經(jīng)前期綜合征（PMS）的文獻(xiàn)研究及山西中醫(yī)學(xué)院女大學(xué)生PMS的證候調(diào)查研究
發(fā)布時(shí)間：2018-08-20 08:55
【摘要】：研究目的本研究主要是探索近10余年來(lái)中醫(yī)文獻(xiàn)經(jīng)前期綜合征(PMS)的證候分布特點(diǎn),為編制調(diào)查表提供參考依據(jù);初步探討山西中醫(yī)學(xué)院女大學(xué)生PMS的發(fā)病率及中醫(yī)臨床證候分布規(guī)律,為女大學(xué)生規(guī)范化的辨證施治和臨床診療奠定重要的理論基礎(chǔ)。研究方法通過(guò)檢索近1O余年來(lái)經(jīng)前期綜合征的文獻(xiàn)資料,根據(jù)納入與剔除標(biāo)準(zhǔn),選取符合的文獻(xiàn),對(duì)其證候進(jìn)行統(tǒng)計(jì)、分析,結(jié)合PMS的中醫(yī)病因病機(jī)、西醫(yī)病因病理,總結(jié)中醫(yī)辨證及臨床診斷分型所需的診斷資料,設(shè)計(jì)所需問(wèn)卷調(diào)查的項(xiàng)目。對(duì)山西中醫(yī)學(xué)院年齡在18-25歲女大學(xué)生進(jìn)行問(wèn)卷調(diào)查,初步篩查出符合PMS診斷標(biāo)準(zhǔn)的受試者。對(duì)所篩選的受試者,進(jìn)行經(jīng)前期綜合征癥狀、體征調(diào)查表的填寫(xiě),問(wèn)卷結(jié)果經(jīng)調(diào)查者認(rèn)真審查后,將全部數(shù)據(jù)錄入EpiData3.1軟件,應(yīng)用SPSS17.0統(tǒng)計(jì)軟件對(duì)所得的數(shù)據(jù)資料進(jìn)行統(tǒng)計(jì)學(xué)分析,分析相關(guān)數(shù)據(jù)是否存在統(tǒng)計(jì)學(xué)意義。研究結(jié)果1.文獻(xiàn)研究1.1文獻(xiàn)研究資料經(jīng)過(guò)規(guī)范化地提取,本病出現(xiàn)的主要證型(頻次≥10),共計(jì)7個(gè);其頻次頻率由多到少依次為:肝氣郁結(jié)證(35次,16.2%)、脾腎陽(yáng)虛證(14次,6.48%)、肝腎陰虛證(13次,6.02%)、氣滯血瘀證(11次,5.09%)、肝郁化火證(10次,4.63%)、肝氣逆證(10次,4.63%)、肝郁脾虛證(10次,4.63%)。1.2文獻(xiàn)研究結(jié)果顯示:本病涉及的臟腑包括肝、脾、腎,其中主要以肝為主,構(gòu)成比為53.13%,其次為脾,構(gòu)成比為20.54%,再次為腎,構(gòu)成比為18.30%,三者累計(jì)頻率為91.97%。1.3文獻(xiàn)研究結(jié)果顯示:病性要素頻次頻率排在前3位由高到低,依次分別是氣滯(85次,28.81%)、火/熱(43次,14.58%)和陰虛(37次,12.54%)。實(shí)性證候要素以氣滯為主,虛性證候要素以陰虛為主。2.臨床研究2.1調(diào)查山西中醫(yī)學(xué)院女大學(xué)生972人,發(fā)現(xiàn)PMS患者406人,PMS的患病率為41.77%。2.2女大學(xué)生經(jīng)前期綜合征高發(fā)年齡為23-25歲,高發(fā)年級(jí)為大五,與所在專業(yè)無(wú)關(guān)。2.3臨床證型研究結(jié)果顯示:主證由多到少,依次為肝氣逆證168例(45.16%),肝氣郁結(jié)證96例(25.81%),肝郁化火證63例(16.94%),肝郁脾虛證30例(8.06%),氣滯血瘀證15例(4.03%),肝腎陰虛證0例,脾腎陽(yáng)虛證0例。次證由多到少,依次為肝郁脾虛證88例,約占33.72%;肝郁化火證53例,約占20.31%;肝氣郁結(jié)證35例,約占13.41%;脾腎陽(yáng)虛證29例,約占11.11%;氣滯血瘀證28例,約占10.73%;肝氣逆證21例,約占8.05%;肝腎陰虛證7例,約占2.68%。本病各種證候的主證及次證分布有顯著性差異(P0.05)。2.4臨床癥狀研究結(jié)果顯示:此次調(diào)查的經(jīng)前期綜合征癥狀共36項(xiàng),精神癥狀頻數(shù)居前兩位的是:急躁易怒262例(70.43%)、情緒抑郁143例(38.98%);行為改變癥狀頻數(shù)居前兩位的是:注意力不集中278例(77.73%)、學(xué)習(xí)能力下降236例(63.44%);軀體癥狀頻數(shù)居前10位統(tǒng)計(jì)的是:小腹脹痛293例(78.76%)、疲乏256例(68.82%)、乳房脹痛242例(65.05%)、失眠多夢(mèng)203例(54.57%)、脘腹脹滿196例(52.69%)、頭痛188例(50.54%)、胸悶176例(47.31%)、胸脅脹痛167例(44.89%)、心煩137例(36.83%)、納呆125例(33.60%)。本病各種癥狀輕度、中度、重度程度分布有顯著性差異(P0.05)。研究結(jié)論1.文獻(xiàn)研究資料經(jīng)過(guò)規(guī)范化地提取,本病證型以肝氣郁滯證、脾腎陽(yáng)虛證、肝腎陰虛證、氣滯血瘀證、肝郁化火證、肝氣逆證、肝郁脾虛證為主。本病病位在肝、脾、腎等臟腑,主要以肝為主。病理性質(zhì)虛實(shí)錯(cuò)雜。實(shí)證以氣滯為主;虛證以陰虛為主。2.本次調(diào)查結(jié)果顯示:所調(diào)查人群PMS的發(fā)病率為41.77%,與文獻(xiàn)資料相符合。3.本次調(diào)查結(jié)果顯示:本病主證主要以肝氣逆證(45.16%)和肝氣郁結(jié)證(25.81%)為主,故主證以肝失疏泄的證型為主,次證主要以肝郁脾虛證(33.72%)、肝郁化火證(20.31%)和肝氣郁結(jié)證(13.41%)為主,故次證中肝郁的變證是出現(xiàn)最多的證型。4.本次調(diào)查結(jié)果顯示:小腹脹痛(78.76%)、注意力不集中(77.73%)、急躁易怒(70.43%)是該人群PMS患者最常見(jiàn)的癥狀。
[Abstract]:Objective To explore the distribution of symptoms of premenstrual syndrome (PMS) in the literature of traditional Chinese medicine (TCM) in the past 10 years, and to provide a reference for the preparation of the questionnaire; to explore the incidence of PMS and the distribution of clinical symptoms of TCM among female college students in Shanxi University of Traditional Chinese Medicine, and to lay a foundation for the standardized treatment and clinical diagnosis of female college students. Research methods: By searching the literature of PMS in the past 10 years, according to the inclusion and exclusion criteria, select the suitable literature, make statistics and Analysis on its syndrome, combine with the etiology and pathogenesis of PMS, etiology and pathology of Western medicine, summarize the diagnostic data needed for TCM syndrome differentiation and clinical diagnosis, and design the questions needed. A questionnaire survey was conducted among female college students aged 18-25 in Shanxi College of Traditional Chinese Medicine. The subjects who met the diagnostic criteria of PMS were screened. The symptoms and signs of premenstrual syndrome were filled out in the questionnaire. The results of the questionnaire were carefully examined and entered into EpiData 3.1 software. SPSS17.0 statistical software was used to analyze the data and analyze whether the relevant data were statistically significant. Results 1. Literature research 1.1 After standardized extraction of literature research data, the main syndrome types (frequency < 10), a total of 7; its frequency from more to less in turn is: liver qi stagnation syndrome (35 times, 1. 6.2%, spleen and kidney yang deficiency syndrome (14 times, 6.48%), liver and kidney yin deficiency syndrome (13 times, 6.02%), qi stagnation and blood stasis syndrome (11 times, 5.09%), liver depression and fire (10 times, 4.63%), liver Qi reversal syndrome (10 times, 4.63%) and liver depression and spleen deficiency syndrome (10 times, 4.63%). 1.3 The results of literature study showed that the frequency of the disease factors ranked the top three from high to low, followed by qi stagnation (85 times, 28.81%), fire / heat (43 times, 14.58%) and yin deficiency (37 times, 12.54%). Clinical research 2.1 Investigation of 972 female college students in Shanxi College of Traditional Chinese Medicine, found that 406 patients with PMS, the prevalence of PMS was 41.77%. 2.2 Female college students with premenstrual syndrome high-incidence age of 23-25 years old, high-incidence grade for the fifth, and their major has nothing to do. 2.3 Clinical syndrome type research results show that the main syndrome from more to less, followed by liver-qi syndrome 168. Cases (45.16%), 96 cases (25.81%), 63 cases (16.94%), 30 cases (8.06%) of liver depression and spleen deficiency, 15 cases (4.03%) of qi stagnation and blood stasis, 0 cases of liver and kidney yin deficiency, and 0 cases of spleen and kidney yang deficiency. 29 cases of kidney yang deficiency syndrome, accounting for 11.11%; 28 cases of qi stagnation and blood stasis syndrome, accounting for 10.73%; 21 cases of liver qi deficiency syndrome, accounting for 8.05%; 7 cases of liver and kidney yin deficiency syndrome, accounting for 2.68%. The distribution of various syndromes and sub-syndromes of this disease has significant differences (P The first two were impatience and irritability in 262 cases (70.43%) and emotional depression in 143 cases (38.98%); behavioral changes in 278 cases (77.73%), learning ability in 236 cases (63.44%) and physical symptoms in 293 cases (78.76%), fatigue in 256 cases (68.82%) and breast swelling pain in 242 cases (65.05%). 203 cases (54.57%), 196 cases (52.69%), 188 cases (50.54%) of headache, 176 cases (47.31%) of chest tightness, 167 cases (44.89%), 137 cases (36.83%) of anxiety, 125 cases (33.60%) of dementia. There were significant differences in the distribution of mild, moderate and severe symptoms (P 0.05). Conclusion 1. The main syndrome types are stagnation of liver-qi, deficiency of spleen-kidney yang, deficiency of liver-kidney yin, stagnation of Qi and blood stasis, stagnation of Liver-qi to dissipate fire, reversion of liver-qi, and deficiency of liver-qi and spleen. The incidence of the disease was 41.77%, which was consistent with the literature. 3. The results showed that the main syndromes of the disease were liver-qi inverse syndrome (45.16%) and Liver-qi Stagnation Syndrome (25.81%). So the main syndromes were liver-qi loss and discharge syndrome, the secondary syndromes were liver-qi stagnation and spleen-deficiency syndrome (33.72%), Liver-qi Depression and fire-removing syndrome (20.31%) and Liver-qi Stagnation Syndrome (13.41%). The results of this survey showed that abdominal distention and pain (78.76%), inattention (77.73%) and irritability (70.43%) were the most common symptoms of PMS.
【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R271.115
本文編號(hào)：2193075
[Abstract]:Objective To explore the distribution of symptoms of premenstrual syndrome (PMS) in the literature of traditional Chinese medicine (TCM) in the past 10 years, and to provide a reference for the preparation of the questionnaire; to explore the incidence of PMS and the distribution of clinical symptoms of TCM among female college students in Shanxi University of Traditional Chinese Medicine, and to lay a foundation for the standardized treatment and clinical diagnosis of female college students. Research methods: By searching the literature of PMS in the past 10 years, according to the inclusion and exclusion criteria, select the suitable literature, make statistics and Analysis on its syndrome, combine with the etiology and pathogenesis of PMS, etiology and pathology of Western medicine, summarize the diagnostic data needed for TCM syndrome differentiation and clinical diagnosis, and design the questions needed. A questionnaire survey was conducted among female college students aged 18-25 in Shanxi College of Traditional Chinese Medicine. The subjects who met the diagnostic criteria of PMS were screened. The symptoms and signs of premenstrual syndrome were filled out in the questionnaire. The results of the questionnaire were carefully examined and entered into EpiData 3.1 software. SPSS17.0 statistical software was used to analyze the data and analyze whether the relevant data were statistically significant. Results 1. Literature research 1.1 After standardized extraction of literature research data, the main syndrome types (frequency < 10), a total of 7; its frequency from more to less in turn is: liver qi stagnation syndrome (35 times, 1. 6.2%, spleen and kidney yang deficiency syndrome (14 times, 6.48%), liver and kidney yin deficiency syndrome (13 times, 6.02%), qi stagnation and blood stasis syndrome (11 times, 5.09%), liver depression and fire (10 times, 4.63%), liver Qi reversal syndrome (10 times, 4.63%) and liver depression and spleen deficiency syndrome (10 times, 4.63%). 1.3 The results of literature study showed that the frequency of the disease factors ranked the top three from high to low, followed by qi stagnation (85 times, 28.81%), fire / heat (43 times, 14.58%) and yin deficiency (37 times, 12.54%). Clinical research 2.1 Investigation of 972 female college students in Shanxi College of Traditional Chinese Medicine, found that 406 patients with PMS, the prevalence of PMS was 41.77%. 2.2 Female college students with premenstrual syndrome high-incidence age of 23-25 years old, high-incidence grade for the fifth, and their major has nothing to do. 2.3 Clinical syndrome type research results show that the main syndrome from more to less, followed by liver-qi syndrome 168. Cases (45.16%), 96 cases (25.81%), 63 cases (16.94%), 30 cases (8.06%) of liver depression and spleen deficiency, 15 cases (4.03%) of qi stagnation and blood stasis, 0 cases of liver and kidney yin deficiency, and 0 cases of spleen and kidney yang deficiency. 29 cases of kidney yang deficiency syndrome, accounting for 11.11%; 28 cases of qi stagnation and blood stasis syndrome, accounting for 10.73%; 21 cases of liver qi deficiency syndrome, accounting for 8.05%; 7 cases of liver and kidney yin deficiency syndrome, accounting for 2.68%. The distribution of various syndromes and sub-syndromes of this disease has significant differences (P The first two were impatience and irritability in 262 cases (70.43%) and emotional depression in 143 cases (38.98%); behavioral changes in 278 cases (77.73%), learning ability in 236 cases (63.44%) and physical symptoms in 293 cases (78.76%), fatigue in 256 cases (68.82%) and breast swelling pain in 242 cases (65.05%). 203 cases (54.57%), 196 cases (52.69%), 188 cases (50.54%) of headache, 176 cases (47.31%) of chest tightness, 167 cases (44.89%), 137 cases (36.83%) of anxiety, 125 cases (33.60%) of dementia. There were significant differences in the distribution of mild, moderate and severe symptoms (P 0.05). Conclusion 1. The main syndrome types are stagnation of liver-qi, deficiency of spleen-kidney yang, deficiency of liver-kidney yin, stagnation of Qi and blood stasis, stagnation of Liver-qi to dissipate fire, reversion of liver-qi, and deficiency of liver-qi and spleen. The incidence of the disease was 41.77%, which was consistent with the literature. 3. The results showed that the main syndromes of the disease were liver-qi inverse syndrome (45.16%) and Liver-qi Stagnation Syndrome (25.81%). So the main syndromes were liver-qi loss and discharge syndrome, the secondary syndromes were liver-qi stagnation and spleen-deficiency syndrome (33.72%), Liver-qi Depression and fire-removing syndrome (20.31%) and Liver-qi Stagnation Syndrome (13.41%). The results of this survey showed that abdominal distention and pain (78.76%), inattention (77.73%) and irritability (70.43%) were the most common symptoms of PMS.
【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R271.115
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