【摘要】：目的:通過癥、舌、脈辨識及實驗測定載脂蛋白E基因型,探討阿爾茨海默病在中醫(yī)學及維吾爾醫(yī)學在辨證分型分布規(guī)律方面的研究。方法:將202例阿爾茨海默病患者通過比較中醫(yī)學和維吾爾醫(yī)學的癥狀、舌質(zhì)、脈象的分布情況,較全面總結出本病在中醫(yī)學與維吾爾醫(yī)學證型中的分布特點。按中醫(yī)學辨證分6型:髓海不足證、肝腎陰虛證、脾腎兩虛證、氣滯血瘀證、痰濁阻竅證和心肝火旺證。按維吾爾醫(yī)學異常體液質(zhì)分型分4型:異常黑膽質(zhì)型、異常粘液質(zhì)型、異常膽液質(zhì)型、異常血液質(zhì)型,另設正常組30人。通過對232例納入對象進行載脂蛋白E基因型測定,以便了解本病在中醫(yī)學及維吾爾醫(yī)學的證型特點。結果:(1)中醫(yī)學證型分布特點:髓海不足證脾腎兩虛證氣滯血瘀證肝腎陰虛證心肝火旺證痰濁阻竅證;維吾爾醫(yī)學異常體液質(zhì)分型分布特點:異常黑膽質(zhì)型異常粘液質(zhì)型異常膽液質(zhì)型異常血液質(zhì)型。(2)研究病例組與正常組在載脂蛋白E各個基因型中的分布情況,均以ε3/3比例最高,正常組中ε3/3頻率分布構成比(73.4%)較病例組ε3/3(54.5%)高,病例組ε3/4頻率分布構成比(29.2%)明顯高于正常組(3.3%),且差異有統(tǒng)計學意義(P0.01),病例組ε4等位基因與正常組比較分布差異有統(tǒng)計學意義(P0.05)。(3)中醫(yī)學證型中脾腎兩虛證、肝腎陰虛證以及痰濁阻竅證與含有ε4等位基因比較差異均有統(tǒng)計學意義(P0.05),而髓海不足證與含有ε4等位基因比較差異有顯著統(tǒng)計學意義(P0.01)。(4)維吾爾醫(yī)學異常體液質(zhì)分型中,異常黑膽質(zhì)型與含有ε4等位基因比較差異均有統(tǒng)計學意義(P0.05)。結論:通過以癥狀、舌脈辨識分型,借助載脂蛋白E基因型的測定得出,含有ε4等位基因的老年人易患阿爾茨海默病,故得出中醫(yī)學辨證為髓海不足證、脾腎兩虛證、肝腎陰虛證、痰濁阻竅證的老年人易患阿爾茨海默病;維吾爾醫(yī)學異常體液質(zhì)分型中,異常黑膽質(zhì)型的老年人群易患阿爾茨海默病。
[Abstract]:Objective: to study the distribution of Alzheimer's disease in TCM and Uygur medicine. Methods: 202 cases of Alzheimer's disease were compared with the distribution of symptoms, tongue quality and pulse in traditional Chinese medicine (TCM) and Uygur medicine (Uygur). According to TCM syndrome differentiation, there were 6 types: deficiency of marrow and sea, deficiency of liver and kidney, deficiency of spleen and kidney, stagnation of qi and blood stasis, phlegm and turbid obstruction of orifices, and flourishing of heart, liver and fire. According to Uygur medical abnormal humoral type, there were 4 types: abnormal black bile type, abnormal mucus type, abnormal bile fluid type, abnormal blood type, and 30 normal persons. The apolipoprotein E genotypes were determined in 232 subjects in order to understand the syndromes of the disease in traditional Chinese medicine and Uygur medicine. Results: (1) the distribution of TCM syndromes: deficiency of spleen and kidney, stagnation of qi and blood stasis, syndrome of deficiency of liver and kidney yin, flourishing of heart, liver and fire, phlegm and turbid obstruction of orifices; The distribution characteristics of abnormal humoral type in Uygur medicine: abnormal black bile type abnormal mucus type abnormal bile fluid type abnormal blood type. (2) the distribution of apolipoprotein E genotypes in case group and normal group were studied. The ratio of 蔚 3 / 3 frequency distribution in normal group (73.4%) was higher than that in case group (54.5%). The frequency composition ratio of 蔚 3 / 4 in the case group (29.2%) was significantly higher than that in the normal group (3.3%), and the difference was statistically significant (P0.01). The distribution of 蔚 4 allele in the case group was significantly different from that in the normal group (P0.05). (3). There were significant differences between the syndrome of liver and kidney yin deficiency, phlegm turbid obstruction of orifices and the alleles containing 蔚 4 (P0.05). However, there was a significant difference between the deficiency of myeloid sea syndrome and the allele containing 蔚 4 (P0.01). (4) in Uygur medical abnormal body fluid typing. There was significant difference between the abnormal melanoglastic type and the allele containing 蔚 4 (P0.05). Conclusion: according to the symptoms and tongue vein identification and the determination of apolipoprotein E genotype, the elderly with 蔚 4 allele are susceptible to Alzheimer's disease, so it is concluded that the syndrome differentiation of TCM is deficiency of marrow and kidney, deficiency of spleen and kidney, and deficiency of spleen and kidney. The old people with liver and kidney yin deficiency syndrome and phlegm turbid obstruction syndrome are susceptible to Alzheimer's disease; In Uygur medical abnormal humoral typing, the elderly with abnormal black bile are susceptible to Alzheimer's disease.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R277.7

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