發(fā)布時(shí)間：2018-06-11 10:58

  本文選題：福建 + 甘肅��； 參考：《福建中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:探究福建、甘肅兩地區(qū)海洛因男性成癮者的流行病學(xué)特征與中醫(yī)證素關(guān)聯(lián)關(guān)系,為在不同地區(qū)開展中醫(yī)藥臨床戒毒和防復(fù)吸工作提供基礎(chǔ)數(shù)據(jù)。方法:采用《毒品成癮中醫(yī)PRO量表》對2010-2016年福建省下屬司法、公安等戒毒所和甘肅省嘉峪關(guān)市、酒泉市、平?jīng)鍪邢聦俳涠舅?24例(其中福建226例、甘肅298例)自愿參加調(diào)查的海洛因男性成癮人員開展流行病學(xué)調(diào)查,包括人口學(xué)特征、吸毒行為特征、性行為特征、社會(huì)關(guān)系影響因素等內(nèi)容。規(guī)范化收集四診資料,應(yīng)用證素辨證方法提取中醫(yī)證素,在此基礎(chǔ)上分析不同地區(qū)海洛因成癮者中醫(yī)證素特征及其與流行病學(xué)特征的關(guān)聯(lián)。結(jié)果:1.流行病學(xué)特征:(1)兩組吸毒人員均為男性,以漢族為主,甘肅組少數(shù)民族比例較福建組大;平均年齡分別為(38.55±s8.246)a、(39.98±s7.270)a;文化程度均以初中為主,兩組學(xué)歷構(gòu)成比無明顯差異,但福建組本科以上學(xué)歷明顯高于甘肅組;福建組其他職業(yè)所占比例最大,為27.4%,甘肅以無固定職業(yè)為主,占26.5%,甘肅從事農(nóng)、林、牧、漁、水利生產(chǎn)人員較福建比例大;福建已婚比例低于甘肅。(2)兩組地區(qū)吸毒年限均以1-3年為主,其次15年以上所占比例較大;吸毒方式福建以靜脈注射為主,其次為煙槍吸,口服比例次之,甘肅以口服為主,其次為煙槍吸,靜脈注射次之,兩組在口服和靜脈注射的比例具有差異。(3)吸毒原因均以好奇心理為主,其中選擇"生活空虛","治療疾病"的比例差異具有統(tǒng)計(jì)學(xué)意義;復(fù)吸原因均以毒友影響為主,福建組1年后復(fù)吸比例最高,甘肅組3月內(nèi)復(fù)吸比例最高,甘肅組復(fù)吸時(shí)間總體較福建組短。(4)兩組海洛因成癮者均以單一性伴為主,但甘肅組多性伴比例更大;兩組安全套使用率均較大,甘肅組不使用安全套原因中選擇"沒有想到"的比例大于福建組。(5)甘肅組每次使用毒品次數(shù)選擇"每天1-2次"比例大于福建組;對毒品的渴求程度回答中,福建組缺失比例較大;吸毒后性生活方面,甘肅組總體性欲減退情況較福建嚴(yán)重;兩組均感到海洛因成癮對社會(huì)關(guān)系等方面影響較大,但對生活?yuàn)蕵放d趣及與家人朋友矛盾程度的影響福建組小于甘肅組。2.中醫(yī)證素特征兩組男性海洛因成癮者病位證素以肝、腎、脾為主,甘肅組肝病位證素相對突出:虛性證素以氣虛為主,實(shí)性證素以氣滯為主,甘肅組氣滯證素相對突出;甘肅組各個(gè)證素成立比例明顯高于福建。3.中醫(yī)證素與流行病學(xué)特征的關(guān)系(1)成癮嚴(yán)重程度相關(guān)指標(biāo)與中醫(yī)證素:①福建組:吸毒年限與血瘀、心、痰證素的成立顯著相關(guān),且為其危險(xiǎn)因素;吸毒后健康狀況變化與血瘀、心神、膽證素的成立顯著相關(guān),且為其危險(xiǎn)因素。②甘肅組:吸毒后健康狀況變化與血瘀、血虛、心神等證素的成立顯著相關(guān),且為其危險(xiǎn)因素;脫毒后復(fù)吸時(shí)間則與血瘀、胃、濕熱證素的成立顯著相關(guān),且為其保護(hù)因素;對毒品渴求程度與血瘀、痰、熱證素的成立顯著相關(guān),且為其危險(xiǎn)因素;每次使用毒品的量與心神證素的成立顯著相關(guān),且為其危險(xiǎn)因素;每天花在毒品上的時(shí)間與肺證素的成立顯著相關(guān),且為其危險(xiǎn)因素。(2)社會(huì)心理因素與中醫(yī)證素:①福建組:對生活、娛樂興趣下降程度與肝、脾、氣虛、血虛證素的成立顯著相關(guān),且為其危險(xiǎn)因素。②甘肅組:對生活、娛樂興趣下降程度與血虛證素的成立顯著相關(guān),且為其危險(xiǎn)因素;對社交活動(dòng)的影響與痰、肺證素的成立顯著相關(guān),且為其危險(xiǎn)因素。(3)其他流行病學(xué)特征與中醫(yī)證素:①福建組:喜歡清淡飲食與肺證素的成立顯著相關(guān),且為其保護(hù)因素。因?yàn)槌霈F(xiàn)稽延性戒斷癥狀和失眠而復(fù)吸與心證素的成立顯著相關(guān),且為其危險(xiǎn)因素;成癮者婚姻情況與心神證素的成立顯著相關(guān),相對于未婚人員,已婚人員吸毒導(dǎo)致心神證素成立的可能性更大,離婚未再婚人員吸毒導(dǎo)致心神證素成立的可能性最大。②甘肅組:最終學(xué)歷與胃證素的成立顯著相關(guān),且為其保護(hù)因素。結(jié)論:1.海洛因成癮者平均年齡較吸食其他類型毒品成癮者大;甘肅組婚姻狀況較福建組復(fù)雜;但福建組總體文化水平、職業(yè)水平、經(jīng)濟(jì)水平較甘肅高;總體上海洛因成癮呈現(xiàn)高齡化、高知化趨勢,涉及各個(gè)行業(yè),吸食海洛因等傳統(tǒng)毒品成癮情況有反彈趨勢。2.成癮者的好奇心理和難以抵制誘惑是導(dǎo)致兩地吸毒和復(fù)吸的主要原因,在一定程度上反映了成癮者的無知和安全意識的缺乏;海洛因成癮均對兩組人員的身體健康、生活興趣、工作學(xué)習(xí)等方面造成較大影響,總體影響甘肅組更甚。3.海洛因成癮可能與海洛因?qū)е碌亩嗯K腑功能失調(diào)有關(guān),以肝腎脾三臟為主,虛實(shí)夾雜是海洛因毒品成癮的證候?qū)W特點(diǎn),以里虛夾郁為主,存在一定的地域差異。4.血瘀、痰、心神證素可能與成癮的嚴(yán)重程度密切相關(guān),癮越嚴(yán)重,證素的成立可能性越大,血瘀證素可能為海洛因成癮者毒癮嚴(yán)重程度的隱性指標(biāo);甘肅組熱證素與癮的關(guān)系更加密切,這可能與西北寒冷地區(qū)人們的飲食偏好肥甘厚味,加之長期吸食海洛因,體內(nèi)多易出現(xiàn)滯熱有關(guān);脾、氣虛、肝、血虛是影響海洛因成癮者社會(huì)生活興趣的重要中醫(yī)證素;在保證營養(yǎng)的前提下,成癮者應(yīng)盡量提倡清淡飲食;復(fù)雜的婚姻情況可能會(huì)加重心神證素的成立可能。
[Abstract]:Objective: To explore the relationship between the epidemiological characteristics of heroin addicts in Fujian and Gansu, and to provide basic data for the clinical drug addiction treatment and anti relapse in different areas. Methods: using the PRO scale of traditional Chinese medicine of drug addiction to 2010-2016 years in Fujian Province, the Department of public security and other detoxification centers and Gansu province. A total of 524 heroin addicts in Jiayuguan, Jiuquan and Pingliang (of which 226 cases in Fujian and 298 in Gansu) were investigated voluntarily for the epidemiological investigation of heroin addicts, including demographic characteristics, drug behavior characteristics, sexual behavior characteristics, social relations and other factors. Methods the characteristics of TCM syndrome and its correlation with epidemiological characteristics of heroin addicts in different areas were analyzed. Results: 1. epidemiological characteristics were: (1) two groups of drug addicts were male, the majority of the Han people were Han, and the proportion of minority nationalities in Gansu group was larger than that of Fujian group; the average age was (38.55 + s8.246) a, (39.98 + s). 7.270) a; the educational level of the two groups had no obvious difference, but the degree of education of the Fujian group was obviously higher than that of the Gansu group; the other occupations in the Fujian group were the largest, 27.4%, and the Gansu had no fixed occupation, 26.5%. The Gansu was engaged in agriculture, forestry, animal husbandry, fishing, and water conservancy production personnel than Fujian; Fujian was married to the Fujian. The cases were lower than Gansu. (2) the number of years of drug use in the two groups was 1-3 years, followed by more than 15 years; the drug taking mode in Fujian was mainly intravenous, followed by the smoking gun, the second was the oral proportion, the Gansu was taken orally, the second was the smoking gun and the intravenous injection, and the two groups were different in the oral and intravenous injection. (3) drug abuse (3) drug abuse. The main reasons were curious psychology, among which, the proportion of "living empty" and "treating disease" was statistically significant. The cause of relapse was mainly caused by poisonous friends. The ratio of relapse in Fujian group was the highest after 1 years. In Gansu group, the ratio of relapse was the highest in March, and in Gansu group, the total relapse was shorter than that in Fujian group. (4) the two groups of heroin addicts were all single. Sex company was the main partner, but the proportion of Gansu group was larger than that of the two group. The ratio of "no thought" in Gansu group was greater than that of Fujian group. (5) the proportion of "1-2 times a day" in the use of drugs in Gansu group was greater than that of the Fujian group; in the response to the degree of drug craving, the proportion of the missing Fujian group was less than that of the Fujian group. In the aspect of sexual life after drug use, the total sexual abuses in Gansu group were more serious than that in Fujian; the two groups all felt that heroin addiction had great influence on social relations, but the interest in life and entertainment and the degree of contradiction with family and friends in the group of Fujian group were less than the.2. syndrome in the group of two groups of heroin addicts in the group of Gansu. Liver, kidney, spleen mainly, Gansu group liver disease level syndrome is relatively prominent: deficiency syndrome with Qi deficiency mainly, real syndrome with qi stagnation, Gansu group qi stagnation is relatively prominent, the proportion of Gansu group syndrome elements is significantly higher than the Fujian.3. TCM syndrome and epidemiological characteristics (1) correlation index of addiction severity and TCM syndrome: (1) Fujian Group: the duration of drug abuse was significantly related to the establishment of blood stasis, heart and phlegm syndrome, and it was a risk factor. The change of health status after drug abuse was significantly related to the establishment of blood stasis, heart God, biliary syndrome and its risk factors. (2) Gansu group: the change of health status after drug use was significantly related to the establishment of blood stasis, blood deficiency and heart God, and its risk factors; The time of drug relapse was significantly related to the establishment of blood stasis, stomach and damp heat syndrome, and it was a protective factor. The degree of drug craving was significantly related to the establishment of blood stasis, phlegm, heat syndrome and its risk factors; the amount of drug use was significantly related to the establishment of the heart syndrome element, and it was a risk factor; the time and lung spent on drugs every day. The establishment of the syndrome factor was significantly related, and it was a risk factor. (2) social psychological factors and TCM syndromes: (1) Fujian group: the decline of interest in life and entertainment was significantly related to the establishment of liver, spleen, Qi deficiency and blood deficiency syndrome, and it was a risk factor. (2) the decline of interest in life and entertainment was significantly related to the establishment of blood deficiency syndrome in the Gansu group. The risk factors, the influence on social activities and the establishment of phlegm and pulmonary syndrome, and its risk factors. (3) other epidemiological characteristics and TCM syndrome: (1) Fujian group: there is a significant correlation between the light diet and the establishment of lung syndrome, and it is a protective factor. There was a significant correlation and a risk factor; the marital status of addicts was significantly related to the establishment of the heart syndrome factor. Relative to the unmarried people, the possibility of the establishment of the heart syndrome hormone was greater than that of the unmarried people. The possibility of the establishment of the heart syndrome in the divorced unmarried people was the most likely. (2) the Gansu group: the final education and the establishment of the stomach syndrome. The average age of 1. heroin addicts was larger than that of other types of drug addicts; the marital status of the Gansu group was more complex than that of the Fujian group; but the overall cultural level, the professional level and the economic level of the Fujian group were higher than that of the Gansu group; and the general tendency of the addiction in Shanghai was higher, and the trend of high knowledge was involved in various industries. Traditional drug addiction, such as heroin, has a tendency to rebound, the curious psychology of.2. addicts and the difficulty of resisting temptation is the main cause of drug addiction and relapse in both places, to a certain extent, it reflects the ignorance and lack of safety awareness of the addicts; heroin addiction is all for the health, interest, work and study of the two groups of people. There is a great influence on the surface of the more.3. heroin addicts in the Gansu group, which may be related to the dysfunction of the multiple Zang Fu organs caused by heroin, mainly with the liver, kidney and spleen, and the deficiency and solid inclusion is the syndrome characteristics of heroin addicts, mainly with Li Xu Qi depression, and there are some regional differences in.4. blood stasis, phlegm, and the Xin Shen syndrome may be strict with addiction. The more closely related to the degree of heavy addiction, the more serious the addiction, the greater the possibility of the establishment of the syndrome element, the blood stasis syndrome may be a recessive index of the severity of the heroin addicts, and the relationship between the heat syndrome and the addiction of the Gansu group is more closely. This may be with the diet preference of the people in the cold region of the northwest and the long-term absorption of heroin. Heat related; spleen, Qi deficiency, liver and blood deficiency are the important TCM syndromes that affect the social life of heroin addicts. Under the premise of nutrition, the addicts should try to promote the light diet, and the complex marital status may aggravate the possibility of the establishment of the heart syndrome.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R277.7

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