原發(fā)性骨質(zhì)疏松癥維吾爾醫(yī)異常體液病證診斷標(biāo)準(zhǔn)研究
發(fā)布時(shí)間：2018-09-12 14:52
【摘要】：目的:建立原發(fā)性骨質(zhì)疏松癥維吾爾醫(yī)異常體液病證診斷標(biāo)準(zhǔn)。方法:首先以非疾病診斷相關(guān)臨床信息(精神狀況、睡眠質(zhì)量、肌膚、皮膚表面溫度、眼部變化、眼角膜顏色,面色、欲飲與口味、舌象、脈象、小便、大便)為依據(jù)進(jìn)行量化診斷入選項(xiàng)專家咨詢研究。利用多分類Logistic回歸分析法和主成分改進(jìn)的多分類Logistic回歸分析法,分析不同異常體液證候與證候要素之間的非線性相關(guān)關(guān)系,確立每個(gè)不同證候要素對該證候的貢獻(xiàn)率;根據(jù)OR值分?jǐn)?shù)明確原發(fā)性骨質(zhì)疏松癥不同證型的主癥、次癥,制定原發(fā)性骨質(zhì)疏松癥維吾爾醫(yī)異常體液“分型診斷標(biāo)準(zhǔn)”。其次,通過文獻(xiàn)及專家咨詢研究,收集、歸納骨質(zhì)疏松癥臨床診斷特征性癥狀(核心癥狀),并應(yīng)用積分法及構(gòu)成比計(jì)算法研究骨質(zhì)疏松癥核心癥狀在各異常體液分型中的分布規(guī)律,結(jié)合原發(fā)性骨質(zhì)疏松癥維吾爾醫(yī)異常體液分型診斷標(biāo)準(zhǔn)的研究結(jié)果,建立原發(fā)性骨質(zhì)疏松癥維吾爾醫(yī)異常體液“病證診斷標(biāo)準(zhǔn)”;最后,取符合納入標(biāo)準(zhǔn)的166例原發(fā)性骨質(zhì)疏松癥患者及30名健康對照組作為研究對象,檢測骨代謝相關(guān)指標(biāo),探索原發(fā)性骨質(zhì)疏松癥異常體液分型相關(guān)的骨代謝敏感指標(biāo)。結(jié)果:1)原發(fā)性骨質(zhì)疏松癥最核心并最常見的異常體液類型是異常黑膽質(zhì)型,其次為異常粘液質(zhì)型;異常黑膽質(zhì)型中其他體液燒焦后的異常黑膽質(zhì)型最多見;異常粘液質(zhì)型中澀味粘液質(zhì)型較多見;2)異常黑膽質(zhì)型主癥:面色晦暗、皮膚粗糙起鱗屑、多夢、噩夢、抑郁心態(tài);次癥:口味苦澀、舌質(zhì)暗紅、舌苔灰或黑色、大便干結(jié)、脈細(xì)、沉。異常血液質(zhì)型主癥:面色發(fā)紅、皮膚較熱、小便色橙黃、肢體沉重、脈象粗、有力;次癥:駝背、睡眠尚少、口干、舌質(zhì)暗紅、舌苔少。異常粘液質(zhì)型主癥:腰背肢體冷痛、肢體畏寒喜暖、面色暗淡、口黏、少氣懶言;次癥:面色fD白、舌體胖大邊緣齒痕、睡眠較多、肢體麻木、脈象粗、沉、弱。異常膽液質(zhì)型主癥:骨有灼痛、刺痛、疼有定處、皮膚較熱、口干咽燥、口味甘苦、失眠、小便次數(shù)偏多、脈細(xì)、緊。次癥:面色微黃、舌苔黃、盜汗;3)原發(fā)性骨質(zhì)疏松癥最核心并最常見的癥狀是骨疼、身長縮短、駝背、骨折、發(fā)落齒搖;它們在各異常體液分型中分布規(guī)律有差異,骨疼在4種異常體液分型中都出現(xiàn)骨疼癥狀,并在出現(xiàn)率上無明顯差異;其他癥狀中,身長縮短、駝背、脆性骨折在異常黑膽質(zhì)型中所占的比例較其他證型均高;發(fā)落齒搖在異常黏液質(zhì)型中所占的比例較其他證型高;積分值≥7.5視為主要癥狀列入為主證,≤7.5視為次要癥狀列入為次證;4)4種異常體液型核心癥狀輕重有區(qū)別,異常黑膽質(zhì)型較其他分型癥狀較重,它們的輕重程度排序?yàn)?異常黑膽質(zhì)型異常黏液質(zhì)型異常血液質(zhì)型異常膽液質(zhì)型;5)骨密度及骨密度T值數(shù)越低,患者的異常體液分型越傾向于異常黑膽質(zhì)型;反過來25羥基維生素D水平越接近正常值水平,患者的異常體液分型越傾向于異常膽液質(zhì)型,研究結(jié)果可作為原發(fā)性骨質(zhì)疏松癥辨證的微觀指標(biāo)之一。結(jié)論:此標(biāo)準(zhǔn)的建立,為原發(fā)性骨質(zhì)疏松癥辯異常體液論治提供了可靠的依據(jù),為異常體液分型提供了數(shù)據(jù)支持,為進(jìn)一步深入研究提供了標(biāo)準(zhǔn)化尺度,提高辨證的可操作性、科學(xué)性。
[Abstract]:Objective: To establish the diagnostic criteria of abnormal humoral syndrome in Uygur medicine for primary osteoporosis.Methods: The clinical information of non-disease diagnosis (mental status, sleep quality, skin, skin surface temperature, eye changes, corneal color, complexion, appetite and taste, tongue, pulse, urine, stool) was used as the basis for quantitative diagnosis. Expert Consultation Research. By using multi-classification logistic regression analysis and principal component improved multi-classification logistic regression analysis, the non-linear correlation between different abnormal body fluid syndrome and syndrome elements was analyzed, and the contribution rate of each different syndrome element to the syndrome was determined. Secondly, through the literature and expert consultation research, collect and summarize the clinical diagnostic characteristic symptoms (core symptoms) of osteoporosis, and study the core symptoms of osteoporosis by integral method and composition ratio calculation method. According to the results of Uygur medical diagnostic criteria for abnormal body fluids in primary osteoporosis, the diagnostic criteria for abnormal body fluids in primary osteoporosis were established. Finally, 166 patients with primary osteoporosis and 30 healthy controls were selected as the study subjects. Subjects: Bone metabolic markers were detected to explore the sensitive markers of bone metabolism related to abnormal humoral typing in primary osteoporosis. Results: 1) Abnormal black bile type was the most important and common abnormal humoral type in primary osteoporosis, followed by abnormal mucinous type, and abnormal black bile type after burning of other body fluids in abnormal black bile type. Type B is the most common type; type B is the most common type of abnormal mucinous type of astringent mucinous type; 2) abnormal dark gallbladder type of main symptoms: dark complexion, rough skin scaling, dreams, nightmares, depressive mood; secondary symptoms: bitter taste, dark red tongue, tongue fur gray or black, dry stool, fine veins, sinking. Abnormal blood type of main symptoms: redness, hot skin, urine orange yellow, limbs. The main symptoms of abnormal mucinous type: cold and painful back and limbs, cold and warm extremities, dull complexion, sticky mouth, less gas and idle talk; secondary symptoms: white complexion, tongue fat edge teeth, more sleep, numbness of limbs, pulse thick, heavy, weak. Burning pain, tingling pain, pain has a fixed place, the skin is hot, dry mouth and pharynx, taste sweet and bitter, insomnia, urination frequency, fine pulse, tight. Secondary symptoms: yellowish complexion, tongue coating yellow, night sweat; 3) Primary osteoporosis the most core and most common symptoms are bone pain, shortening body length, hump back, fracture, loss of teeth shake; They are in the distribution of abnormal body fluid types in the law is poor. In other symptoms, shortening of body length, hump back and brittle fracture accounted for a higher proportion in abnormal black gall type than in other syndromes; the proportion of falling teeth in abnormal mucus type was higher than that in other syndromes; the score (> 7.5) was regarded as the main symptom. If the symptoms were included as the main symptom, <7.5 as the secondary symptom was included as the secondary syndrome; (4) The core symptoms of the four abnormal humoral types were different in severity, and the abnormal melanobiliary type was more serious than other types of symptoms. The order of severity of these symptoms was as follows: abnormal melanobiliary type, abnormal mucinous type, abnormal blood type, abnormal biliary type; 5) the higher bone mineral density and bone mineral density T value. The abnormal body fluid typing of the patients tended to be abnormal melanobiliary type, while the abnormal body fluid typing of the patients tended to be abnormal biliary type when the level of 25-hydroxyvitamin D approached the normal level. The results could be used as one of the microscopic indicators for the differentiation of primary osteoporosis. It provides a reliable basis for the treatment of abnormal body fluids and data support for the classification of abnormal body fluids. It also provides a standardized scale for further study and improves the operability and scientificity of syndrome differentiation.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R29
[Abstract]:Objective: To establish the diagnostic criteria of abnormal humoral syndrome in Uygur medicine for primary osteoporosis.Methods: The clinical information of non-disease diagnosis (mental status, sleep quality, skin, skin surface temperature, eye changes, corneal color, complexion, appetite and taste, tongue, pulse, urine, stool) was used as the basis for quantitative diagnosis. Expert Consultation Research. By using multi-classification logistic regression analysis and principal component improved multi-classification logistic regression analysis, the non-linear correlation between different abnormal body fluid syndrome and syndrome elements was analyzed, and the contribution rate of each different syndrome element to the syndrome was determined. Secondly, through the literature and expert consultation research, collect and summarize the clinical diagnostic characteristic symptoms (core symptoms) of osteoporosis, and study the core symptoms of osteoporosis by integral method and composition ratio calculation method. According to the results of Uygur medical diagnostic criteria for abnormal body fluids in primary osteoporosis, the diagnostic criteria for abnormal body fluids in primary osteoporosis were established. Finally, 166 patients with primary osteoporosis and 30 healthy controls were selected as the study subjects. Subjects: Bone metabolic markers were detected to explore the sensitive markers of bone metabolism related to abnormal humoral typing in primary osteoporosis. Results: 1) Abnormal black bile type was the most important and common abnormal humoral type in primary osteoporosis, followed by abnormal mucinous type, and abnormal black bile type after burning of other body fluids in abnormal black bile type. Type B is the most common type; type B is the most common type of abnormal mucinous type of astringent mucinous type; 2) abnormal dark gallbladder type of main symptoms: dark complexion, rough skin scaling, dreams, nightmares, depressive mood; secondary symptoms: bitter taste, dark red tongue, tongue fur gray or black, dry stool, fine veins, sinking. Abnormal blood type of main symptoms: redness, hot skin, urine orange yellow, limbs. The main symptoms of abnormal mucinous type: cold and painful back and limbs, cold and warm extremities, dull complexion, sticky mouth, less gas and idle talk; secondary symptoms: white complexion, tongue fat edge teeth, more sleep, numbness of limbs, pulse thick, heavy, weak. Burning pain, tingling pain, pain has a fixed place, the skin is hot, dry mouth and pharynx, taste sweet and bitter, insomnia, urination frequency, fine pulse, tight. Secondary symptoms: yellowish complexion, tongue coating yellow, night sweat; 3) Primary osteoporosis the most core and most common symptoms are bone pain, shortening body length, hump back, fracture, loss of teeth shake; They are in the distribution of abnormal body fluid types in the law is poor. In other symptoms, shortening of body length, hump back and brittle fracture accounted for a higher proportion in abnormal black gall type than in other syndromes; the proportion of falling teeth in abnormal mucus type was higher than that in other syndromes; the score (> 7.5) was regarded as the main symptom. If the symptoms were included as the main symptom, <7.5 as the secondary symptom was included as the secondary syndrome; (4) The core symptoms of the four abnormal humoral types were different in severity, and the abnormal melanobiliary type was more serious than other types of symptoms. The order of severity of these symptoms was as follows: abnormal melanobiliary type, abnormal mucinous type, abnormal blood type, abnormal biliary type; 5) the higher bone mineral density and bone mineral density T value. The abnormal body fluid typing of the patients tended to be abnormal melanobiliary type, while the abnormal body fluid typing of the patients tended to be abnormal biliary type when the level of 25-hydroxyvitamin D approached the normal level. The results could be used as one of the microscopic indicators for the differentiation of primary osteoporosis. It provides a reliable basis for the treatment of abnormal body fluids and data support for the classification of abnormal body fluids. It also provides a standardized scale for further study and improves the operability and scientificity of syndrome differentiation.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R29
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