【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(zhì)的調(diào)查,統(tǒng)計(jì)調(diào)查研究的數(shù)據(jù),運(yùn)用流行病學(xué)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(zhì)分布做出初步研究,并且探討他們之間的相關(guān)性,為臨床實(shí)踐上中醫(yī)個體化防治子宮腺肌病提供臨床依據(jù)。研究方法：采用問卷調(diào)查方法,選擇2015年4月-2016年3月期間在成都中醫(yī)藥大學(xué)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(zhì)、中醫(yī)證候等信息,用Excel表格錄入基本數(shù)據(jù)后,運(yùn)用SPSS17.0軟件中的頻數(shù)分析、聚類分析及非參數(shù)檢驗(yàn)等統(tǒng)計(jì)方法分析患者的病因、中醫(yī)證候、體質(zhì)分布規(guī)律及相關(guān)性。研究結(jié)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(shù)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(shù)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(jīng)行腹痛最多,占總數(shù)的91.17%,程度以重度痛經(jīng)占多數(shù),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(jié)(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(zhì)類型中陽虛質(zhì)占總數(shù)的22.55%,氣郁質(zhì)占總數(shù)的19.61%,氣虛質(zhì)占總數(shù)的1 3.73%,血瘀質(zhì)占總數(shù)的12.75%。有兼夾體質(zhì)的占61.76%。(5)調(diào)查的子宮腺肌病患者中各中醫(yī)證型與年齡、學(xué)歷、流產(chǎn)次數(shù)、血清CA125、痛經(jīng)程度等因素均無統(tǒng)計(jì)學(xué)意義(P0.05)。各中醫(yī)體質(zhì)與年齡、學(xué)歷、痛經(jīng)程度、宮腔手術(shù)或操作次數(shù)等因素均無統(tǒng)計(jì)學(xué)意義(P0.05)。(6)調(diào)查的子宮腺肌病患者中各中醫(yī)證型與宮腔手術(shù)或操作次數(shù)有統(tǒng)計(jì)學(xué)意義(P0.05)。不同中醫(yī)體質(zhì)與不同證型分布有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：(1)年齡、飲食習(xí)慣、多次宮腔手術(shù)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(shù)或操作次數(shù)有相關(guān)性。隨著次數(shù)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(zhì)與證型之間有相關(guān)性。氣郁質(zhì)與氣滯血瘀證有一定的相關(guān)性,陽虛質(zhì)與腎虛血瘀證有一定的相關(guān)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(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R271.9

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