缺血性腸病臨床特點(diǎn)及中醫(yī)證候回顧性分析研究
發(fā)布時(shí)間：2019-05-08 00:01
【摘要】：目的通過回顧性分析缺血性腸病患者病例資料,探討本病的臨床表現(xiàn)、診斷方法及中醫(yī)證候特點(diǎn),提高對(duì)本病的認(rèn)識(shí),為缺血性腸病的防治做出有益探索。方法回顧性分析研究2005年1月至2016年12月北京中醫(yī)醫(yī)院、廣安門中醫(yī)醫(yī)院、北京中醫(yī)醫(yī)院延慶醫(yī)院住院患者,并確診為缺血性腸病患者病例共50例,通過對(duì)病例的閱讀,提取患者一般情況、生物學(xué)指標(biāo)、中醫(yī)四診信息,并對(duì)相關(guān)資料進(jìn)行回顧性的描述分析,總結(jié)其西醫(yī)臨床特點(diǎn)、診治規(guī)律、中醫(yī)證候特點(diǎn)。結(jié)果(1)本病發(fā)病人群:50例患者中,男性14例(28%),女性36例(72%),男:女=1:2.57,平均年齡:64.40±12.74歲。(2)本病臨床表現(xiàn)以腹痛(100%)、便血(58%)、腹瀉(14%)為主,且癥狀與體征多不相符,具有癥狀重,體重輕的特點(diǎn)。3、患者多具有1種甚至多種基礎(chǔ)疾病,高血壓病史29例(29/50,58%),冠心病病史15例(15/50,30%),糖尿病病史9例(9/50,18%),高脂血癥病史7例(7/50,14%),腦梗塞病史9例(9/50,18%),房顫病史5例(5/50,10%)。(4)23例患者行CTA檢查,可見動(dòng)脈血栓形成、腸系膜動(dòng)脈或靜脈狹窄、栓塞、夾層及腸靜脈血栓形成。36例患者行電子腸鏡下檢查,34例表現(xiàn)為病變處黏膜有不同程度的充血水腫、糜爛、潰瘍,部分病例有管腔狹窄。僅2例未見異常。(5):發(fā)病季節(jié),50例患者中春季發(fā)病共5例(10%),夏季發(fā)病共10例(20%),秋季發(fā)病共12例(24%),冬季發(fā)病共23例(46%)。以冬季發(fā)病為主。24節(jié)氣中以冬至發(fā)病最為多見。(6)舌脈信息:舌質(zhì)多為舌暗26例(52%),舌淡15例(30%),舌紅9例(18%);舌苔以苔黃9例(8%),苔白26例(52%),苔厚16例(32%),苔膩18例(36%),苔薄15例(30%)為主。脈象以脈沉18例(36%),脈細(xì)22例(44%),脈弦10例(20%),脈滑8例(16%)為主。(7)中醫(yī)辯證分型:本組50例患者缺血性腸病的中醫(yī)證型為:氣虛血瘀證,濕熱蘊(yùn)腸證,脾腎陽(yáng)虛證,肝郁脾虛證,脾不攝血型證,以氣虛血瘀證、濕熱蘊(yùn)腸證最多,分別為20例(40%),濕熱蘊(yùn)腸證12例(24%)。結(jié)論:1、對(duì)于老年患者突發(fā)腹痛便血腹瀉,伴有心腦血管疾病的患者,盡快完善腹部CTA、腸鏡以明確診斷。2、本病的中醫(yī)證型可分為氣虛血瘀證、濕熱蘊(yùn)腸證、脾腎陽(yáng)虛證、肝郁脾虛證、脾不攝血證,舌暗、苔白,脈沉細(xì)最為多見。
[Abstract]:Objective to study the clinical manifestations, diagnostic methods and characteristics of TCM syndrome of ischemic bowel disease by retrospectively analyzing the data of patients with ischemic bowel disease, so as to improve the understanding of the disease and make a useful exploration for the prevention and treatment of ischemic bowel disease. Methods from January 2005 to December 2016, 50 cases of ischemic bowel disease were analyzed retrospectively in Beijing traditional Chinese Medicine Hospital, Guanganmen traditional Chinese Medicine Hospital and Yanqing Hospital of Beijing traditional Chinese Medicine Hospital. The general situation, biological indexes, four diagnostic information of traditional Chinese medicine (TCM) were extracted, and the related data were described and analyzed retrospectively. The clinical characteristics, diagnosis and treatment rules and TCM syndrome characteristics of western medicine were summarized. Results (1) among the 50 patients, 14 (28%) were male and 36 (72%) were female. The average age was 64.40 鹵12.74 years old. (2) abdominal pain (100%) was the clinical manifestation of the disease, and the mean age was 64.40 鹵12.74 years old, the average age was 64.40 鹵12.74 years old. Hematochezia (58%), diarrhoea (14%), and symptoms and signs do not match, with symptoms, low weight characteristics. 3, patients with one or more basic diseases, hypertension history in 29 cases (29 / 50, 58%), the patient has a history of hypertension in 29 cases (29 / 50, 58%). The history of coronary heart disease (15 / 50, 30%), diabetes mellitus (9 / 50, 18%), hyperlipidemia (7 / 50, 14%) and cerebral infarction (9 / 50, 18%). CTA examination was performed in 23 patients (5: 50, 10%). (4) with a history of atrial fibrillation. Arterial thrombosis, mesenteric artery or vein stenosis, embolism, dissection and intestinal vein thrombosis were performed in 36 patients. 34 cases showed different degrees of hyperemia, edema, erosion, ulcers, and stenosis of lumen in some cases. (5) there were 5 cases (10%) in spring, 10 cases (20%) in summer, 12 cases (24%) in autumn and 23 cases (46%) in winter in the 50 cases in spring, 10 cases (20%) in summer, 12 cases (24%) in autumn and 23 cases (46%) in winter. 26 cases (52%) with dark tongue, 15 cases (30%) with light tongue and 9 cases (18%) with red tongue were found in 24 solar terms. (6) the information of tongue vein was mostly dark in 26 cases (52%), light tongue in 15 cases (30%) and red tongue in 9 cases (18%). The tongue coating was yellow in 9 cases (8%), white in 26 cases (52%), thick in 16 cases (32%), greasy in 18 cases (36%) and thin in 15 cases (30%). There were 18 cases of pulse sedimentation (36%), 22 cases of pulse fineness (44%), 10 cases of pulse string (20%) and 8 cases of pulse slip (16%). (7) TCM dialectical classification: the TCM syndrome type of 50 patients with ischemic bowel disease was Qi deficiency and blood stasis syndrome. There were 20 cases (40%) with dampness-heat retention syndrome, 12 cases (24%) with dampness-heat syndrome, and 20 cases (40%) with damp-heat syndrome, 12 cases (24%) with dampness-heat syndrome, among which the syndrome of qi deficiency and blood stasis, the syndrome of dampness-heat containing intestines were the most common. Conclusions: 1, for the elderly patients with sudden abdominal pain, stool diarrhea and cardiovascular and cerebrovascular diseases, improve the abdominal CTA, enteroscopy as soon as possible to determine the diagnosis. 2, the TCM syndromes of this disease can be divided into Qi deficiency and blood stasis syndrome, dampness-heat accumulation of intestine syndrome, the disease can be divided into Qi deficiency and blood stasis syndrome, dampness-heat retention bowel syndrome. Spleen and kidney yang deficiency syndrome, liver stagnation spleen deficiency syndrome, spleen does not take blood syndrome, tongue dark, white, pulse thickness is the most common.
【學(xué)位授予單位】：首都醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259
本文編號(hào)：2471466
[Abstract]:Objective to study the clinical manifestations, diagnostic methods and characteristics of TCM syndrome of ischemic bowel disease by retrospectively analyzing the data of patients with ischemic bowel disease, so as to improve the understanding of the disease and make a useful exploration for the prevention and treatment of ischemic bowel disease. Methods from January 2005 to December 2016, 50 cases of ischemic bowel disease were analyzed retrospectively in Beijing traditional Chinese Medicine Hospital, Guanganmen traditional Chinese Medicine Hospital and Yanqing Hospital of Beijing traditional Chinese Medicine Hospital. The general situation, biological indexes, four diagnostic information of traditional Chinese medicine (TCM) were extracted, and the related data were described and analyzed retrospectively. The clinical characteristics, diagnosis and treatment rules and TCM syndrome characteristics of western medicine were summarized. Results (1) among the 50 patients, 14 (28%) were male and 36 (72%) were female. The average age was 64.40 鹵12.74 years old. (2) abdominal pain (100%) was the clinical manifestation of the disease, and the mean age was 64.40 鹵12.74 years old, the average age was 64.40 鹵12.74 years old. Hematochezia (58%), diarrhoea (14%), and symptoms and signs do not match, with symptoms, low weight characteristics. 3, patients with one or more basic diseases, hypertension history in 29 cases (29 / 50, 58%), the patient has a history of hypertension in 29 cases (29 / 50, 58%). The history of coronary heart disease (15 / 50, 30%), diabetes mellitus (9 / 50, 18%), hyperlipidemia (7 / 50, 14%) and cerebral infarction (9 / 50, 18%). CTA examination was performed in 23 patients (5: 50, 10%). (4) with a history of atrial fibrillation. Arterial thrombosis, mesenteric artery or vein stenosis, embolism, dissection and intestinal vein thrombosis were performed in 36 patients. 34 cases showed different degrees of hyperemia, edema, erosion, ulcers, and stenosis of lumen in some cases. (5) there were 5 cases (10%) in spring, 10 cases (20%) in summer, 12 cases (24%) in autumn and 23 cases (46%) in winter in the 50 cases in spring, 10 cases (20%) in summer, 12 cases (24%) in autumn and 23 cases (46%) in winter. 26 cases (52%) with dark tongue, 15 cases (30%) with light tongue and 9 cases (18%) with red tongue were found in 24 solar terms. (6) the information of tongue vein was mostly dark in 26 cases (52%), light tongue in 15 cases (30%) and red tongue in 9 cases (18%). The tongue coating was yellow in 9 cases (8%), white in 26 cases (52%), thick in 16 cases (32%), greasy in 18 cases (36%) and thin in 15 cases (30%). There were 18 cases of pulse sedimentation (36%), 22 cases of pulse fineness (44%), 10 cases of pulse string (20%) and 8 cases of pulse slip (16%). (7) TCM dialectical classification: the TCM syndrome type of 50 patients with ischemic bowel disease was Qi deficiency and blood stasis syndrome. There were 20 cases (40%) with dampness-heat retention syndrome, 12 cases (24%) with dampness-heat syndrome, and 20 cases (40%) with damp-heat syndrome, 12 cases (24%) with dampness-heat syndrome, among which the syndrome of qi deficiency and blood stasis, the syndrome of dampness-heat containing intestines were the most common. Conclusions: 1, for the elderly patients with sudden abdominal pain, stool diarrhea and cardiovascular and cerebrovascular diseases, improve the abdominal CTA, enteroscopy as soon as possible to determine the diagnosis. 2, the TCM syndromes of this disease can be divided into Qi deficiency and blood stasis syndrome, dampness-heat accumulation of intestine syndrome, the disease can be divided into Qi deficiency and blood stasis syndrome, dampness-heat retention bowel syndrome. Spleen and kidney yang deficiency syndrome, liver stagnation spleen deficiency syndrome, spleen does not take blood syndrome, tongue dark, white, pulse thickness is the most common.
【學(xué)位授予單位】：首都醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 付婷婷;王炳元;;缺血性腸病研究進(jìn)展[J];中國(guó)臨床醫(yī)生雜志;2016年12期
2 王平;;丹參酮治療缺血性腸病的體會(huì)[J];中國(guó)社區(qū)醫(yī)師;2016年29期
3 吳曉麗;李麗;陳瑞鑫;;探討64排CT診斷腸壁缺血性病變的價(jià)值[J];中國(guó)繼續(xù)醫(yī)學(xué)教育;2016年26期
4 張榮榮;王瑩;高函;劉樂天;;血漿D-二聚體早期診斷急性缺血性腸病的價(jià)值研究[J];國(guó)際檢驗(yàn)醫(yī)學(xué)雜志;2016年16期
5 向海鴻;周宇元;陳濤;程功文;胡奇林;;64-MDCTA在急性腸系膜缺血性疾病中的診斷價(jià)值[J];江西醫(yī)藥;2016年08期
6 徐兵;;芍藥湯聯(lián)合中藥灌腸治療缺血性腸病[J];中醫(yī)臨床研究;2016年20期
7 檀薇薇;張玫;;D-二聚體對(duì)缺血性腸病及其嚴(yán)重程度的臨床早期診斷價(jià)值[J];檢驗(yàn)醫(yī)學(xué)與臨床;2016年11期
8 秦穎;張旭艷;童瑞;梁浩;;41例缺血性腸病的相關(guān)危險(xiǎn)因素分析[J];解放軍醫(yī)學(xué)院學(xué)報(bào);2016年10期
9 徐賽群;劉麗;王偉寧;黃萍;周震;;缺血性腸病臨床特點(diǎn)和診治的回顧性分析[J];湖南師范大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2016年02期
10 陳偉;;缺血性腸病的再認(rèn)識(shí)[J];中國(guó)冶金工業(yè)醫(yī)學(xué)雜志;2016年02期
相關(guān)會(huì)議論文 前2條
1 莊坤;宋瑛;徐俊榮;楊振威;李曉芳;唐海靈;;心腦血管疾病在老年缺血性腸病發(fā)生中的作用研究[A];全國(guó)高血壓防治知識(shí)推廣培訓(xùn)班暨健康血壓中國(guó)行福建漳州會(huì)論文綜合刊[C];2014年
2 任順平;李娜;;論益氣化瘀法治療缺血性腸炎[A];第二十五屆全國(guó)中西醫(yī)結(jié)合消化系統(tǒng)疾病學(xué)術(shù)會(huì)議論文集[C];2013年
相關(guān)碩士學(xué)位論文 前2條
1 吳泱;丹參制劑對(duì)于缺血性腸病的臨床療效觀察[D];湖北中醫(yī)藥大學(xué);2015年
2 劉紅華;自擬清熱祛濕益氣方治療缺血性腸病的臨床觀察[D];湖北中醫(yī)藥大學(xué);2012年
，本文編號(hào)：2471466
本文鏈接：http://sikaile.net/zhongyixuelunwen/2471466.html
最近更新
教材專著
