【作者】 丁彩红；

【导师】 潘月丽；

【作者基本信息】 山东中医药大学 ， 中医儿科学， 2011， 硕士

【摘要】 目的:通过对儿童难治性肾病综合征的临床证候分析,初步探讨其证候特征。方法:1.采用德尔菲法进行两轮专家调查,以SPSS16.0统计软件进行统计分析,采用描述性分析等方法,筛选、整理专家意见的集中程度、协调程度,总结本病证候特点。2.运用回顾性研究方法,收集临床资料,采用SPSS16.0统计软件进行描述性分析等方法,总结本病临床证候特点。3.对比两种方法的结果,初步探讨本病中医证候特点。结果:1.调查问卷:提示肺脾气虚证、脾肾阳虚证、肝肾阴虚证、气阴两虚证、水湿内泛证等为临床常见证型。2.临床研究:①根据证型标准能明确辨证的病例中湿热内蒸证出现频率最高,其次是风水相搏证、肝肾阴虚证;病程中症状记录不详细,不能根据证型标准进行辨证而以方测证病例中湿热内蒸证出现频率最高,其次是肝肾阴虚证、气阴两虚证和瘀血内阻证。②根据激素应用阶段,其中足量激素治疗阶段辨证频率居前两位的证型为湿热内蒸证和肝肾阴虚证;激素减量阶段辨证频率居前两位的为湿热内蒸证和气阴两虚证。结论:本病以肺脾气虚证、脾肾阳虚证、肝肾阴虚证、气阴两虚证本虚为主,标实以湿热内蒸证、瘀血内阻证居多;各证型分类与应用激素治疗有一定关系:足量激素治疗阶段以湿热内蒸证和肝肾阴虚证居多,激素减量阶段以湿热内蒸证和气阴两虚证居多。更多还原

【Abstract】 Objective:to probe syndrome characteristics of children intractable nephrotic syndrome through analysing clinical symptoms. Methods:1.Two turns of expert investigation were managed by using delphi method. Statistical analyse were made by way of software of SPSS16.0. Methods such as descriptive analysis were adopted. Concentrative degree, coordination degree of expert opinions were selected and arranged. Syndrome characteristics of this disease were summarized. 2. Clinical data were collected by using retrospective study method. Methods such as descriptive analysis were applied by using software SPSS16.0 and clinical syndrome characteristics were concluded. 3.The results got through the two methods mentioned above were contrasted. The syndrome characteristics of children intractable nephrotic syndrome were discussed.Results: 1. Spleen and lung qi deficiency, spleen and kidney yang deficiency, liver and kidney yin deficiency, qi and yin deficiency, dampness syndrome were studied as the most commonly seen syndromes in questionnaire survey. 2. Clinical research:①The frequency of dampness-heat syndrome was thought as the highest one in the cases that the syndromes could be differentiated according to the standard of syndromes. Edema caused by pathogenic wind syndrome, liver and kidney yin deficiency were the next. The frequency of dampness-heat syndrome were thought as highest in the cases that having no detailed clinical symptoms records and syndromes could not be differentiated as the standard of syndromes but using the method of differentiating syndromes through elucidating mechanism of Chinese formula.②The first two rank of syndromes in the therapeutic phase of using sufficient hormone were dampness-heat syndrome and liver and kidney deficiency. The first two rank of syndromes in the therapeutic phase of hormone reduction were dampness-heat syndrome, qi and yin deficiency syndrome.Conclusions: lung and spleen qi deficiency, spleen and kidney yang deficiency, liver and kidney yin deficiency, qi and yin deficiency are the main syndromes of children intractable nephroticsyndrome for the root deficiency aspect. Dampness-heat syndrome, blood stasis syndrome are the main syndromes for the branch deficiency aspect. The classification of syndromes has close relationship with hormone application. Dampness-heat syndrome, liver and kidney yin deficiency are the main syndrome in the sufficient hormone therapeutic phase. Dampness-heat syndrome, yin and yin deficiency syndrome are main syndromes in hormone reduction phase.更多还原