本文選題：耳鳴 + 脾胃��； 參考：《廣州中醫(yī)藥大學(xué)》2014年碩士論文

【摘要】：研究目的 耳鳴為臨床上常見的頑癥之一,迄今為止,耳鳴的發(fā)病機(jī)制仍無突破性的研究進(jìn)展。本文通過對(duì)200例耳鳴患者進(jìn)行詳細(xì)的耳鳴信息采集及脾胃功能調(diào)查,了解耳鳴的發(fā)病與脾胃的關(guān)系,探討耳鳴嚴(yán)重程度、耳鳴特征與脾胃功能的相關(guān)性,從中醫(yī)脾胃角度探討耳鳴的病因病機(jī),為合理選擇治療方案提供臨床依據(jù)。 研究方法 收集廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院耳鼻喉科2013年1月至2014年1月門診及住院部診斷為耳鳴的患者作為研究對(duì)象。首先,詳細(xì)調(diào)查其耳鳴部位、聲響、病程、聽力狀況、是否經(jīng)過治療、治療效果等基本信息,同時(shí)了解其脾胃系疾病史和日常飲食、用藥、壓力、睡眠等情況,分別評(píng)價(jià)其耳鳴嚴(yán)重程度和脾胃功能,進(jìn)行耳鳴心理聲學(xué)測(cè)試及聽力學(xué)檢查。其次,將所有患者信息輸入電腦,建立數(shù)據(jù)庫。最后,統(tǒng)計(jì)耳鳴患者存在脾胃系疾病的比例,分析其整體脾胃功能與健康成人的差異,比較不同嚴(yán)重程度的耳鳴患者脾胃功能差異,探討其脾胃功能失調(diào)的潛在因素,并對(duì)具有不同耳鳴特征的患者脾胃功能進(jìn)行單因素分析,探討耳鳴特征與脾胃功能的關(guān)系,進(jìn)一步分析耳鳴特征對(duì)中醫(yī)辨證的意義。 研究結(jié)果 1.耳鳴患者的一般資料：共計(jì)收集病例200例。其中,男121例(占60.50%),女79例(占39.50%)。年齡15-79歲,平均42.68±12.99歲；病程8天-33年,平均36.76±52.35月。職業(yè)：專業(yè)技術(shù)人員57例,文職33例,退休24例,個(gè)體經(jīng)營(yíng)者15例,公務(wù)員11例,工人9例,學(xué)生8例,其它43例。耳鳴部位：左耳39例(19.50%),右耳47例(23.50%),雙耳95例(47.50%),頭顱內(nèi)12例(6.00%),頭顱外3例(1.50%),身體外3例(1.50%),說不清1例(0.50%)。伴聽力下降111例(55.50%),聽力正常89例(49.50%)。 2.200例耳鳴患者存在脾胃系統(tǒng)器質(zhì)性疾病者105例占52.5%,整體脾胃功能平均積分與健康成人比較明顯升高(P0.05),不同等級(jí)的耳鳴患者脾胃功能積分隨耳鳴程度的加重而升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 3.脾胃失調(diào)的病因調(diào)查：79.5%患者嗜食肥甘厚味,73.50%患者嗜食寒涼食物,66.50%的患者在耳鳴發(fā)病前存在壓力,80.00%的患者在耳鳴發(fā)病前存在睡眠問題。 4.分別對(duì)具有不同耳鳴部位、聲響、主調(diào)聲頻率、殘余抑制試驗(yàn)結(jié)果、佛德曼曲線類型的患者脾胃功能進(jìn)行單因素分析,其差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。 5.169例耳鳴患者既往經(jīng)過西醫(yī)、中醫(yī)補(bǔ)腎、活血化瘀等治療的無效率為84.02%。 結(jié)論 1.耳鳴患者大多存在脾胃系統(tǒng)器質(zhì)性疾病及脾胃功能失調(diào),耳鳴的嚴(yán)重程度與脾胃功能大致呈負(fù)相關(guān),脾胃功能失調(diào)可能是耳鳴發(fā)病的基本病機(jī)。 2.耳鳴患者多存在嗜食肥甘厚味及寒涼食物的不良飲食習(xí)慣,且多存在熬夜或失眠的問題及壓力較大,這些是導(dǎo)致其脾胃功能失調(diào)的主要原因。使用寒涼藥物可能成為耳鳴的誘因。 3.耳鳴的部位、耳鳴聲響特征、耳鳴主調(diào)聲頻率、殘余抑制試驗(yàn)結(jié)果、佛德曼曲線類型與脾胃功能無關(guān),患者所描述及耳鳴心理聲學(xué)檢測(cè)所得到的耳鳴特征對(duì)中醫(yī)辨證的意義不大。
[Abstract]:research objective
Tinnitus is one of the common clinical symptoms, so far, the pathogenesis of tinnitus still has no breakthrough. In this paper, 200 cases of tinnitus patients were collected in detail, and the relationship between the onset of tinnitus and the spleen and stomach was investigated. The severity of tinnitus, the relationship between the characteristics of tinnitus and the function of the spleen and stomach were discussed. The etiology and pathogenesis of tinnitus were explored from the perspective of spleen and stomach in Chinese medicine.
research method
The patients who were diagnosed as tinnitus in the outpatient and inpatient department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2013 to January 2014 were collected as the research object. First, to investigate the location, sound, course, hearing status, treatment, treatment effect and other basic information, and to understand the history of spleen and stomach diseases and daily drinking. To evaluate the severity of the tinnitus and the function of the spleen and stomach, and to carry out the acoustic and audiological examination of the tinnitus. Secondly, the information of all the patients was input to the computer and the database was set up. Finally, the proportion of the patients with tinnitus had the spleen and stomach diseases, and the difference between the overall function of the spleen and the stomach and the healthy adults was analyzed. The difference of spleen and stomach function of patients with different severity of tinnitus was compared, and the potential factors of spleen and stomach dysfunction were discussed. The single factor analysis of spleen and stomach function in patients with different tinnitus characteristics was carried out to explore the relationship between the characteristics of tinnitus and the function of spleen and stomach, and the significance of tinnitus characteristics to TCM syndrome differentiation was further analyzed.
Research results
1. general data of patients with tinnitus: a total of 200 cases were collected. Among them, 121 men (60.50%), 79 women (39.50%). The average age was 42.68 + 12.99 years old; the course of disease was 8 days -33 years, average 36.76 + 52.35 months. The other 43 cases were in the position of tinnitus: 39 cases (19.50%) in left ear, 47 in right ear (23.50%), 95 in double ears (47.50%), 12 in the skull (6%), 3 (1.50%) outside the skull and 3 (1.50%) outside the body.
In 2.200 cases of tinnitus, 105 cases of spleen and stomach systemic diseases were 52.5%, the average integral of spleen and stomach function increased significantly (P0.05). The score of spleen and stomach function in different grades of tinnitus patients increased with the aggravation of tinnitus degree, the difference was statistically significant (P0.05).
3. the cause of the disorder of spleen and stomach: 79.5% patients were fat and sweet, 73.50% were addicted to cold food, 66.50% of the patients had pressure before the onset of tinnitus, and 80% of the patients had sleep problems before the onset of tinnitus.
4. the single factor analysis of the function of the spleen and stomach in patients with different tinnitus location, sound, primary tone frequency and residual inhibition test, and the difference of the function of the spleen and stomach of the patients with the type of the Buddha's curve was not statistically significant (P0.05).
5.169 cases of tinnitus were treated by western medicine, Chinese medicine for tonifying kidney, activating blood circulation and removing blood stasis, and the ineffective rate was 84.02%.
conclusion
1. patients with tinnitus are mostly organic diseases of the spleen and stomach and dysfunction of spleen and stomach. The severity of tinnitus is negatively related to the function of spleen and stomach, and the dysfunction of spleen and stomach may be the basic pathogenesis of the onset of tinnitus.
2. patients with tinnitus exist most of the bad eating habits of fat, sweet, thick and cold food, and there are many problems of staying up late or insomnia and pressure. These are the main causes of the dysfunction of the spleen and stomach.
3. the location of the tinnitus, the characteristics of the tinnitus sound, the tone frequency of the tinnitus and the results of the residual inhibition test, the type of the Buddha's curve has nothing to do with the function of the spleen and stomach. The characteristics of the tinnitus described by the patients and the acoustic detection of the tinnitus have little significance to the syndrome differentiation of traditional Chinese medicine.
【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】：2014
【分類號(hào)】：R276.1

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