本文選題：胃痛 + 中醫(yī)辨證分型　； 參考：《廣州中醫(yī)藥大學》2016年碩士論文

【摘要】：目的：本研究的目的在于通過嚴格科學的方案設計和規(guī)范的研究操作,在祖國醫(yī)學經(jīng)絡理論的指導下,探討胃痛中醫(yī)辨證分型與胃息肉發(fā)生率及病理類型之間存在的可能關系,為探索祖國傳統(tǒng)中醫(yī)結(jié)合西醫(yī)辨證分析、治療胃痛患者及胃癌的防治提供有用的臨床資料,為中醫(yī)辨證尋求更多的客觀指標及理論依據(jù),初步揭示其客觀規(guī)律,更好地為臨床和科學研究服務。方法：查閱廣東省中西醫(yī)結(jié)合醫(yī)院2012年-2014年收住院的胃痛患者共769例,收集其中符合納入標準及不符合排除標準的胃息肉患者210例,依據(jù)胃痛的中醫(yī)辯證分型分為5個證型：肝胃不和證、脾胃虛弱證、脾胃濕熱證、胃陰不足證以及胃絡瘀血證,統(tǒng)計各組病例4種不同胃息肉病理類型的分布情況,并比較各組病例之間這種分布情況是否具有統(tǒng)計學差異,以探討胃痛中醫(yī)分型與慢性胃炎胃息肉病理類型的可能聯(lián)系。成果：1.病例組方面,胃陰不足證和胃絡瘀血證病例數(shù)極少,主要集中在肝胃不和證(59.5%)、脾胃虛弱證(27.1%)、脾胃濕熱證(8.6%)。而息肉病理類型方面,以胃底腺息肉(76.2%)、增生性息肉(15.7%)為主,其余炎性纖維性息肉(7.1%)、腺瘤性息肉(1.0%)則較少。2.發(fā)病率方面,在HP陽性病例,各證型胃息肉發(fā)病率分別為肝胃不和證26.37%(48/182),脾胃虛弱證18.57%(13/70),脾胃濕熱證17.78%(8/45),胃陰不足證14.29%(1/7),胃絡瘀血證50.00%(5/10),各證型胃息肉發(fā)病率比較無顯著統(tǒng)計學差異(P=0.150)。在HP陰性病例,則發(fā)病率分別為肝胃不和證30.68%(77/251),脾胃虛弱證36.67%(44/120),脾胃濕熱證17.24%(10/58),胃陰不足證11.76%(2/17),胃絡瘀血證22.22%(2/9),各證型胃息肉發(fā)病率兩兩比較無顯著統(tǒng)計學差異(P0.005)。在全部病例中,各證型胃息肉發(fā)病率肝胃不和證28.67%(125/433),脾胃虛弱證30.00%(57/190),脾胃濕熱證17.48%(18/103),胃陰不足證12.50%(3/24),胃絡瘀血證36.84%(7/19),各證型胃息肉發(fā)病率兩兩比較無顯著統(tǒng)計學差異(P0.005)。3.各證型胃痛患者胃息肉病理類型比較,因脾胃濕熱證、胃陰不足證、胃絡瘀血證及腺瘤性息肉、炎性纖維性息肉例數(shù)較少,本研究中無論HP陽性與陰性,肝胃不和組與脾胃虛弱組在增生性息肉與胃底腺息肉發(fā)生率比較均無明顯統(tǒng)計學差異(P0.05)。4.胃息肉4種病理類型與性別、年齡、中醫(yī)證型、HP感染相關性的logistic分析表明,本研究中提示女性與腺瘤性息肉及胃底腺息肉呈負相關,年齡為胃底腺息肉的危險因素,HP感染與腺瘤性息肉呈正相關而與胃底腺息肉呈負相關。而胃息肉的病理類型與中醫(yī)證型無確切的相關性。結(jié)論：本研究中各證型胃息肉發(fā)病率無顯著統(tǒng)計學差異,肝胃不和組與脾胃虛弱組在增生性息肉與胃底腺息肉發(fā)生率上比較無明顯統(tǒng)計學差異,胃息肉的病理類型與中醫(yī)證型無確切的相關性。
[Abstract]:Objective: the purpose of this study was to explore the possible relationship between TCM syndrome differentiation of stomach pain and the incidence and pathological types of gastric polyps through strict and scientific scheme design and standardized research operation under the guidance of the meridian theory of traditional Chinese medicine.In order to explore the traditional Chinese medicine combined with western medicine dialectical analysis, the treatment of stomach pain patients and the prevention and treatment of gastric cancer to provide useful clinical data, for TCM syndrome differentiation to seek more objective indicators and theoretical basis, and to preliminarily reveal its objective laws.Better serve clinical and scientific research.Methods: a total of 769 patients with gastric pain were collected from Guangdong Integrated Chinese and Western Medicine Hospital from 2012 to 2014. Among them, 210 patients with gastric polyps who met the inclusion criteria and did not meet the exclusion criteria were collected.According to the dialectical classification of gastric pain, there were five types of syndrome: disharmony of liver and stomach, deficiency of spleen and stomach, dampness and heat of spleen and stomach, deficiency of stomach yin and blood stasis of stomach collaterals. The distribution of four different pathological types of gastric polyps in each group was analyzed.To study the possible relationship between TCM classification of gastric pain and pathological type of chronic gastritis gastric polyps.Result: 1.In the case group, the number of cases with deficiency of stomach yin and blood stasis of stomach collaterals was very few, mainly concentrated in liver and stomach disharmony syndrome 59.5am, spleen and stomach deficiency syndrome 27. 1 and spleen and stomach dampness and heat syndrome.In the pathological types of polyps, the gastric fundus polyps (76. 2%), proliferative polyps (15. 7%), other inflammatory fibrous polyps (7. 1%), adenomatous polyps (1. 0%) and adenomatous polyps (1. 0%) were less.In HP positive cases, the incidence of gastric polyps in each syndrome was 26.37 / 182 / 48, 18.5713 / 70 / 70, 17.78 / 45 / 45, 14.29 / 7 and 50.005 / 10 / 10, respectively. There was no significant difference in the incidence of gastric polyps among different syndromes.In HP negative cases, the incidence rates were liver and stomach disharmony (30.68 / 251), spleen and stomach weakness (36.67 / 44 / 120), spleen and stomach dampness heat (17.24 / 58), stomach yin deficiency (11.76 / 2 / 17), gastric blood stasis (22.22 / 2 / 9). There was no significant difference in the incidence of gastric polyps between the two syndromes (P 0.005).In all cases, the incidence of gastric polyps in each syndrome was 28.67125 / 433g, in spleen and stomach deficiency 30.0057 / 190N, in dampness and heat of spleen and stomach 17.48g / 103n, in deficiency of stomach and yin 12.50m / 32 / 24, in syndrome of gastric collaterals and blood stasis 36.847 / 7 / 19N, there was no significant difference in the incidence of gastric polyps between the two types (P0.0050.0.33). (2) there was no significant difference in the incidence of gastric polyps between the two types of syndrome (P 0.005. 3), and there was no significant difference in the incidence of gastric polyps between the two types (P 0.005. 3).The pathological types of gastric polyps in patients with gastric pain were less due to damp-heat syndrome of spleen and stomach, deficiency of stomach yin, blood stasis of gastric collaterals and adenomatous polyps, inflammatory fibrous polyps, no matter HP positive or negative in this study.There was no significant difference in the incidence of proliferative polyps and fundus gland polyps between the liver and stomach disharmony group and the spleen and stomach asthenia group.Logistic analysis of the correlation between four pathological types of gastric polyps and sex, age, TCM syndromes and HP infection showed that there was a negative correlation between women and adenomatous polyps and fundus adenomatous polyps in this study.Age was a risk factor for gastric fundus polyps. HP infection was positively correlated with adenomatous polyps and negatively correlated with gastric fundus polyps.But the pathological type of gastric polyp has no definite correlation with TCM syndrome type.Conclusion: there was no significant difference in the incidence of gastric polyps among different syndromes in this study, but there was no significant difference in the incidence of proliferative polyps and gastric fundus polyps between the liver and stomach disharmony group and the spleen and stomach asthenia group.There is no definite correlation between pathological type of gastric polyp and TCM syndrome type.
【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】：R256.3

【參考文獻】

相關期刊論文 前10條

1 章員良;黃文;彭輝;閻曉初;楊仕明;彭貴勇;;胃息肉與幽門螺桿菌感染相關性研究[J];重慶醫(yī)學;2013年35期

2 房殿春;;胃黏膜癌前病變的研究進展[J];現(xiàn)代消化及介入診療;2013年02期

3 俞雷;侯安繼;王文海;;活血化瘀養(yǎng)陰方聯(lián)合FOLFOX4化療方案治療中晚期胃癌30例[J];上海中醫(yī)藥雜志;2012年07期

4 于慧;殷東風;;256例原發(fā)性胃癌中醫(yī)證候特點及演變規(guī)律[J];中華中醫(yī)藥學刊;2012年07期

5 鄧宏;孫良生;張曉軒;龍順欽;吳萬垠;;扶陽法治療胃癌探討[J];新中醫(yī);2011年03期

6 葉玲;劉霆;冷愛民;張桂英;;胃息肉的臨床特征分析與治療決策[J];中國現(xiàn)代醫(yī)學雜志;2011年05期

7 孫惠麗;陸為民;;中醫(yī)藥治療胃癌前病變的研究[J];長春中醫(yī)藥大學學報;2010年02期

8 王亞東;王曉波;白軍偉;尹家俊;;人胃癌細胞系端粒酶逆轉(zhuǎn)錄酶基因啟動子區(qū)域甲基化的檢測[J];中國實驗診斷學;2009年10期

9 劉萱;白成;張曉麗;于中麟;張澍田;;胃息肉與幽門螺桿菌感染的關系[J];中華醫(yī)院感染學雜志;2009年19期

10 張賀軍;丁士剛;金珠;崔榮麗;;胃息肉的臨床病理特征及其與癌變和幽門螺桿菌感染關系的研究[J];胃腸病學;2009年08期

，

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