本文選題：失眠 + 傷寒論��； 參考：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:基于六經(jīng)病欲解時(shí)理論,運(yùn)用經(jīng)方對(duì)失眠患者辨證治療,觀察其臨床效果;從而為失眠的中醫(yī)臨床辨治開拓新思路提供參考依據(jù),初步探討六經(jīng)病經(jīng)方辨治思路的實(shí)際價(jià)值,從而為失眠癥的中醫(yī)臨床辨治開拓新思路提供參考依據(jù)。方法:本研究采用非對(duì)照臨床觀察性研究,根據(jù)納入和排除標(biāo)準(zhǔn),納入就診于2016年1月至2017年1月廣東省中醫(yī)院內(nèi)科門診的失眠患者61例,運(yùn)用六經(jīng)病欲解時(shí)辨證常規(guī)使用經(jīng)方進(jìn)行干預(yù),觀察治療前后PSQI量表積分變化情況,并按《中藥新藥臨床研究指導(dǎo)原則》評(píng)定其臨床療效。所有數(shù)據(jù)應(yīng)用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)分析。計(jì)量數(shù)據(jù)采用(均數(shù)士標(biāo)準(zhǔn)差)表示,符合正態(tài)性數(shù)據(jù)使用配對(duì)t檢驗(yàn),不符合正態(tài)分布的數(shù)據(jù)采用配對(duì)資料的化Wilcoxon符號(hào)秩和檢驗(yàn)。確定P0.05為有顯著性差異,P0.01為有非常顯著性差異。根據(jù)檢驗(yàn)結(jié)果評(píng)價(jià)六經(jīng)病欲解時(shí)理論運(yùn)用經(jīng)方治療失眠患者的臨床療效。結(jié)果:從2016年1月至2017年1月,共納入研究病例79例,脫落18例,最后完成療效觀察納入數(shù)據(jù)分析為61例。根據(jù)六經(jīng)病欲解時(shí)辨證理論初診診斷為少陽(yáng)病患者5例,太陽(yáng)病患者1例,陽(yáng)明病患者2例,太陰病患者3例,少陰病患者5例,厥陰病患者28例,多經(jīng)病患者17例。根據(jù)治療前PSQI量表填寫結(jié)果判斷病情的輕重,共收集輕度患者18例,中度患者34例,重度患者9例。1.臨床療效:治療4周結(jié)束后痊愈21例,顯效15例,有效22例,無(wú)效3例,總有效率為95.1%。其中少陽(yáng)病患者痊愈1例,顯效2例,有效2例;太陽(yáng)病患者痊愈1例;陽(yáng)明病患者有效1例,無(wú)效1例;太陰病患者顯效2例,有效1例;少陰病患者痊愈1例,顯效2例,有效2例;厥陰病患者痊愈11例,顯效7例,有效9例,無(wú)效1例;多經(jīng)病患者痊愈6例,顯效2例,有效8例,無(wú)效1例。其中輕度患者臨床痊愈11例,顯效1例,有效5例,無(wú)效1例,總有效率為94.4%;中度患者臨床痊愈10例,顯效9例,有效13例,無(wú)效2例,總有效率為94.1%;重度患者臨床治愈0例,顯效5例,有效4例,無(wú)效0例,總有效率為100%。2.P5Q1評(píng)分:61例患者治療前總分(13.38±3.62),治療后(8.79±3.71),治療前后PSQI評(píng)分有顯著性差別。3.PSQI主要睡眠指標(biāo)的變化:治療前后睡眠質(zhì)量指標(biāo):(2.43±0.56),(1.59±0.78),P0.001,提示治療前后差異具有統(tǒng)計(jì)學(xué)意義;治療前后入睡時(shí)間指標(biāo):(2.00±1.08),(1.34±0.96),P0.001,提示治療前后差異具有統(tǒng)計(jì)學(xué)意義;治療前后睡眠時(shí)間指標(biāo):(2.44±0.74),(1.57±0.87),P0.001,提示治療前后差異具有統(tǒng)計(jì)學(xué)意義;治療前后睡眠效率指標(biāo):(2.21±1.05),(1.41±1.12),P0.001,提示治療前后差異具有統(tǒng)計(jì)學(xué)意義;治療前后睡眠障礙指標(biāo):(1.87±0.53),(1.33±0.57),P0.001,提示治療前后差異具有統(tǒng)計(jì)學(xué)意義;治療前后睡眠障礙指標(biāo):(1.87±0.53),(1.33±0.57),P0.000,提示治療前后差異具有統(tǒng)計(jì)學(xué)意義;治療前后催眠藥物的使用指標(biāo):(0.66±1.15),(0.34±0.81),P0.005,提示治療前后差異具有統(tǒng)計(jì)學(xué)意義;治療前、后日間功能指標(biāo):(1.72±1.10),(1.13±0.96),P0.001,提示治療前后差異具有統(tǒng)計(jì)學(xué)意義。結(jié)論:1.初步提示基于六經(jīng)病欲解時(shí)理論的經(jīng)方治療對(duì)于輕、中、重度失眠患者均具有良好的療效。2.六經(jīng)病欲解時(shí)辨證理論對(duì)于失眠患者的睡眠質(zhì)量、入睡時(shí)間、睡眠時(shí)間、睡眠效率、睡眠障礙、減少催眠藥物的使用、日間功能均具有一定的作用。3.基于六經(jīng)病欲解時(shí)辨證理論,臨床應(yīng)用《傷寒論》經(jīng)方,治療失眠病證是可行的。六經(jīng)病欲解時(shí)辨證論治是當(dāng)今辨證論治類型特別是六經(jīng)辨證的一種補(bǔ)充。
[Abstract]:Objective: Based on the theory of six meridian disease, the clinical effect of syndrome differentiation of insomnia patients was observed and the clinical effect was observed, so as to provide reference for the clinical diagnosis and treatment of insomnia, and to explore the practical value of the thought of the treatment of six meridian diseases, so as to provide a reference for the clinical diagnosis and treatment of insomnia. Methods: in this study, 61 cases of insomnia patients in the Department of internal medicine of Guangdong Province Traditional Chinese Medical Hospital from January 2016 to January 2017 were treated with non controlled clinical observational studies and 61 cases of insomnia patients in the Guangdong Province Traditional Chinese Medical Hospital from January 2016 to January 2017. Clinical study guiding principle > evaluation of its clinical efficacy. All data are statistically analyzed with SPSS17.0 statistical software. The measurement data is represented by the standard deviation of the number of men, which conforms to normal data using paired t test, which does not conform to the normal distribution of data using the paired data of the Wilcoxon symbol rank sum test. The determination of P0.05 is significant. The difference, P0.01 has a very significant difference. According to the test results, the clinical efficacy of the theory used in the treatment of insomnia patients was evaluated. Results: from January 2016 to January 2017, 79 cases were included, 18 cases were dropped, and 61 cases were analyzed. The diagnosis was 5 cases of shaoyang disease, 1 cases of sun disease, 2 cases of Yangming disease, 3 cases of Taiyin disease, 5 cases of yin disease, 28 cases of yin disease, 28 cases of syncope, 17 cases of multiple diseases. According to the results of the PSQI scale before treatment, we collected 18 cases of mild patients, 34 moderate patients, and 9 cases of severe patients with.1.: treat 4 clinical efficacy: treat 4 with treatment: treatment 4 treatment effect: treat 4 treatment: treat 4 clinical curative effect: treat 4 treatment: treat 4 Effect: treat 4 clinical curative effect: treat 4 After the end of the week, 21 cases were cured, 15 cases were effective, 22 cases were effective and 3 cases were invalid. The total effective rate was 95.1%.. The total effective rate was 1 cases, 2 cases were markedly effective, 2 cases were effective, 1 cases were cured, 1 cases of Yang Ming disease were effective and 1 cases were invalid. 11 cases were cured, 7 cases were effective, 9 cases were effective, 1 cases were invalid, 6 cases were cured, 2 cases were markedly effective, 8 cases were effective, 1 cases were invalid, of which the mild patients were clinically cured, 1 cases, effective 5, invalid 1 cases, total effective rate was 94.4%; the moderate patients were clinically cured, effective cases, effective cases, invalid cases 0 cases were cured, 5 cases were effective, 4 cases were effective and 0 cases were ineffective. The total effective rate was 100%.2.P5Q1 score: the total score of 61 patients before treatment (13.38 + 3.62) and after treatment (8.79 + 3.71). The changes of.3.PSQI main sleep indexes were significantly different before and after treatment: the quality index of sleep and sleep before and after treatment: (2.43 + 0.56), (1.59 + 0.78), P0.001, suggesting the difference before and after treatment. The difference was statistically significant; the index of sleep time before and after treatment: (2 + 1.08), (1.34 + 0.96), P0.001, indicated that the difference between before and after treatment was statistically significant; the sleep time index before and after treatment: (2.44 + 0.74), (1.57 + 0.87), P0.001, indicating the difference between before and after treatment; (2.21 + 1.05), (2.21 + 1.05), (1.41 + 1.1) before and after treatment. 2), P0.001, the difference was statistically significant before and after treatment, and the index of sleep disorders before and after treatment: (1.87 + 0.53), (1.33 + 0.57), P0.001, indicating that the difference between before and after treatment was statistically significant; the index of sleep disorders before and after treatment: (1.87 + 0.53), (1.33 + 0.57), P0.000, suggesting that the difference between before and after treatment was statistically significant; and the hypnotic before and after treatment. The index of use: (0.66 + 1.15), (0.34 + 0.81), P0.005, indicated that the difference between before and after treatment was statistically significant; before and after treatment, the index of interdaily function: (1.72 + 1.10), (1.13 + 0.96), P0.001, suggested that the difference between before and after treatment was statistically significant. Conclusion: 1. preliminarily suggest that the meridian therapy based on the theory of six meridian disease is light, medium, and severe. The sleeping patients have good effect on the.2. six meridian disease. The theory of syndrome differentiation for the sleep quality, time of sleep, sleep time, sleep time, sleep efficiency, sleep disturbance, the use of hypnotic drugs, the function of daytime all have a certain effect on.3. based on the theory of syndrome differentiation of six meridian diseases, clinical application < typhoid > meridian, insomnia for insomnia. It is feasible to diagnose the disease. Differentiation of symptoms and signs is the supplement of syndrome differentiation and treatment.
【學(xué)位授予單位】：廣州中醫(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)】：R256.23

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