本文選題：緩解期哮喘 + 中醫(yī)分型��； 參考：《大連醫(yī)科大學》2016年碩士論文

【摘要】：目的:探討哮喘緩解期不同中醫(yī)證型患兒的胃腸動力障礙臨床表現(xiàn)和胃電圖改變。方法:入選本課題的60例患兒均來源于2013年10月至2015年2月到空軍總醫(yī)院兒科門診就診的4-12歲緩解期哮喘患兒。對所有入組患兒填寫病情基線調(diào)查表,記錄其胃腸動力障礙臨床癥狀,進行胃電圖檢測,同時進行中醫(yī)辨證,分為肺虛型、脾虛型、腎虛型,并對其胃電參數(shù)進行分析。另選取30例健康兒童為對照組。本實驗使用XDJ-S8B型消化道動力檢測儀處理系統(tǒng),分別對兩組患兒進行餐前、餐后各8min的胃電圖及胃電參數(shù)描記,并對各導聯(lián)餐前、餐后的胃電參數(shù)做比較分析。分析的胃電參數(shù)包括胃電平均幅值(Vpp)、平均頻率(f)、波形反應面積(Ra)、正常慢波百分比(PNSW)、餐后/餐前功率比等。所得數(shù)據(jù)采用正態(tài)性t檢驗。所得試驗數(shù)據(jù)均應用SPSS17.0統(tǒng)計軟件進行統(tǒng)計學分析,P0.05為差異有統(tǒng)計學意義。結(jié)果:(1)60例緩解期哮喘患兒均有不同程度的胃腸動力障礙的臨床表現(xiàn),存在納差者占60.00%(其中肺虛證占45.45%,脾虛證占86.67%,腎虛證占66.67%),噯氣者70.00%(肺虛證占69.70%,脾虛證占80.00%,腎虛證占58.33%),惡心、嘔吐者38.88%(肺虛證占33.33%,脾虛證占66.67%,腎虛證占16.67%),66.67%的患兒出現(xiàn)食后腹脹、腹痛(肺虛證占60.61%,脾虛證占86.67%,腎虛證占58.33%),71.67%的患兒存在大便秘結(jié)不暢(肺虛證占60.61%,脾虛證占93.33%,腎虛證占75%)。(2)胃體、胃竇導聯(lián),緩解期哮喘組的餐后胃電參數(shù)Vpp、Ra較餐前均有所升高,差異有統(tǒng)計學意義(P0.05),胃電參數(shù)f、PNSW餐前、餐后無明顯差異。餐后/餐前功率比1。對照組的胃電參數(shù)Vpp、Ra餐后明顯比餐前升高,兩者差異有顯著性(P0.05),胃電參數(shù)f、PNSW餐前、餐后無明顯差異,餐后/餐前功率比1。(3)胃體、胃竇導聯(lián),緩解期哮喘兒童組的餐前胃電參數(shù)Vpp、f、Ra均低于對照組,差異有顯著性(P0.05),餐前胃電參數(shù)PNSW與對照組比較無明顯差異。緩解期哮喘組餐后胃電參數(shù)Vpp、f、Ra均小于對照組,差異有顯著性(P0.05),而餐后胃電參數(shù)PNSW兩組比較無明顯差異。(4)胃體、胃竇導聯(lián),緩解期哮喘組各中醫(yī)證型餐前胃電參數(shù)Vpp、f、Ra均無顯著性差異,餐后胃電參數(shù)Vpp、f、Ra亦均無顯著性差異。結(jié)論:緩解期哮喘患兒常有不同程度胃腸動力障礙的臨床表現(xiàn),主要表現(xiàn)為納差、噯氣、食后腹脹、腹痛及大便秘結(jié)不暢等,脾虛證患兒表現(xiàn)尤其明顯。與健康兒童胃電圖相比,緩解期哮喘患兒的胃電活動異常,胃電功率降低,胃電基本節(jié)律減慢,胃舒縮功能降低,胃動過緩,胃排空減慢,胃動力不足。但緩解期哮喘各中醫(yī)辨證分型之間的胃電圖比較無顯著性差異。
[Abstract]:Objective: To investigate the clinical manifestations and Electrogastrogram changes of gastrointestinal motility disorders in children with different TCM syndrome types during the remission period of asthma. Methods: all 60 children enrolled in this subject were from 4-12 year old children with asthma in outpatient department of Pediatrics of General Hospital of the Air Force PLA from October 2013 to February 2015. The clinical symptoms of gastrointestinal motility disorders were recorded, and the electrogastrogram was detected. At the same time, the TCM syndrome differentiation was divided into lung deficiency type, spleen deficiency type and kidney deficiency type, and the gastric electrical parameters were analyzed. 30 healthy children were selected as the control group. The XDJ-S8B digestive tract dynamic test instrument was used in the experiment. Two groups of children were treated before meals and 8 after meals respectively. The electrogram and electrogram of min were used to make a comparative analysis of the gastric electrical parameters before and after meals. The analysis of the gastric electrical parameters included the average amplitude of the stomach (Vpp), the average frequency (f), the area of the wave response (Ra), the normal slow wave percentage (PNSW), the postprandial / pre meal power ratio, and so on. The data obtained by the normal T test. Statistical analysis was carried out with SPSS17.0 statistical software, and the difference was statistically significant. Results: (1) 60 cases of children with asthma had different degrees of clinical manifestations of gastrointestinal motility disorder, 60% (45.45% of lung deficiency syndrome, 86.67% of spleen deficiency, 66.67% of kidney deficiency syndrome, 66.67% of kidney deficiency syndrome), and 70% (69.70% of asthenia of lung, spleen deficiency). Syndrome accounted for 80%, kidney deficiency syndrome accounted for 58.33%), nausea, vomiting 38.88% (33.33% of asthenia of the lung, 66.67% of spleen deficiency, 16.67% of kidney deficiency), 66.67% of children with abdominal distention, abdominal pain (60.61% of lung deficiency syndrome, 86.67% of spleen deficiency, 58.33% of kidney deficiency syndrome, 58.33% of kidney deficiency syndrome, 58.33%), 71.67% of children with feces (deficiency of lung syndrome, 60.61%, spleen deficiency 93.33%, kidney deficiency) (2) 75%. (2) gastric body, gastric antrum lead, and remission asthma group had higher postprandial gastric electrical parameters Vpp and Ra than before meals. The difference was statistically significant (P0.05). There was no significant difference between the gastric electrical parameters and PNSW before meals. The gastric electrical parameters of the postprandial / pre meal power ratio of the 1. control group were Vpp, Ra after the meal was significantly higher than that before the meal, and the difference was significant (P0.05). The gastric electrical parameters F, PNSW before meal, no obvious difference after meal, after meal / pre meal power ratio 1. (3) stomach body, gastric antrum lead, Vpp, F, Ra of the children with asthma in the remission stage were lower than the control group, the difference was significant (P0.05), the pre meal gastric electrical parameters PNSW was not significantly different from the control group. The postprandial gastric electrical parameters Vpp, F, Ra were smaller in the remission stage asthma group. In the control group, the difference was significant (P0.05), but there was no significant difference in the PNSW two groups after the meal. (4) there was no significant difference between the gastric body, the gastric antrum lead, and the Vpp, F, and Ra of the TCM syndrome types, and there were no significant differences in the postprandial gastric electrical parameters Vpp, F, Ra. The clinical manifestations of dynamic dysphasia were mainly characterized by Na, belching, abdominal distention, abdominal pain and poor constipation, especially in children with spleen deficiency syndrome. Compared with the healthy children's electrogram, the abnormal gastric electrical activity, the decrease of gastric electric power, the decrease of gastric electric base rhythm, the decrease of gastric systolic and contractile function, the slow gastric motility and gastric emptying in the children of the healthy children were compared with the healthy children's electrogram. There was no significant difference in the electrocardiogram between TCM Syndromes of asthma in remission stage.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R272

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