本文選題：急性酒精中毒 + 中醫(yī)證候　； 參考：《安徽中醫(yī)藥大學》2016年碩士論文

【摘要】：1目的通過文獻調(diào)查研究和臨床調(diào)查研究的方法,初步探索出急性酒精中毒的中醫(yī)證侯特點、中醫(yī)證素和中醫(yī)辯證分型的分布規(guī)律、臨床指標與中醫(yī)證型的相關性,為臨床中醫(yī)辨證治療急性酒精中毒提供具有參考價值的理論依據(jù),為確立統(tǒng)一的和標準的急性酒精中毒中醫(yī)診療指南或規(guī)范貢獻自己的一份力量。2方法2.1文獻研究通過制定檢索詞和檢索時間兩個方面,檢索中醫(yī)古籍知識庫、中國學術期刊全文數(shù)據(jù)庫(CNKI)、萬方數(shù)據(jù)庫、中文科技期刊數(shù)據(jù)庫(維普)、國家發(fā)布的行業(yè)標準、著作和教材等文獻,統(tǒng)計急性酒精中毒中醫(yī)四診信息的頻數(shù)和百分比,根據(jù)統(tǒng)計結(jié)果制定急性酒精中毒中醫(yī)證侯信息初步調(diào)查表。2.2制定正式急性酒精中毒中醫(yī)證侯臨床調(diào)查表對急性酒精中毒中醫(yī)證侯信息初步調(diào)查表進行專家咨詢評價和臨床試填,修改完善后形成正式調(diào)查表。2.3臨床研究使用急性酒精中毒中醫(yī)證侯信息調(diào)查表收集臨床患者一般情況(包括年齡、性別、職業(yè)、身高和體重等)、中醫(yī)四診信息和臨床指標信息。2.4統(tǒng)計方法使用統(tǒng)計軟件SPSS 17.0對患者的一般情況和中醫(yī)四診信息進行描述性統(tǒng)計分析,對整理后的中醫(yī)四診信息進行因子分析和聚類分析。3結(jié)果3.1發(fā)病特點急性酒精中毒患者的發(fā)病率男性遠大于女性,為女性的4.3倍(男:女=4.3:1),發(fā)病年齡主要集中在20~50歲年齡段之間,其中以20~30歲之間患者最多,以學生居多,未婚患者與已婚患者數(shù)量相當,文化程度多在初中文化以上,常見的并發(fā)癥有上消化道出血、低血糖、低血壓、低鉀血癥、代謝性酸中毒、心律失常、急性肝損傷、雙硫侖反應和呼吸衰竭等,最常見的并發(fā)癥為心律失常,發(fā)生率為9%,最嚴重的并發(fā)癥為呼吸衰竭,發(fā)生率較低,為0.6%。3.2急性酒精中毒中醫(yī)證侯分布特點百分比在10%以上的共有20條,包括惡心嘔吐、胃脘灼痛、多笑多言,心悸怔忡、頭目脹痛、急躁易怒、目赤眩暈、氣喘息粗、神識不清、面色蒼白、四肢厥冷、噯氣、身熱口渴、胸悶、脅痛、大便秘結(jié)、小便短黃和二便失禁、大便秘結(jié)和小便短黃,舌色以舌淡(32%)和舌絳(23.67%)為主,舌苔則以黃苔(38.00%)或白膩苔(32.00%)為主,脈象以脈弦數(shù)、脈細數(shù)和脈微欲絕為主。3.3急性酒精中毒的中醫(yī)辨證分型通過對急性酒精中毒中醫(yī)四診信息進行因子分析后,結(jié)果得出11個公因子,根據(jù)中醫(yī)診斷標準和臨床經(jīng)驗判斷:因子F1、公因子F5、公因子F6為脫證因子;公因子F2、F7為心陰虛證因子;公因子F3、公因子F11為肝證因子;公因子F4、公因子F10為濕熱證因子;公因子F8、F9為實熱證因子,經(jīng)聚類分析后,將急性酒精中毒分為:濕熱蘊脾證、肝火熾盛證、痰火擾心證、氣陰兩虛證和脫證五大型。4結(jié)論急性酒精中毒患者的中醫(yī)證侯特點:前期以實證為主,病性主要為濕熱,病位主要在脾胃;中期兼有實證和虛證,病性以內(nèi)熱為主,病位主要在肝膽;后期以虛證為主,病性以虛熱為主,病位主要在心臟。病機特點:酒作為濕熱之邪,前期攝入人體,首損脾胃,即濕熱蘊結(jié)脾胃;中期濕熱久郁化生內(nèi)熱,傳及肝膽,此時脾胃已傷,即:脾胃虛弱,肝火熾盛;后期脾胃虛弱,聚生痰飲,痰火互結(jié),擾亂心神,久則耗傷津液而發(fā)脫證。濕熱蘊脾證、肝火熾盛證、痰火擾神證、氣陰兩虛證和脫證為急性酒精中毒患者常見的中醫(yī)證侯類型。
[Abstract]:1 through the methods of literature investigation and clinical investigation, the characteristics of TCM syndrome of acute alcoholism, the distribution of TCM syndrome and the dialectical type of TCM, the correlation of clinical indexes and TCM syndrome types are found, and the theoretical basis for the treatment of acute alcoholism in clinical TCM syndrome differentiation is provided. A unified and standard TCM diagnosis and treatment guidelines for acute alcoholism or standard contribution to their own strength.2 method 2.1 literature research through the formulation of two aspects of retrieval words and retrieval time, retrieval of Chinese ancient books knowledge base, Chinese academic journal full text database (CNKI), Wanfang database, Chinese sci-tech journal database (VP), national hair The frequency and percentage of the four diagnosis information of acute alcoholism, the preliminary questionnaire of TCM syndrome of acute alcoholism,.2.2, the preliminary questionnaire of TCM syndrome of acute alcoholism on acute alcoholism, the preliminary questionnaire of TCM syndrome information on acute alcoholism Expert consultation and evaluation and clinical trial filling, revision and improvement, formal questionnaire.2.3 clinical study using acute alcoholism TCM syndrome information questionnaire to collect clinical patients general conditions (including age, sex, occupation, height and weight), TCM four diagnosis information and clinical index information.2.4 statistical method using the statistical software SPSS 17 A descriptive statistical analysis of the general situation of the patients and the information of four diagnosis of traditional Chinese medicine, the factors of factor analysis and cluster analysis of the four diagnosis information of traditional Chinese medicine after the arrangement were analyzed by.3 results. The incidence of acute alcoholism among the male patients was far greater than that of women, 4.3 times as much as women (male: =4.3:1), and the age of onset was mainly at the age of 20~50 years. Among them, the majority of the patients were 20~30 years old, the majority of the students, the number of unmarried patients and married patients, more culture above the junior middle school culture, the common complications were upper gastrointestinal bleeding, hypoglycemia, hypotension, hypokalemia, metabolic acidosis, arrhythmia, acute liver injury, disulfdison reaction and respiratory failure, and so on. The common complication is arrhythmia, the incidence rate is 9%, the most serious complication is respiratory failure, the incidence is low, the percentage of the TCM Syndromes of 0.6%.3.2 acute alcoholism is more than 10%, including nausea and vomiting, stomachache pain, more laughter, palpitation, headache, irritability, dizziness and gasping. Thick, pale, pale, cold face, belching, body heat thirst, chest tightness, hypochondriac pain, constipation, stool short yellow and two feces incontinence, constipation and urine incontinence, lingual color with tongue light (32%) and tongue crimson (23.67%), tongue fur with yellow moss (38%) or white greasy moss (32%), pulse image with pulse string number, pulse detail and pulse micro desire to be.3.3 urgent. The TCM syndrome differentiation of alcoholic intoxication was analyzed by factor analysis of four diagnosis information of acute alcoholism, the results obtained 11 common factors, according to the diagnosis standard and clinical experience of Chinese medicine: factor F1, common factor F5, and common factor F6 as the proof factor; public factor F2, F7 as the deficiency syndrome factor of heart Yin; public factor F3, public factor F11 as the liver syndrome factor The male factor F4 and the public factor F10 are the damp heat syndrome factor; the public factor F8 and the F9 are the real heat syndrome factors. After the cluster analysis, the acute alcoholism is divided into the characteristics of TCM syndrome of the patients with acute alcoholism: the damp heat accumulation syndrome, the liver fire flaming syndrome, the phlegm fire and the heart syndrome, the Qi Yin two deficiency syndrome and the five large.4 conclusion of acute alcohol poisoning: the early stage is mainly empirical and the disease is mainly wet. Heat, the disease is mainly in the spleen and stomach; in the middle of the disease, the main disease is heat, the disease is mainly in the liver and gallbladder, the latter is mainly in the liver and the liver, the disease is mainly in the deficiency syndrome, the disease is mainly in the heart. The disease position is mainly in the heart. The disease machine features: the wine is the damp heat evil, the early intake of the human body, the first loss of the spleen and stomach, that is, the damp heat contains the spleen and stomach; At this time, the spleen and stomach have been injured, that is, weak spleen and stomach, liver fire, weak spleen and stomach, accumulation of sputum, phlegm and fire, disturbing heart, and injure body fluid for a long time.
【學位授予單位】：安徽中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R259

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