本文選題：原發(fā)性骨質(zhì)疏松癥 + 病機(jī)　； 參考：《山東中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：研究目的:通過證素辨證方法對(duì)原發(fā)性骨質(zhì)疏松癥(POP)進(jìn)行辨證分析,探討其中醫(yī)證型分布特點(diǎn),并分析不同證型與患者的一般情況、發(fā)病特點(diǎn)及臨床指標(biāo)的相關(guān)性。從而為本病中醫(yī)分型客觀化尋找依據(jù),有利于全面探析其證治規(guī)律,為POP的早期診斷、分型、確立治法、選方用藥提供理論支持。研究方法:采用統(tǒng)一的信息收集表對(duì)80例原發(fā)性骨質(zhì)疏松癥患者的證素信息等資料進(jìn)行采集,應(yīng)用證素辨證研究方法,分析原發(fā)性骨質(zhì)疏松癥中醫(yī)證型分布特點(diǎn),利用統(tǒng)計(jì)學(xué)方法計(jì)算中醫(yī)證型與各發(fā)病因素的相關(guān)性,并對(duì)其特點(diǎn)進(jìn)行總結(jié)歸納。結(jié)果:1.病位證素以腎最多見,其次是脾、肝、筋骨、心、經(jīng)絡(luò)。病性證素中,虛證證素以陽(yáng)虛最多見,其次是陰虛、氣虛、血虛、精虧;實(shí)證證素出現(xiàn)次數(shù)最多的是血瘀,其余依次為氣滯、寒、熱、痰、濕。2.常見中醫(yī)證型按出現(xiàn)頻次排序前5位依次為:肝腎陰虛、脾腎陽(yáng)虛、氣虛血瘀、腎陽(yáng)虛、筋骨痹阻。3.不同證型與發(fā)病因素的相關(guān)性:(1)各證型中性別分布無統(tǒng)計(jì)學(xué)差異(P0.05);骨密度分布無統(tǒng)計(jì)學(xué)差異(P0.05);身高、體重、BMI分布無統(tǒng)計(jì)學(xué)差異(P0.05)。(2)骨痛癥狀在不同證型中的分布有統(tǒng)計(jì)學(xué)差異(P0.05)。氣虛血瘀組和筋骨痹阻組均與其他3組存在統(tǒng)計(jì)學(xué)差異(p0.05),而氣虛血瘀組與筋骨痹阻組之間無統(tǒng)計(jì)學(xué)差異(p0.05)。(3)有否脊柱變形在不同證型中的分布無統(tǒng)計(jì)學(xué)差異(P0.05)。(4)骨折發(fā)生率在不同證型中的分布中有顯著統(tǒng)計(jì)學(xué)差異(P0.01)。氣虛血瘀組與其余4組存在統(tǒng)計(jì)學(xué)差異(P0.05)(5)骨質(zhì)疏松癥有否合并高血壓在各證型中的分布無統(tǒng)計(jì)學(xué)差異(P0.05)。(6)骨質(zhì)疏松癥有否合并冠心病在各證型中的分布有顯著統(tǒng)計(jì)學(xué)差異(P0.01)。氣虛血瘀組與筋骨痹阻組、肝腎陰虛組、脾腎陽(yáng)虛組存在顯著性差異(P0.01),與腎陽(yáng)虛組存在統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:1.原發(fā)性骨質(zhì)疏松癥病位主要在腎,多或可涉及肝、脾。病理性質(zhì)虛中夾實(shí),陽(yáng)、陰、氣虛均較為多見。實(shí)性病理因素以血瘀、氣滯為主。2.筋骨痹阻證多出現(xiàn)骨痛癥狀。氣虛血瘀證多發(fā)骨痛、骨折,多合并冠心病。3.研究結(jié)果提示原發(fā)性骨質(zhì)疏松癥的治療應(yīng)以補(bǔ)腎為主,兼顧肝、脾,重視活血化瘀法的應(yīng)用。對(duì)于氣虛血瘀型患者強(qiáng)調(diào)活血止痛,預(yù)防骨折。
[Abstract]:Objective: to analyze the syndrome differentiation of primary osteoporosis (POP) by syndrome element differentiation, to discuss the distribution of TCM syndrome types, and to analyze the relationship between different syndromes and patients' general situation, disease characteristics and clinical indexes. So as to find the basis for the objective classification of TCM, which is conducive to the comprehensive analysis of the law of syndrome and treatment, for the early diagnosis of POP, typing, the establishment of treatment methods, the choice of prescription to provide theoretical support. Methods: the information of syndromes of 80 patients with primary osteoporosis was collected by using a unified information collection table, and the distribution characteristics of TCM syndromes of primary osteoporosis were analyzed by syndrome differentiation. The correlation between TCM syndromes and various factors was calculated by statistical method, and its characteristics were summarized. The result is 1: 1. Kidney is the most common syndrome, followed by spleen, liver, bones, heart, meridian. Among the factors of disease syndrome, deficiency syndrome is characterized by deficiency of yang, followed by deficiency of yin, deficiency of qi, deficiency of blood and deficiency of essence; the most frequent occurrence of syndrome factor is blood stasis, and the others are stagnation of qi, cold, heat, phlegm, dampness, and dampness. The most common TCM syndromes in order of frequency are liver and kidney yin deficiency, spleen and kidney yang deficiency, qi deficiency and blood stasis, kidney yang deficiency, and stagnation of muscles and bones. There was no significant difference in sex distribution among different syndrome types (P 0.05); there was no significant difference in bone mineral density (P 0.05); there was no significant difference in the distribution of height, body weight and BMI; there was no significant difference in the distribution of bone pain symptoms in different syndromes (P 0.05. 0. 05; P 0. 05; P 0. 05; P 0. 05; P 0. 05; P 0. 05; P 0. 05; P 0. 05; P 0. 05; P 0. 05); There was statistical difference between Qi deficiency and blood stasis group and the other three groups, but there was no significant difference between Qi deficiency and blood stasis group and bone obstruction group. (P 0.05) there was no significant difference in the distribution of spinal deformity in different syndromes. There was significant difference in the distribution of incidence rate among different syndromes (P 0.01). There was statistical difference between the Qi deficiency and blood stasis group and the other four groups (P < 0.05). There was no significant difference in the distribution of osteoporosis with hypertension in each syndrome type. There was no significant difference in the distribution of osteoporosis with coronary heart disease (P 0.01). There was significant difference between Qi deficiency and blood stasis group and stagnation group, liver and kidney yin deficiency group, spleen and kidney yang deficiency group (P 0.01), and there was statistical difference between Qi deficiency group and kidney yang deficiency group (P 0.05). Conclusion 1. Primary osteoporosis is mainly located in the kidney, more or may involve liver, spleen. The pathological nature of deficiency in the inclusion of consolidation, Yang, Yin, Qi deficiency are more common. Solid pathological factors were blood stasis and qi stagnation. The symptoms of bone pain are often found in the syndrome of arthralgia of the muscles and bones. Qi deficiency and blood stasis syndrome multiple bone pain, fracture, more complicated with coronary heart disease. 3. The results suggest that primary osteoporosis should be treated mainly by tonifying the kidney, taking into account the liver and spleen, and paying attention to the application of the method of promoting blood circulation and removing blood stasis. For Qi deficiency and blood stasis type patients emphasis on promoting blood circulation to relieve pain and prevent fracture.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259

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