【摘要】：圍絕經(jīng)期是婦女從壯年向老年過度必經(jīng)的特殊生理時期,由于物質(zhì)生活的豐富和精神壓力的增加,現(xiàn)代女性進入圍絕經(jīng)期的年齡較以往有提前的趨勢,且由此產(chǎn)生的圍絕經(jīng)期綜合征對女性的生活質(zhì)量有著較大的影響。目前研究表明,約有90%的婦女在45～55歲的這個年齡段會出現(xiàn)不同程度的臨床表現(xiàn),也有一些女性雖然沒有達到圍絕經(jīng)期的診斷標準,但是已經(jīng)出現(xiàn)了圍絕經(jīng)期綜合征的臨床癥狀,因此我們根據(jù)內(nèi)經(jīng)的描述,對圍絕經(jīng)期婦女以及圍絕經(jīng)期前的婦女進行研究,希望能夠明確到圍絕經(jīng)期婦女生理病理的特點,為圍絕經(jīng)期綜合征的早期診斷和防治提供依據(jù)。目的：采用流行病學研究方法,根據(jù)中醫(yī)“五七”、“六七”、“七七”的理論對不同年齡段女性進行劃分,評估不同年齡段女性的中醫(yī)病理特點,分析圍絕經(jīng)期綜合征的易患因素,為臨床中醫(yī)藥防治圍絕經(jīng)期綜合征提供參考。方法：本研究遵循臨床流行病學的調(diào)研原則,采用問卷調(diào)查的方式,設計三個統(tǒng)一的臨床調(diào)研表,分別是一般情況調(diào)查表、改良KI表及四診信息采集表。隨機選取2014年12月至2015年8月就診于福建中醫(yī)藥大學附屬第三人民醫(yī)院及社區(qū)醫(yī)院的35-55歲的婦女450例,其中,35-41歲、42-48歲以及49-55歲各150例。由經(jīng)過統(tǒng)一培訓的中醫(yī)師對這450例調(diào)查對象進行一般情況、四診信息的采集,同時由450例調(diào)查對象對出現(xiàn)圍絕經(jīng)期癥狀進行自我評價。調(diào)查資料經(jīng)整理歸類、核實無誤后,采用單人輸入的方法對調(diào)查資料進行錄入并校對,建立數(shù)據(jù)庫,再用SPSS19.0統(tǒng)計軟件對所錄入的數(shù)據(jù)進行統(tǒng)計學分析處理。參照人民衛(wèi)生出版社出版的朱文鋒教授的《證素辨證學》,根據(jù)證素辨證原理確定病位證素和病性證素。結(jié)果：本次調(diào)查一共收集到450份調(diào)查問卷,排除錯漏、矛盾以及缺損的調(diào)查問卷30份,有效問卷420份,有效應答率為93.33%。其中,35-41歲年齡段女性141例,42-48歲年齡段女性140例,49-55歲年齡段女性139例。1 圍絕經(jīng)期綜合征的易患因素本次研究發(fā)現(xiàn),圍絕經(jīng)期綜合征的發(fā)生與被調(diào)查者年齡、孕次、性格特點、家庭情況、是否有婦科病史、文化程度及飲食口味等均存在一定的相關(guān)性。懷孕次數(shù)越多、性格內(nèi)向、家庭情況越差、有婦科炎癥病史、受教育程度越高以及有飲食口味偏好的女性,越容易患圍絕經(jīng)期綜合征。2不同年齡段圍絕經(jīng)期綜合征患者中醫(yī)證素分析本研究認為,圍絕經(jīng)期女性的病性特點為本虛標實、虛實夾雜。本虛主要以陰虛、氣虛、血虛為主,陰虛最為明顯。標實主要以氣滯、濕、血瘀、熱為主,氣滯最為明顯。圍絕經(jīng)期綜合征的形成與發(fā)展和肝、脾、腎有密切相關(guān)。3 圍絕經(jīng)期綜合征易患因素與中醫(yī)病理因素的關(guān)系懷孕次數(shù)越多、性格內(nèi)向、家庭和睦情況越差、有婦科病史、文化程度高、飲食口味有所偏好等與圍絕經(jīng)期綜合征的發(fā)生有關(guān),且直接影響圍絕經(jīng)期綜合征的中醫(yī)病理因素。結(jié)論：1 圍絕經(jīng)期綜合征的發(fā)生與被調(diào)查者年齡、孕次、性格特點、家庭情況、是否有婦科病史及文化程度等均存在一定的相關(guān)性。2 圍絕經(jīng)期女性的病性特點為本虛標實、虛實夾雜�！案斡簟睘閲^經(jīng)期綜合征病理變化的重要環(huán)節(jié)。無論是病位證素積分還是病性證素積分,均是在49-55歲年齡段為最高。3懷孕次數(shù)、性格、家庭情況、婦科病史、文化程度等與圍絕經(jīng)期綜合征的發(fā)生有關(guān),且直接影響圍絕經(jīng)期綜合征的中醫(yī)病理因素。
[Abstract]:Perimenopausal period is a special period of special physiological period for women from strong years to old age. Due to the abundance of material life and the increase of mental pressure, the age of modern women enters the perimenopausal period in advance, and the resulting perimenopausal syndrome has a great influence on the quality of life of women. 90% of women have different levels of clinical manifestation at this age of 45~55, and some women have not reached the diagnostic criteria for perimenopause, but the clinical symptoms of perimenopausal syndrome have appeared. Therefore, according to the description of the menopause, we study perimenopausal women and pre perimenopausal women. In the hope of providing the basis for the early diagnosis and prevention of perimenopausal syndrome, it is hoped to provide the basis for the early diagnosis and prevention of perimenopausal syndrome. Objective: to divide the women of different age groups according to the theory of epidemiology and the theory of "57", "six or seven" and "77" to evaluate the Chinese traditional medicine of different age groups. The pathological features of perimenopausal syndrome are analyzed to provide reference for the prevention and treatment of perimenopausal syndrome in clinical traditional Chinese medicine. Methods: This study follows the principles of clinical epidemiology, and designs three unified clinical survey forms by questionnaire survey, which are the general situation questionnaire, improved KI table and four diagnosis information collection. A random selection of 450 cases of 35-55 year old women aged 35-55 years from December 2014 to August 2015 at the third people's Hospital and community hospital affiliated to the Fujian University of traditional Chinese medicine were selected. Among them, 35-41 years, 42-48 years and 150 cases of 49-55 years old. The traditional Chinese medicine teachers were given the general situation for the 450 cases, the four diagnosis information was collected, and 450 was collected at the same time. The subjects were evaluated for perimenopausal symptoms. After sorting and checking the data, the survey data were recorded and proofread by single person input method, the database was established, and the data received by SPSS19.0 statistical software were analyzed with statistical analysis. In this survey, 450 questionnaires were collected, 30 questionnaires were excluded, contradictions and defects were excluded, 420 questionnaires were valid, and the effective response rate was 93.33%., 141 cases of 35-41 year old women and 42-48 year old women. 140 cases of sex, 139 cases of.1 peri menopause syndrome in 49-55 year old women, this study found that the occurrence of perimenopausal syndrome is related to the age, pregnancy, character, family condition, history of gynaecology, the degree of culture and the taste of diet. The more the number of pregnancy, the introverted character, the home. The worse the situation of the tribunal, the history of gynecologic inflammation, the higher education and the preference for diet, the more vulnerable to perimenopausal syndrome.2 in different age groups of perimenopausal syndrome, the analysis of the TCM syndrome of perimenopausal syndrome of perimenopausal syndrome is that the characteristics of perimenopausal women are virtual and false, and the deficiency is mainly Yin deficiency and Qi deficiency. Blood deficiency mainly, yin deficiency is the most obvious. The main objective is Qi stagnation, wet, blood stasis, heat mainly, qi stagnation is the most obvious. The formation of peri menopausal syndrome is closely related to the liver, spleen and kidney. The more frequent factors of.3 peri menopause syndrome are related to the pathological factors of traditional Chinese medicine, the more pregnant times, the introverted character, the worse the family harmony, the gynecopathy. History, high level of culture and preference of food and taste are related to the occurrence of perimenopausal syndrome and directly affect the pathological factors of Chinese medicine in perimenopausal syndrome. Conclusion: the occurrence of 1 perimenopausal syndrome is related to the age, pregnancy, character, family condition, the history of gynecology and the degree of culture. The characteristics of the related.2 perimenopausal women are deficiency and real, and "liver depression" is an important link in the pathological changes of perimenopausal syndrome. Both the score of the syndrome and the syndrome score of the disease are the highest number of.3 pregnancy, character, family, history of Gynecology, and the degree of culture at the age of 49-55. The occurrence of menstrual syndrome is directly related to the pathological factors of perimenopausal syndrome.
【學位授予單位】：福建中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R271.116

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