【摘要】：目的:慢性胃病是臨床常見病和多發(fā)病,屬于中醫(yī)的“胃痛”、“痞滿”、“嘈雜”等。本研究通過計算機(jī)檢索、手工檢索的方式、古籍的查閱,對慢性胃炎與中醫(yī)的“濕證”相關(guān)的文獻(xiàn)進(jìn)行統(tǒng)計學(xué)分析,得出慢性胃炎與“濕”有關(guān)的主癥有泄瀉、便溏,口淡、納少,煩躁易怒,汗多,心慌,出汗,失眠,脅肋脹痛、情緒影響,胃院痛、嘈雜,胃脹,脘腹怕冷,反酸,頭暈,面色萎黃,大便不爽,舌紅苔黃,小便黃,口粘膩,口苦,惡心、嘔吐,胸悶,肢體困重,噯氣,四肢乏力,口臭,神疲懶言,失眠多夢,善太息,口干,口渴28個癥狀,舌象有舌暗,舌紅,淡紅舌,胖大舌,舌有齒痕,苔薄白,苔白膩,苔黃膩,苔厚如積粉;脈象有弦脈、沉脈、細(xì)脈、澀脈、滑脈,總共42個要素。以中醫(yī)診斷學(xué)辨證要素為基礎(chǔ),結(jié)合多元數(shù)理統(tǒng)計方法,以期確定慢性胃炎濕郁脾胃證宏觀辨證標(biāo)準(zhǔn),探討建立中醫(yī)證候辨證標(biāo)準(zhǔn)的方法和手段。方法:選擇2014年9月至2015年12月間,就診于廣西中醫(yī)藥大學(xué)附屬瑞康醫(yī)院消化科門診患者,經(jīng)內(nèi)窺鏡及病理組織學(xué)檢查,確診為慢性非萎縮性胃炎患者200例。并設(shè)計的方法對200例慢性胃炎患者進(jìn)行臨床流行病學(xué)調(diào)查,符合中醫(yī)的濕證,給予排行氣健脾,化濕解郁的安胃二號方服用后好轉(zhuǎn)的患者,除兼有其它臟器嚴(yán)重疾病者,其中90例患者符合探究慢性胃炎濕郁脾胃這一證型臨床癥狀特點。對90例資料進(jìn)行聚類分析、兩次SPSS回歸分析,以此篩選出對慢性胃炎濕郁脾胃證辨證有意義的主要癥狀、體征。其中男性38例,女性52例。平均年齡45.5歲,標(biāo)準(zhǔn)差為12.24歲�；颊咝詣e、年齡、身高、體重?zé)o顯著性差異(P0.05)。結(jié)果與結(jié)論:1、通過對臨床流行病學(xué)調(diào)查數(shù)據(jù)進(jìn)行了中醫(yī)理論的辯證要素的分類、聚類分析、主成分分析以及回歸分析,發(fā)現(xiàn)對于診斷為慢性胃炎的患者,如果有胃脘部不適伴有口淡、納少,失眠多夢,胃脘痛、嘈雜,胃脹,大便不爽,惡心、嘔吐,肢體困重,煩躁易怒,舌紅苔黃膩這些癥狀,則中醫(yī)診斷為濕郁脾胃證的可能性較大。2、濕郁脾胃證可以概括臨床上慢性胃病濕邪郁阻的患者,但是濕郁脾胃證的患者是否具有中醫(yī)郁證或西醫(yī)相關(guān)的焦慮與抑郁癥有待進(jìn)一步的考究。3、通過對中醫(yī)學(xué)理論與多元統(tǒng)計方法的結(jié)合,可以篩選出中醫(yī)證型診斷中有意義的辯證要素。
[Abstract]:Objective: chronic gastropathy is a common and frequent clinical disease, which belongs to traditional Chinese medicine (TCM), such as "stomach pain", "ruffian fullness", "noise" and so on. This research through the computer retrieval, the manual retrieval way, the ancient books consult, carries on the statistical analysis to the chronic gastritis and the traditional Chinese medicine "dampness syndrome" related literature, obtains the chronic gastritis and the "wet" related main symptom to have the diarrhea, the stool is loose, the mouth is light, Little, irritable, sweaty, nervous, sweating, insomnia, flank pain, emotional influence, stomach pain, noise, stomach distension, stomach pain, stomach distension, stomach ache, regurgitation, dizziness, yellow complexion, bad stool, yellow tongue, yellow urination, sticky mouth, bitter mouth, Nausea, vomiting, chest tightness, body drowsiness, belching, limb fatigue, bad breath, tired talk, insomnia and dreams, good breath, dry mouth, 28 symptoms of thirst, tongue with dark tongue, red tongue, pale red tongue, fat tongue, teeth mark on tongue, thin white fur, White and greasy fur, yellow greasy fur, thick as powder; Pulse has chord pulse, deep vein, thin vein, astringent vein, slippery vein, total 42 elements. Based on the dialectical elements of TCM diagnostics and the multivariate mathematical statistical method, this paper aims to determine the macro syndrome differentiation standard of chronic gastritis with dampness depression and spleen and stomach syndrome, and to discuss the methods and means of establishing TCM syndrome differentiation standard. Methods: from September 2014 to December 2015, 200 cases of chronic non-atrophic gastritis were diagnosed by endoscopy and histopathology. The designed method was used to investigate the clinical epidemiology of 200 patients with chronic gastritis. According to the traditional Chinese medicine's dampness syndrome, the patients who got better after taking Anwei No. 2, which ranked qi to strengthen the spleen and dissipated dampness and relieve depression, except for those with serious diseases of other organs, were given. 90 of them were in accordance with the clinical symptoms of chronic gastritis with dampness depression and spleen-stomach syndrome. By cluster analysis and SPSS regression analysis of 90 cases, the main symptoms and signs of chronic gastritis with dampness depression and spleen and stomach syndrome differentiation were screened out. There were 38 males and 52 females. The average age was 45.5 years and the standard deviation was 12.24 years old. There was no significant difference in sex, age, height and weight (P0.05). Results & conclusion: 1. Through the classification of dialectical elements of TCM theory, cluster analysis, principal component analysis and regression analysis, we found that the patients with chronic gastritis were diagnosed as chronic gastritis. If there are stomach discomfort accompanied by light mouth, Na Shao, insomnia, many dreams, epigastric pain, noise, stomach distension, stool upset, nausea, vomiting, limb sleepy, irritable and irritable, tongue red fur yellow greasy these symptoms, The TCM diagnosis of dampness stagnation spleen and stomach syndrome is more likely. 2. Dampness stagnation spleen and stomach syndrome can be summarized in clinical patients with chronic stomach disease dampness and evil stagnation. However, whether the patients with dampness depression spleen and stomach syndrome have TCM depression syndrome or western medicine related anxiety and depression need further study. 3. Through the combination of traditional Chinese medicine theory and multivariate statistical methods, We can screen out the dialectical elements in the diagnosis of TCM syndromes.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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