes and basic information of myasthenia gravis from the selected literature. The Microsoft Excel frequency statistics were used to analyze the types of syndromes, syndrome factors and the distribution of TCM Syndrome Types in different time periods. The literature on all the randomized controlled trials of myasthenia gravis in the Chinese Periodicals of nearly 20 years (December January 1996 -2015 December) was collected. The inclusion and exclusion criteria were selected, and 4 criteria for the evaluation of the standard and the improved Jadad rating scale were incorporated into the internationally recognized clinical trial reports. Results: a total of 27 literature and 2403 cases of myasthenia gravis were included in the 1. literature study. The types of TCM syndromes were included: spleen qi deficiency syndrome, spleen and kidney two deficiency syndrome, Qi deficiency syndrome, spleen and kidney yang deficiency syndrome, spleen and stomach qi deficiency syndrome, atmospheric depression syndrome, liver kidney yin deficiency syndrome, asthenia syndrome of spleen and lung, deficiency of spleen and lung, Qi deficiency and blood stasis Syndrome, kidney deficiency and blood stasis syndrome, spleen kidney yin deficiency syndrome, spleen deficiency dampness syndrome, yin deficiency and blood heat syndrome, the main syndrome types (proportion > 10%) are spleen and kidney deficiency syndrome, spleen and kidney two deficiency syndrome, Qi deficiency syndrome, spleen and kidney yang deficiency syndrome, spleen and stomach Qi deficiency syndrome.2. spleen qi deficiency syndrome and spleen lung deficiency syndrome significantly reduced in 1986-1995 years. The proportion of qi depression syndrome and liver kidney yin deficiency syndrome for 2006-2015 years was more than 1986-1995 years, and the proportion of qi deficiency syndrome for 2006-2015 years decreased significantly than that of 1996-2005 years, while the proportion of spleen and stomach qi deficiency syndrome and the 2006-2015 years of atmospheric depression was significantly increased than that of 1996-2005 years, and 16 kinds of syndromes were extracted from the 1996-2005 years, including the spleen, kidney, and Qi meridian, including the spleen, the kidney and the Qi. 7 items of the stomach, liver, cell, lung and lung (Qi deficiency, yin deficiency, Yang deficiency, blood stasis, heat, blood deficiency, dampness, depression, Tianjin) 9 items. The disease is mostly in the spleen, kidney, and Qi (the proportion is more than 5%), most of the disease is Qi deficiency, yin deficiency, Yang deficiency (ratio > 5%).4. literature review: No 1 articles strictly follow the CONSORT statement entry standard report, Jad Ad scores were all low quality research. Conclusion: 1. through the study of TCM syndrome of myasthenia gravis, syndrome factors and the distribution of syndromes in different time periods, it is found that the dialectical classification of myasthenia gravis is mainly based on the syndrome differentiation of viscera, and combined with etiological syndrome differentiation and Qi blood Yin Yang syndrome differentiation. Qi deficiency, yin deficiency and yang deficiency are more common. In recent years, the proportion of syndromes of liver kidney yin deficiency, damp heat immersion and other syndromes in myasthenia gravis syndrome is significantly increased. Therefore, we suggest that on the basis of syndrome differentiation and treatment in the treatment, the liver and kidney should be paid much attention to on the basis of both syndrome differentiation and treatment, and the prevention and control of.2. through the MG random control test It is found that the quality of the present randomized controlled trial reports is low, and it is necessary to vigorously promote and use the CONSORT statement to standardize the report of the randomized controlled trial.

【學(xué)位授予單位】：長春中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R277.7

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