【摘要】：研究目的：通過對子宮腺肌病患者病因、中醫(yī)證候及體質的調查,統(tǒng)計調查研究的數據,運用流行病學研究方法,對子宮腺肌病的發(fā)病影響因素、中醫(yī)證候分布及體質分布做出初步研究,并且探討他們之間的相關性,為臨床實踐上中醫(yī)個體化防治子宮腺肌病提供臨床依據。研究方法：采用問卷調查方法,選擇2015年4月-2016年3月期間在成都中醫(yī)藥大學附屬醫(yī)院婦科門診就診的患者,共102例,收集患者的一般情況、體質、中醫(yī)證候等信息,用Excel表格錄入基本數據后,運用SPSS17.0軟件中的頻數分析、聚類分析及非參數檢驗等統(tǒng)計方法分析患者的病因、中醫(yī)證候、體質分布規(guī)律及相關性。研究結果：(1)收集的102例子宮腺肌病患者中,35-50歲年齡階段的患者占總數的72.55%。喜食辛辣的占48.04%、喜食豆制品的占38.24%。有過3次及以上宮腔手術操作史的占42.15%。(2)子宮腺肌病患者的血清CA125升高者占80.39%,CA199升高者占25.69%。主要病況以經行腹痛最多,占總數的91.17%,程度以重度痛經占多數,約42.16%。(3)子宮腺肌病的中醫(yī)證型聚類分析后分為四類：腎虛氣滯血瘀(占37.25%)、氣滯血瘀(占27.54%)、氣虛血瘀(占18.63%)、濕熱瘀結(占16.67%),其中單證型中血瘀型最多,占70.59%。(4)子宮腺肌病的中醫(yī)體質類型中陽虛質占總數的22.55%,氣郁質占總數的19.61%,氣虛質占總數的1 3.73%,血瘀質占總數的12.75%。有兼夾體質的占61.76%。(5)調查的子宮腺肌病患者中各中醫(yī)證型與年齡、學歷、流產次數、血清CA125、痛經程度等因素均無統(tǒng)計學意義(P0.05)。各中醫(yī)體質與年齡、學歷、痛經程度、宮腔手術或操作次數等因素均無統(tǒng)計學意義(P0.05)。(6)調查的子宮腺肌病患者中各中醫(yī)證型與宮腔手術或操作次數有統(tǒng)計學意義(P0.05)。不同中醫(yī)體質與不同證型分布有統(tǒng)計學意義(P0.05)。結論：(1)年齡、飲食習慣、多次宮腔手術操作史均是子宮腺肌病發(fā)病的重要影響因素。(2)中醫(yī)證型分布與宮腔手術或操作次數有相關性。隨著次數的增加,患者證型中出現(xiàn)腎虛證的比例亦隨之增加。(3)中醫(yī)體質與證型之間有相關性。氣郁質與氣滯血瘀證有一定的相關性,陽虛質與腎虛血瘀證有一定的相關性。
[Abstract]:Objective: to investigate the etiology, TCM syndrome and physique of patients with adenomyosis of uterus, to investigate the data of statistical investigation, and to use epidemiological methods to study the factors affecting the pathogenesis of adenomyosis. The distribution of TCM syndromes and physique were studied, and the correlation between them was discussed, which could provide clinical basis for individualized prevention and treatment of adenomyosis in traditional Chinese medicine (TCM) in clinical practice. Methods: a total of 102 patients from the gynecological outpatient department of Chengdu University of traditional Chinese Medicine from April 2015 to March 2016 were selected by questionnaire survey. The general situation, physique, TCM syndrome and other information of the patients were collected, and the results showed that there were 102 patients in the gynecological outpatient department of Chengdu University of traditional Chinese Medicine. After inputting the basic data with Excel form, using the statistical methods of frequency analysis, cluster analysis and non-parameter test in SPSS17.0 software to analyze the etiology, TCM syndrome, physique distribution rule and correlation of the patients. Results: (1) of 102 cases of adenomyosis, 35% of 50-year-olds accounted for 72.55% of the total. Spicy food accounted for 48.04%, soybean products accounted for 38.24%. (2) Serum CA125 was elevated in 80.39% of patients with adenomyosis and 25.69% of patients with adenomyosis. The main diseases were abdominal pain (91.17%) and severe dysmenorrhea (42.16%). (3) the syndrome types of adenomyosis were classified into four categories: deficiency of kidney, qi stagnation and blood stasis (37.25%). Qi stagnation and blood stasis (27.54%), Qi deficiency and blood stasis (18.63%), dampness-heat stasis (16.67%), among which the blood stasis type was the most. (4) among the types of traditional Chinese medicine constitution of adenomyosis, yang deficiency accounted for 22.55%, qi depression 19.61%, qi deficiency 13.73% and blood stasis 12.75%. (5) there was no significant difference in TCM syndrome type and age, academic background, abortion times and dysmenorrhea degree of serum CA125, among the investigated patients with adenomyosis of uterus (P0.05). Chinese medicine constitution and age, education, dysmenorrhea degree, There was no statistical significance in the frequency of uterine surgery or operation (P0.05). (6) among the patients with adenomyosis (P0.05), there was significant difference between the types of TCM syndrome and the frequency of uterine surgery or operation (P0.05). Different TCM constitution and distribution of different syndrome types have statistical significance (P0.05). Conclusion: (1) Age, diet habit, multiple operation history of uterine cavity are all important influencing factors of adenomyosis of uterus. (2) the distribution of TCM syndrome type is related to the frequency of uterine cavity operation or operation. With the increase of times, the proportion of patients with kidney deficiency syndrome also increased. (3) there is a correlation between TCM constitution and syndrome type. There is a certain correlation between qi stagnation and blood stasis, Yang deficiency and kidney deficiency and blood stasis.
【學位授予單位】：成都中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R271.9

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