【摘要】：目的:探討142例免疫性血小板減少癥(immune thrombocytopenic purpura ITP)的中醫(yī)證型分布特征,及中醫(yī)證型與性別、年齡、病程、出血傾向、血小板計(jì)數(shù)、巨核細(xì)胞數(shù)之間的關(guān)系。方法:將142例ITP患者進(jìn)行中醫(yī)辨證分型,同時(shí)對142例ITP患者的性別、年齡、病程、出血傾向、血小板計(jì)數(shù)、巨核細(xì)胞數(shù)進(jìn)行統(tǒng)計(jì)分析,探討中醫(yī)證型分布特征,分析中醫(yī)證型與性別、年齡、病程、出血傾向、血小板計(jì)數(shù)、巨核細(xì)胞數(shù)之間的關(guān)系。結(jié)果:1.142例ITP中醫(yī)證型分布特征:陰虛火旺型(62.0%)、氣不攝血型(21.1%)、血熱妄行型(9.2%)、瘀血阻絡(luò)型(7.7%),其中陰虛火旺型最為常見;2.142例ITP患者中男女比例為1:1.33,性別差異有統(tǒng)計(jì)學(xué)意義(P0.05),而四種證型間性別差異無統(tǒng)計(jì)學(xué)意義(P0.05);3.142例ITP患者年齡以19-39歲年齡段最多(41.6%),四型中血熱妄行組患者年齡均值最小;4.中醫(yī)證型與病程的關(guān)系:陰虛火旺型、血熱妄行型病程相對較短,氣不攝血型、血熱妄行型病程相對較長。5.中醫(yī)證型與出血傾向的關(guān)系:陰虛火旺型、氣不攝血型的出血傾向評分均值低于血熱妄行型和瘀血阻絡(luò)型(P0.05);6.中醫(yī)證型與血小板計(jì)數(shù)的關(guān)系:陰虛火旺型、氣不攝血型的血小板計(jì)數(shù)均值高于血熱妄行型和瘀血阻絡(luò)型(P0.05);7.27例ITP患者中醫(yī)證型與巨核細(xì)胞數(shù)關(guān)系:陰虛火旺型、氣不攝血型的巨核細(xì)胞均值高于血熱妄行型和瘀血阻絡(luò)型(P0.05)。結(jié)論:1.142例ITP患者中醫(yī)證型以陰虛火旺型最多;2.142例ITP患者發(fā)病以女性多見,四種證型間無明顯性別差異;3.ITP可見于各個(gè)年齡段,以19-39歲年齡段最多,四型中血熱妄行組患者年齡均值最小,提示可能與小兒純陽體質(zhì)有關(guān);4.各證型在病程長短方面存在不同,提示病程的長短是影響中醫(yī)證型分布的因素之一,而中醫(yī)證型在一定程度上可反應(yīng)病程的長短;5.中醫(yī)證型與出血傾向評分、血小板計(jì)數(shù)、巨核細(xì)胞有統(tǒng)計(jì)學(xué)意義,陰虛火旺、氣不攝血兩組出血傾向評分均值較低,而血小板計(jì)數(shù)均值、巨核細(xì)胞均值均較高,可推測考慮將出血傾向評分、血小板計(jì)數(shù)、巨核細(xì)胞數(shù)做為ITP中醫(yī)辨證分型客觀指標(biāo)的參考依據(jù)。
[Abstract]:Aim: to investigate the distribution characteristics of TCM syndrome type of (immune thrombocytopenic purpura ITP) and the relationship between TCM syndrome type and sex, age, course of disease, bleeding tendency, platelet count and megakaryocyte count in 142 cases of immune thrombocytopenia. Methods: a total of 142 patients with ITP were divided into two groups: sex, age, course of disease, bleeding tendency, platelet count and megakaryocyte count, and the distribution characteristics of TCM syndrome type were discussed. To analyze the relationship between TCM syndrome type and sex, age, course of disease, bleeding tendency, platelet count, megakaryocyte count. Results: the distribution characteristics of TCM syndrome types of 1.142 cases of ITP were as follows: Yin deficiency and fire type (62.0%), Qi not ingestion type (21.1%), blood-heat delusion type (9.2%), blood stasis type (7.7%), the most common type was Yin-deficiency and fire-abatement type (62.0%), blood-heat delusion type (9.2%) and blood stasis type (7.7%). In 2.142 patients with ITP, the ratio of male to female was 1 / 1.33, the gender difference was statistically significant (P0.05), but there was no significant difference among the four types of syndrome (P0.05). The age of 3.142 patients with ITP was the most (41.6%) in the 19-39-year-old group, and the mean age in the delusional group of type 4 blood fever was the lowest. The relationship between TCM syndrome type and the course of disease: Yin deficiency fire type, blood-heat delusional type is relatively short, qi is not blood type, blood-heat delusional type is relatively long. 5. The relationship between TCM syndrome type and bleeding tendency: Yin deficiency and fire flourishing type, the mean value of bleeding tendency score of Qi not ingestion blood type was lower than that of blood-heat delusion type and blood stasis obstruction type (P0.05); 6. The relationship between TCM syndrome type and platelet count: the mean value of blood platelet count of Yin-deficiency-fire-prosperous type was higher than that of blood-heat delusion type and stasis-blood blocking collaterals type (P0.05); 7. The relationship between TCM syndrome type and megakaryocyte count in 27 patients with ITP: the mean value of megakaryocyte in the type of yin deficiency and fire was higher than that in type of blood-heat delusion and stagnation of collaterals (P0.05). Conclusion: 1.142 patients with ITP have the most syndrome types of yin deficiency and fire, 2.142 patients with ITP are female, and there is no significant gender difference among the four syndrome types. 3.ITP can be found in all ages, the most in the 19-39-year-old age group and the smallest in the 4-type delusional blood fever group, suggesting that it may be related to the pure masculine constitution of children; 4. It is suggested that the length of the disease course is one of the factors affecting the distribution of TCM syndrome type, and the TCM syndrome type can reflect the duration of the disease to a certain extent. 5. TCM syndrome type and bleeding tendency score, platelet count, megakaryocyte have statistical significance, Yin deficiency fire is prosperous, qi does not absorb blood the two groups bleeding tendency score average value is lower, but platelet count mean value, megakaryocyte mean value is higher. It can be inferred that the score of bleeding tendency, platelet count and megakaryocyte count should be considered as the reference basis for the objective index of TCM syndrome differentiation and classification of ITP.
【學(xué)位授予單位】：山東中醫(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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