【摘要】：研究目的：通過對痞滿患者基本資料收集,對中醫(yī)證型和中醫(yī)體質(zhì)的辯別,了解痞滿發(fā)病的特點,將中醫(yī)體質(zhì)學說與臨床結(jié)合,運用臨床調(diào)查方法,分析痞滿中醫(yī)證型與中醫(yī)體質(zhì)類型的分布情況,并進行統(tǒng)計分析,探討它們之間的相關(guān)性,為從中醫(yī)體質(zhì)學角度預防和治療本病提供新的思路,以提高痞滿的中醫(yī)藥治療效果。研究方法：采用臨床流行病學觀察性橫斷面研究的方法,由兩名不同的中醫(yī)師對2015年1月-2016年3月來廣東省中醫(yī)院門診、廣州中醫(yī)藥大學附屬南海婦產(chǎn)兒童醫(yī)院中醫(yī)門診就診的患者,根據(jù)嚴格的納入標準與排除標準,將符合332例痞滿患者進行中醫(yī)辨證分型,并指導患者完成《中醫(yī)體質(zhì)量表》,比較痞滿不同證型中不同體質(zhì)類型所占比率,將所得數(shù)據(jù)采用SPSS13.0統(tǒng)計軟件分析,從而研究它們之間可能存在的相關(guān)性。研究結(jié)果：1.332例痞滿患者其中女性為224例(67.47%),男性為108例(32.53%)。痞滿患者不同性別在各年齡層有統(tǒng)計學意義。2.痞滿發(fā)病誘因上與飲食不潔相關(guān)頻數(shù)最高,頻率為32.56%,其次為情志不暢；而飲食偏嗜中,肥甘油膩最多,其次為濃茶；吸煙、飲酒情況上,其不吸煙的痞滿患者為277人,占83.43%,不喝酒為290人,占87.34%；從運動情況上,幾乎不鍛煉的痞滿為185人,占55.06%,其次為平均每天鍛煉1小時為82人,占24.69%。3.痞滿中醫(yī)證型分布與性別、年齡、飲食偏嗜均具有統(tǒng)計學意義(P0.05),而與運動情況無統(tǒng)計學意義(P0.05)；中醫(yī)體質(zhì)分布同樣與患者的性別、年齡差異、飲食偏嗜有關(guān)(P0.05),不認為與運動情況有關(guān)。4.332例痞滿患者中醫(yī)證型出現(xiàn)的頻率依次為脾胃虛弱證(24.09%))肝胃不和證(18.98%)=痰濕中阻證(18.98%))濕熱阻胃證(17.17%))飲食內(nèi)停證(11.44%))胃陰不足證(9.34%)。5.332例痞滿患者中平和質(zhì)53例,占15.96%:偏頗質(zhì)245例,占73.80%:兼夾質(zhì)34例,占10.24%。在298例單一體質(zhì)中出現(xiàn)的體質(zhì)類型構(gòu)成比為陽虛質(zhì)(42.50%))氣郁質(zhì)(17.79%)=平和質(zhì)(17.09%)〉氣虛質(zhì)(11.09%))陰虛質(zhì)(7.72%))濕熱質(zhì)(7.38%))痰濕質(zhì)(7.05%))血瘀質(zhì)(5.03%))特稟質(zhì)(1.68%),以陽虛質(zhì)最多見。6.298例單一體質(zhì)的痞滿患者中,脾胃虛弱證,陽虛質(zhì)多見,占33.80%,其次為氣虛質(zhì)(19.72%)；肝胃不和證,氣郁質(zhì)(46.43%)多見；痰濕中阻證,陽虛質(zhì)多見,占36.84%,其次為痰濕質(zhì)(19.30%) ；濕熱阻胃證,濕熱質(zhì)多見,占32.65%,其次為平和質(zhì)(24.49%)7.298例單一體質(zhì)的痞滿患者陽虛質(zhì)中醫(yī)證型中,脾胃虛弱證(32.88%)最多,其次為痰濕中阻證(28.71%)；平和質(zhì)中飲食內(nèi)停證多見,占32.08%；氣郁質(zhì)以肝胃不和證最多,占49.06%；氣虛質(zhì)中脾胃虛弱證最多,占42.42%,其次為痰濕中阻證(21.21%)：陰虛質(zhì)中胃陰不足證多見,占60.87%：濕熱質(zhì)中,濕熱阻胃證多見,占72.73%；痰濕質(zhì)中痰濕中阻證最多,占52.38%,其次為濕熱阻胃證(28.57%)。8.痞滿的中醫(yī)證型與中醫(yī)體質(zhì)具有統(tǒng)計學意義,P0.05。研究結(jié)論：痞滿患者中醫(yī)證型以脾胃虛弱證、肝胃不和證、痰濕中阻證、濕熱阻胃證最多見。中醫(yī)體質(zhì)類型主要為陽虛質(zhì)、氣郁質(zhì)、平和質(zhì)、氣虛質(zhì)。本研究通過對痞滿患者中醫(yī)證型與中醫(yī)體質(zhì)相關(guān)性研究得出,中醫(yī)體質(zhì)與中醫(yī)證型具有顯著相關(guān)性,陽虛質(zhì)、氣虛質(zhì)患者發(fā)病后易患脾胃虛弱證,濕熱質(zhì)患病后易患濕熱阻胃證,陰虛質(zhì)患者易患胃陰不足證。同時,臨床治療中,應注意辨病、辯證的同時結(jié)合辨體質(zhì),通過干預及調(diào)整患者體質(zhì),降低其發(fā)病率,并提高中醫(yī)藥治療痞滿效果及降低復發(fā)率。
[Abstract]:Objective: To study the characteristics of the syndrome of TCM and the constitution of Chinese medicine by collecting the basic data of the patients with full-time and to understand the characteristics of the disease, and to use the clinical investigation method to analyze the distribution of the syndrome of TCM and the type of the constitution of the Chinese medicine. In order to improve the curative effect of the traditional Chinese medicine, this paper makes a statistical analysis and discusses the correlation between them and provides a new way to prevent and treat the disease from the angle of the constitution of Chinese medicine. Methods: The clinical and epidemiological cross-sectional study was adopted, and two different Chinese doctors from January 2015 to March,2016, the outpatient of Guangdong Central Hospital, the Affiliated South China Medical University of Guangzhou University of Traditional Chinese Medicine, and the patients in the clinic of the Chinese medicine clinic of the children's hospital of the South China Sea, According to the strict inclusion criteria and exclusion criteria, the syndrome differentiation of 332 patients with Richmond will be met, and the proportion of the different types of body constitution in the different types of TCM is compared, and the data obtained will be analyzed by the SPSS13.0 statistical software. So as to study the possible correlation between them. The results of the study: 1.332 cases of full-filled patients were 224 (67.47%) and 108 (32.53%). The different sex of the patients with Richmond had a statistical significance in all ages. The frequency was the highest, the frequency was 32.56%, the second was the unsmooth feeling, while the diet was in the middle, the fat and the fat were the most, the second was the thick tea, smoking, alcohol consumption, the non-smoking, full of the patients was 277, accounting for 83.43%, the non-drinking was 290, accounting for 87.34%; In the exercise, almost no exercise was full of 185, accounting for 55.06%, followed by an average of 82 people per day for an average of 24.69%. There was no significant difference in the distribution of TCM syndrome type and sex, age and diet (P0.05). The physical distribution of Chinese medicine was similar to that of the patients (P <0.05). The physical distribution of the Chinese medicine was also related to the sex, age and diet of the patients (P0.05). The frequency of TCM syndrome of 4.332 patients with Richmond was found to be the weakness of the spleen and stomach (24.09%), the liver and stomach syndrome (18.98%), the damp-heat resistance (18.98%), the damp-heat resistance (17.17%), the deficiency of the stomach (11.44%), and the deficiency of the stomach (9.34%). There were 53 cases of moderate and moderate quality, 15.96%, and 245 cases, 73.80% and 10.24%, respectively. The type of body constitution in 298 cases of single body constitution is deficiency of yang (42.50%), Qi stagnation (17.79%), Qi deficiency (11.09%), yin deficiency (7.72%), damp-heat quality (7.38%), damp-heat quality (7.05%), blood stasis (5.03%), and blood stasis (1.68%). The deficiency of the spleen and the stomach was more common, accounting for 33.80%, followed by Qi deficiency (19.72%), liver and stomach syndrome, and Qi stagnation (46.43%), and the syndrome of phlegm and dampness was more common, accounting for 36.84%. The second was the phlegm-dampness (19.30%), the damp-heat resistance and the stomach syndrome, the heat and heat were more common, accounting for 32.65%, followed by a moderate (24.49%) of 7.298 patients with single body constitution, the spleen and stomach weakness syndrome (32.88%) was the most, followed by phlegm-dampness obstruction (28.71%); It was more common in the middle and middle diet, accounting for 32.08%, most of which accounted for 32.08%, the most of which were the liver and stomach, accounting for 49.06%, and the deficiency of the spleen and stomach in the Qi-deficiency was the most common, accounting for 42.42%, followed by phlegm-dampness obstruction (21.21%): the deficiency of the stomach and yin in the yin-deficiency mass was more common, accounting for 60.87%: the damp-heat quality and the damp-heat resistance of the stomach were more common. 72.73% of phlegm-dampness, 52.38% of phlegm-dampness, followed by damp-heat-resistance (28.57%). The TCM syndrome type of Richmond is of statistical significance with the constitution of Chinese medicine, P0.05. Conclusion: The syndrome of traditional Chinese medicine in Richmond is the most common syndrome in the spleen and stomach, the syndrome of liver and stomach, the syndrome of phlegm and dampness, and the syndrome of damp-heat resistance. The type of physical constitution of the Chinese medicine is mainly yang-deficiency, qi-stagnation, mild, and Qi-deficiency. According to the study of the correlation between the TCM syndrome type and the constitution of the traditional Chinese medicine, the TCM constitution of the Chinese medicine has a significant correlation with the TCM syndrome types, and the deficiency of the spleen and the stomach in the patients with the deficiency of the spleen and the stomach after the onset of the deficiency of the spleen and the stomach and the heat and heat resistance of the patients after the heat and heat are affected, The patients with yin deficiency have the syndrome of deficiency of the stomach and yin. At the same time, in the clinical treatment, attention should be paid to the identification of the disease, the dialectical and simultaneous combination of the physical constitution, the intervention and the adjustment of the patient's body constitution, the reduction of its morbidity, and the improvement of the full-filling effect of the traditional Chinese medicine and the reduction of the recurrence rate.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R256.32

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