本文選題：干燥綜合征 + 中醫(yī)��； 參考：《南京中醫(yī)藥大學(xué)》2016年博士論文

【摘要】：研究目的通過(guò)文獻(xiàn)研究從理論上探討原發(fā)性干燥綜合征的中醫(yī)病機(jī)與證型,并觀(guān)察導(dǎo)師汪悅治療原發(fā)性干燥綜合征經(jīng)驗(yàn)方增液活露湯的臨床療效及安全性。方法1.理論研究方法：檢索古今中外關(guān)于本病的相關(guān)記載,分析現(xiàn)代醫(yī)學(xué)對(duì)于原發(fā)性干燥綜合征的病因病機(jī)研究,結(jié)合中醫(yī)比類(lèi)取象的古典哲學(xué),為中醫(yī)在治療本病時(shí)提供較為簡(jiǎn)便的辨證程序。2.臨床研究方法：對(duì)60例符合原發(fā)性干燥綜合征臨床診斷標(biāo)準(zhǔn)的患者,采用1：1平行對(duì)照原則建立治療組與對(duì)照組,每組各含30例,療程為12周。治療組給予中藥增液活露湯,每日1劑,早晚口服。對(duì)照組予本病兩種常規(guī)口服藥：硫酸羥氯喹片,每次O.1g,2次/日；白芍總苷膠囊每次0.6g,2次/日。觀(guān)察治療前后的癥狀、中醫(yī)證候、淚液流量、唾液流量、實(shí)驗(yàn)室檢查及安全性觀(guān)測(cè)等指標(biāo),并進(jìn)行比較與統(tǒng)計(jì)學(xué)分析。結(jié)果1.理論研究結(jié)果：認(rèn)為其病機(jī)應(yīng)包含陰虛津虧、內(nèi)火傷津、津氣失常、痰濕瘀阻、燥毒為患共5個(gè)津液流通節(jié)點(diǎn),任何一個(gè)節(jié)點(diǎn)上的異常狀況,如相關(guān)臟腑津液納藏不足,津液耗損程度過(guò)高,津氣無(wú)力推運(yùn),通道存在阻礙,津液質(zhì)量變異,都可導(dǎo)致終端生燥的癥狀。2.臨床研究結(jié)果：①治療前各觀(guān)測(cè)項(xiàng)目在治療組和對(duì)照組間無(wú)顯著性差異,提示本研究基線(xiàn)具可比性。②治療組中醫(yī)證候療效總有效率為90.00%,優(yōu)于對(duì)照組總有效率63.33%(P0.05)。③治療組疾病療效總有效率為86.67%,優(yōu)于對(duì)照組疾病療效總有效率60.00%(P0.05)。④兩組的淚液和唾液流量與治療前相比均有改善(P0.05),治療組改善優(yōu)于對(duì)照組(P0.05)。⑤在中醫(yī)證候量化評(píng)分和生活質(zhì)量評(píng)分的改善上,中藥治療組亦明顯優(yōu)于照組(P0.05)。⑥相關(guān)肝、腎功能檢查均無(wú)異常,未見(jiàn)毒副反應(yīng)及其他明顯不良事件的發(fā)生。結(jié)論1.提出先辨病性,再審病位,依其所患,選藥組方的燥痹辨證流程,作為本病臨床辨證上的一個(gè)新的思維模式。其類(lèi)比理論在國(guó)內(nèi)可協(xié)助患者對(duì)醫(yī)療方案的理解,在國(guó)際上可作為拓展中醫(yī)辨治本病的交流輔助方案。2.增液活露湯兼顧滋陰潤(rùn)燥、活血通絡(luò)、清熱解毒法,在治療原發(fā)性干燥綜合征上較常規(guī)西藥具有顯著優(yōu)勢(shì),能明顯減輕患者口眼干燥癥狀,增加淚液與唾液流量,改善中醫(yī)證候和生活質(zhì)量評(píng)分,且在臨床觀(guān)察中未降低安全性,值得深入研究與推廣應(yīng)用。
[Abstract]:Objective to study the TCM pathogenesis and syndrome type of primary Sjogren syndrome through literature research, and observe the clinical efficacy and safety of Wang Yue, the Tutor Wang Yue, in the treatment of primary Sjogren syndrome. Method 1. theoretical research methods: retrieve the related records of the disease in ancient and modern, and analyze the modern medicine The etiology and pathogenesis of primary Sjogren syndrome (Sjogren syndrome), combined with the classical philosophy of traditional Chinese medicine, provides a simple.2. clinical study method for TCM in the treatment of the disease: 60 cases of patients with primary Sjogren syndrome clinical diagnostic criteria, the treatment group and control group were set up by 1:1 control principle, each group was set up. The treatment group was given 30 cases, the treatment course was 12 weeks. The treatment group was given the decoction of Zeng liquid and live dew, 1 doses per day and orally. The control group was given two conventional oral medicine for the disease: Hydroxychloroquine Sulfate Tablets, O.1g, 2 times per day, and Total Glucosides of Paeony Capsules each time, 2 times / day. The symptoms and symptoms of the treatment, the volume of tear, the flow of saliva, the laboratory examination and the safety of the treatment were observed. Results of total observation and comparison and statistical analysis. Results the results of 1. theoretical studies were that the disease machine should include deficiency of yin deficiency, internal fire injury, phlegm dampness, phlegm dampness and blood stasis, and dryness toxin as the node of 5 body fluid, and the abnormal condition on any one node, such as the insufficiency of the related Zang Fu Zang fluid storage and the excessive loss of body fluid. The results of the clinical study of the symptoms of terminal dryness with the obstruction of the passage and the quality variation of the body fluid could lead to the clinical results of.2.. (1) there was no significant difference between the observation items before treatment in the treatment group and the control group, suggesting that the baseline of the study was comparable. The total effective rate of TCM syndrome treatment in the treatment group was 90%, which was better than the control group with a total effective rate of 63. .33% (P0.05). (3) the total effective rate of the treatment group was 86.67%, which was better than the control group, the total effective rate was 60% (P0.05). (4) the tear and saliva flow in the two groups were improved (P0.05) and the treatment group was better than the control group (P0.05). 5. In the improvement of TCM syndrome quantifying score and quality of life score, Chinese medicine treatment group Also obviously better than the group (P0.05). (6) related liver, renal function examination no abnormal, no toxic side effects and other obvious adverse events. Conclusion 1. proposed first identify the disease, retrial of the disease, according to the disease, the dryness arthralgia syndrome process of selection group, as a new mode of thinking in the clinical syndrome differentiation. Its analogy theory can be combined in China. To help the patients understand the medical scheme, in the world, it can be used as an auxiliary scheme to expand the treatment of the disease of traditional Chinese medicine (.2.). It has a remarkable advantage over the conventional western medicine in the treatment of primary dry syndrome. It can obviously reduce the dry symptoms of the mouth of the patients and increase the tears and saliva. The flow rate improved the score of TCM syndrome and quality of life, and did not reduce the safety in clinical observation. It is worthy of further research and application.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R259

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