本文選題：重癥肌無力 + 文獻(xiàn)回顧��； 參考：《遼寧中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:本研究以中醫(yī)理論為基礎(chǔ),收集了近20年有關(guān)重癥肌無力證型研究及治療的中醫(yī)臨床文獻(xiàn),總結(jié)得出重癥肌無力的證素特點(diǎn)及證型分布規(guī)律,為重癥肌無力臨床規(guī)范辨證提供理論指導(dǎo)。方法:從中國(guó)知網(wǎng)文獻(xiàn)數(shù)據(jù)庫(kù)篩選近20年有關(guān)重癥肌無力辨證的文獻(xiàn),建立數(shù)據(jù)庫(kù),對(duì)所收集到的證型和證素通過統(tǒng)計(jì)學(xué)方法進(jìn)行頻次、頻率、聚類等分析,研究探討其規(guī)律,再根據(jù)相關(guān)的中醫(yī)理論對(duì)結(jié)果進(jìn)行全面分析。結(jié)果:1.收集到有關(guān)中醫(yī)藥辨證治療重癥肌無力的臨床研究文獻(xiàn)28篇,納入病例共計(jì)7989例,歸納不同辨證分型共計(jì)22個(gè),其中頻率5%的前4個(gè)證型分別為脾氣虛型、脾腎陽(yáng)虛型、氣陰兩虛型、肝腎陰虛型。2.提取到重癥肌無力證素共計(jì)18個(gè),其中包含6個(gè)病位證素(脾、腎、肝、胃、經(jīng)絡(luò)、肺)及12個(gè)病性證素(氣虛、陰虛、陽(yáng)虛、血虛、熱、血瘀、濕、津虧、氣陷、氣滯、痰、動(dòng)風(fēng))。3.據(jù)病位證素分布特點(diǎn)數(shù)據(jù)可以得知重癥肌無力的主要病位在脾。由病性證素分布特點(diǎn)可知,氣虛是該病最主要的病性證素。據(jù)復(fù)合病位證素分布表得知,這里脾+腎的病位組合出現(xiàn)頻次最多,說明了先天之本腎與后天之本脾相結(jié)合,共同致痿。從病性虛實(shí)分布表看出,虛性病性證素在總病性中占比明顯高于實(shí)性類病性證素,這說明重癥肌無力的病機(jī)特點(diǎn)為虛實(shí)夾雜、但以虛性病性為主。通過對(duì)各表的分析,可以得知本病的確沒有有關(guān)寒性病性證素的樣本。4.通過聚類分析得出,重癥肌無力的證素聚類中,脾、氣虛為一類;腎、陰虛、陽(yáng)虛為一類;胃、肝、血虛、經(jīng)絡(luò)、血瘀、濕、熱為一類,可能提示這3類為重癥肌無力基本病機(jī)單位。結(jié)論:(1)通過收集相關(guān)文獻(xiàn)結(jié)合《中醫(yī)內(nèi)科學(xué)》教材中有關(guān)辨證分型,我們可以將重癥肌無力的證型歸納為:脾氣虛型、脾腎陽(yáng)虛型、肝腎陰虛型、濕熱浸淫型、脈絡(luò)淤阻型。(2)重癥肌無力主要證素共18個(gè),其中病位證素包括脾、腎、肝、胃、經(jīng)絡(luò)、肺;病性證素包括氣虛、陰虛、陽(yáng)虛、血虛、熱、血瘀、濕、津虧、氣陷、氣滯、痰、動(dòng)風(fēng)。(3)證素特點(diǎn)的認(rèn)識(shí):脾是最主要的病位證素;氣虛是主要病性證素;脾與腎二證素結(jié)合致痿;虛實(shí)夾雜,本虛標(biāo)實(shí),以虛為主是病機(jī)特點(diǎn);痿病無寒。
[Abstract]:Objective: Based on the theory of traditional Chinese medicine, this study collected the clinical literature about the research and treatment of myasthenia gravis in the past 20 years, summed up the characteristics of myasthenia gravis and the pattern of syndrome distribution, and provided theoretical guidance for the clinical standard differentiation of myasthenia gravis. Method: screening from the Chinese knowledge network database for nearly 20 years. The literature of myasthenia gravis syndrome differentiation, the establishment of a database, the collection of syndrome and syndrome through statistical methods, frequency, frequency, clustering analysis, study its laws, and then according to the related theory of traditional Chinese medicine to carry out a comprehensive analysis. Results: 1. collection of clinical literature about TCM syndrome differentiation for myasthenia gravis 2 8 cases were included in the total of 7989 cases, including 22 different types of syndrome differentiation, of which the first 4 syndromes of frequency 5% were spleen qi deficiency type, spleen kidney yang deficiency type, Qi Yin deficiency type, liver kidney yin deficiency type.2. extraction to myasthenia gravis 18, including 6 syndrome elements (spleen, kidney, liver, stomach, meridian, lung) and 12 disease factors (Qi deficiency, Yin) Deficiency, Yang deficiency, blood deficiency, heat, blood stasis, damp, Tianjin, qi stagnation, qi stagnation, phlegm, movement wind).3. according to the distribution characteristic data of the disease position syndrome factor can be found that the main disease of myasthenia gravis is in the spleen. It shows that the congenital kidney is combined with the spleen of the day after the disease. From the distribution table of the disease, it can be seen that the proportion of venereal syndrome in the total disease is obviously higher than that of the solid disease syndrome, which indicates that the pathogenesis of myasthenia gravis is virtual and solid, but it is mainly a virtual venereal disease. It is true that the disease does not have a sample of cold sex syndrome factor.4. through cluster analysis. In the cluster analysis of myasthenia gravis, spleen and Qi deficiency are a class, kidney, yin deficiency and yang deficiency are a class; stomach, liver, blood deficiency, meridian, blood stasis, dampness, heat are one type, which may suggest that these 3 types are basic pathogenesis units of myasthenia gravis. (1) collects related literature by collecting relevant literature < Chinese Medicine Medicine > teaching material about syndrome differentiation, we can conclude the syndrome type of myasthenia gravis: spleen qi deficiency type, spleen kidney yang deficiency type, liver kidney yin deficiency type, damp heat immersion type, choroid stasis type. (2) the main syndromes of myasthenia gravis are 18, including the spleen, kidney, liver, stomach, meridian, lung; syndrome factors including Qi deficiency, yin deficiency and yang deficiency Blood deficiency, heat, blood stasis, wet, Tianjin loss, gas depression, qi stagnation, sputum, moving wind. (3) the characteristics of the syndrome: the spleen is the most important syndrome factor; Qi deficiency is the main syndrome factor; the spleen and kidney two syndrome are combined with flaccid, deficiency and solid, the deficiency is the main point of the disease machine, and the disease is not cold.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R277.7

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