【摘要】：目的:通過(guò)回顧性分析,探索遼寧中醫(yī)藥大學(xué)附屬醫(yī)院近3年來(lái)慢性便秘住院患者的發(fā)病特點(diǎn)及中醫(yī)證型分布情況,并且分析中醫(yī)用藥規(guī)律,通過(guò)回顧性分析對(duì)慢性便秘的證治規(guī)律進(jìn)行總結(jié),以便為今后開展針對(duì)慢性便秘的中西醫(yī)結(jié)合治療提供客觀依據(jù)和幫助。資料與方法:收集自2014年1月至2016年9月在遼寧中醫(yī)藥大學(xué)附屬醫(yī)院脾胃科住院治療的136例慢性便秘患者的基本自然信息、發(fā)病相關(guān)因素以及中醫(yī)辨證分型和用藥等資料,將收集整理后的數(shù)據(jù)建立成數(shù)據(jù)庫(kù),運(yùn)用SPSS17.0軟件,對(duì)其進(jìn)行統(tǒng)計(jì)分析處理,P0.05認(rèn)為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1.一般資料分析:本次研究共收集慢性便秘患者病例136例,其中男性患者49例占36.02%,女性患者87例占63.98%,男女比例為1:1.77,總體平均年齡為(65.67±12.73)歲;年齡區(qū)間在60-89歲的老年組患者人數(shù)比例最大,為68.4%(P0.05);患者的職業(yè)構(gòu)成中業(yè)務(wù)員及離退休人員占據(jù)絕大多數(shù),為總?cè)藬?shù)的86.8%(P0.05);病程最短為1年,病程最長(zhǎng)為40年,患病2-5年的人數(shù)最多為40.4%(P0.05);不同季節(jié)患病人數(shù)基本相同。2.證型分布情況:慢性便秘分為四個(gè)證型,腸道實(shí)熱證28例(20.59%),肺脾氣虛證58例(42.65%),腸道氣滯證42例(30.88%),津虧血少證8例(5.88%),肺脾氣虛證和腸道氣滯證的人數(shù)較多(P0.05);各個(gè)證型在不同年齡區(qū)間的差異沒(méi)有統(tǒng)計(jì)學(xué)意義(P0.05),各年齡段均以肺脾氣虛證及腸道氣滯證占多數(shù);不同性別的各證型比例無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。3.中醫(yī)用藥統(tǒng)計(jì):136名患者共使用藥物總數(shù)為115味,總頻次為1605次,使用頻次最高的20味藥:郁李仁、枳實(shí)、陳皮、大黃、甘草、桃仁、柴胡、杏仁、白術(shù)、厚樸、白芍、茯苓、木香、檳榔、火麻仁、當(dāng)歸、牛膝、萊菔子、生地黃、黃芪。不同證型的常用藥:腸道實(shí)熱證應(yīng)用頻次最高的10味藥:杏仁、枳實(shí)、桃仁、牛膝、厚樸、麥冬、白術(shù)、白芍、麻子仁、大黃,為麻子仁丸加減的主要藥物組成;肺脾氣虛證應(yīng)用頻次最高的10味藥:枳實(shí)、甘草、陳皮、白術(shù)、火麻仁、厚樸、桃仁、茯苓、黃芪、黨參,為黃芪湯加減的主要藥物組成;腸道氣滯證應(yīng)用頻次最高的10味藥:枳實(shí)、大黃、柴胡、木香、火麻仁、檳榔、郁李仁、厚樸、陳皮、烏藥,為六磨湯加減的主要藥物組成;津虧血少證應(yīng)用頻次最高的10味藥:火麻仁、陳皮、黃芪、生地黃、當(dāng)歸、桃仁、芒硝、枳實(shí)、厚樸、大黃,為潤(rùn)腸丸的主要藥物組成。結(jié)論:1.一般資料分析:慢性便秘的發(fā)生與年齡、性別、職業(yè)、季節(jié)相關(guān),患病病程以2-5年者最多。中年人、工作生活壓力較大的腦力勞動(dòng)者及平時(shí)缺乏運(yùn)動(dòng)的退休老年人為本病高發(fā)人群,本病秋季多發(fā)。2.中醫(yī)證型分布以肺脾氣虛證和腸道氣滯證所占比例最大,患病證型與年齡無(wú)關(guān),各年齡段發(fā)病均以肺脾氣虛證和腸道氣滯為主。3.辨證用藥:本病的常用藥:厚樸、大黃、火麻仁、甘草、桃仁、當(dāng)歸、郁李仁、柴胡、杏仁、枳實(shí)、白芍、茯苓、陳皮、木香、檳榔、黃芪、牛膝、萊菔子、生地黃。4.基本方:根據(jù)實(shí)際治療情況,歸納出治療本病的基本方由黃芪、白術(shù)、枳實(shí)、陳皮、厚樸、火麻仁、桃仁、大黃8味藥物構(gòu)成。
[Abstract]:Objective: To study the characteristics of the patients with chronic constipation and the distribution of the syndrome of traditional Chinese medicine in the last three years of the affiliated hospital of the University of Traditional Chinese Medicine in Liaoning Province through the retrospective analysis, and to analyze the rule of the traditional Chinese medicine, and to make a summary of the rule of the treatment of the chronic constipation by retrospective analysis. so as to provide an objective basis and a help for future combined treatment of the traditional Chinese medicine and the western medicine aiming at the chronic constipation. Materials and Methods: 136 cases of chronic constipation were collected from January 2014 to September 2016 in the Department of the Spleen and the Stomach of the Affiliated Hospital of the University of Traditional Chinese Medicine. The collected data was established as a database, and the software of SPSS17.0 was used to carry out the statistical analysis and treatment, and the difference was considered to be of statistical significance. Results: 1. General data analysis: In this study, 136 cases of patients with chronic constipation were collected. Among them, 49 of the male patients accounted for 36.02%, 87 of the female patients were 63. 98%, the ratio of the male to female was 1: 1.77, the overall average age was (65. 67 to 12. 73) years, and the proportion of patients in the old group with the age range of 60 to 89 years was the largest. The number of men and the retirees in the occupational group of the patients was 60.8% (P0.05). The duration of the course was 1 year, the duration of the course was 40 years, and the number of the patients with the disease of 2 to 5 years was 40.4% (P0.05); the number of patients with different seasons was basically the same. The pattern of syndrome distribution: chronic constipation was divided into four syndrome types: 28 cases (20. 59%) of intestinal solid heat syndrome, 58 cases (42. 65%) of lung-qi deficiency syndrome, 42 cases of intestinal qi stagnation syndrome (30. 88%), 8 cases (5.88%) with less blood-deficient blood syndrome, and a higher number of lung-qi and qi-stagnation syndrome (P <0.05). There was no significant difference in the different age range (P0.05), and all the different age groups were in the majority of the lung-spleen-qi deficiency syndrome and the intestinal qi-stagnation syndrome, and there was no statistical difference in the number of the different sexes (P0.05). The traditional Chinese medicine statistics: 136 patients have a total of 115 drugs, the total frequency is 1605, and the most frequently used 20-flavor medicines are: Yu Liren, Fructus Aurantii, Chen Pi, Radix et Rhizoma Rhei, Radix Glycyrrhizae, Semen Persicae, Bupleuri Radix, Semen Armeniacae Amarum, Rhizoma Atractylodis Macrocephalae, Cortex Magnolia Officinalis, Radix Paeoniae Alba, Poria, Radix Aucklandiae, Semen Arecae, Fructus Cannabae, and Radix Angelicae Sinensis. Achyranthis Achyranthis, Lepidium, Radix Rehmanniae, and Radix et Rhizoma Rhei. The common medication of different syndrome type: 10 medicines with the highest application frequency of the intestinal solid heat syndrome: Semen Armeniacae Amarum, Fructus Aurantii, Semen Persicae, Achyranthis Radix, Cortex Magnolia Officinalis, Radix Ophiopogonis, Rhizoma Atractylodis Macrocephalae, Radix Paeoniae Alba, Fructus Cannabis, and Radix et Rhizoma Rhei, and is the main drug added or modified by the Fructus Cannabinae pill; and the lung qi deficiency syndrome has the highest application frequency of 10 medicines: Fructus Aurantii Immaturus, Radix Glycyrrhizae, Pericarpium Citri Reticulatae, Rhizoma Atractylodis Macrocephalae, Fructus Cannabis, Cortex Magnolia Officinalis, Semen Persicae, Poria, Rhizoma Dioscoreae, and Radix Codonopsis, and is the main drug for adding and subtracting the yellow decoction; the ten medicines with the highest application frequency of the intestinal qi stagnation syndrome: Fructus Aurantii, Radix et Rhizoma Rhei, Bupleuri Radix, Radix Aucklandiae, Fructus Cannabae, Semen Arecae, Semen Pruni, Cortex Magnolia Officinalis, Pericarpium Citri Reticulatae, and Radix Linderae, The preparation method comprises the following components in parts by weight: 10 Chinese-medicinal materials with the highest application frequency, such as fructus cannabis, Chen Pi, Huang Yi, Radix Rehmanniae, Radix Angelicae Sinensis, Semen Persicae, Natrii Sulfas, Fructus Aurantii Immaturus, Cortex Magnolia Officinalis, and Radix et Rhizoma Rhei, and is the main drug for moistening the intestine. Conclusion: 1. General data analysis: The occurrence of chronic constipation is related to age, sex, occupation and season, and the disease course is the most in 2-5 years. middle-aged people, mental workers with high working life pressure and retired old people who do not normally lack exercise are the high-risk group of the disease, and the disease is more frequent in autumn. The pattern of the syndrome of TCM is the largest in the deficiency of the lung-qi and the syndrome of the qi-stagnation of the intestinal tract, and the type of the disease is not related to the age, and the morbidity of each age group is mainly due to the deficiency of the lung-qi and the qi-stagnation of the intestine. The medicine for the treatment of this disease: the common use of the disease: Magnolia officinalis, Radix et Rhizoma Rhei, Fructus Cannabis, Radix Glycyrrhizae, Semen Persicae, Radix Angelicae Sinensis, Semen Pruni, Bupleuri Radix, Semen Armeniacae Amarum, Fructus Aurantii, Radix Paeoniae Alba, Poria, Pericarpium Citri Reticulatae, Radix Aucklandiae, Arecae Semen, Radix Achyranthis Bidentatae, Achyranthis Achyranthis Bidentatae, and Radix Rehmanniae. The basic prescription: according to the actual treatment, it is concluded that the basic prescription for treating the disease is composed of the following Chinese medicinal materials: Huang Yi, Atractylodis Rhizoma, Fructus Aurantii Immaturus, Pericarpium Citri Reticulatae, Cortex Magnolia Officinalis, Fructus Cannabei, Semen Persicae, and Radix et Rhizoma Rhei.
【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)】：R256.35

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