中医治疗68例慢性胆囊炎回顾性分析

【作者】 张艳明；

【导师】 刘小北；

【作者基本信息】 北京中医药大学 ， 中医内科学， 2010， 硕士

【摘要】 研究目的：本课题采用病例回顾分析的方法,对68例确诊为慢性胆囊炎(非结石性)住院病例进行的中医病因、发病、证型与处方用药的分析,初步探讨了慢性胆囊炎的中医病因特点、发病特点、证型分布规律与临床处方用药规律,为临床治疗提供了一定的依据。研究方法：遴选东直门医院1989年—2008年68例确诊为慢性胆囊炎(非结石性)住院病例,严格按照严格按照《中药新药临床研究指导原则(2002年)》“中药新药治疗慢性胆道感染,胆石病的临床研究指导原则”诊断标准及病例选择排除标准,客观认真的填写病例回顾调查表,观察其年龄、性别、诱因、症状、中医辩证分型、处方用药,并应用观察所得之数据建立数据库,采用统计学方法分析慢性胆囊炎患者的性别、年龄、诱因、症状等分布特点,及其中医证型分布的规律和临床处方用药规律。研究结果：1、68例慢性胆囊炎(非结石性)的发病诱因以饮食不节和情志不遂最为常见；2、慢性胆囊炎患者中医症状以食少纳呆、恶心、右上腹疼痛、右胁疼痛、大便干、厌食油腻、呕吐、胃脘满闷、大便溏、嗳气,小便黄赤、失眠、困倦乏力、头身困重出现频率最高；3、慢性胆囊炎中医证型分布为证型分布为肝胆湿热证最常见,肝郁气滞证与肝胃郁热次之,气滞血瘀证较少,肝郁脾虚和肝阴不足所占比例最少；4、不同性别证型分布中无差异；5、通过68例慢性胆囊炎病例的首次使用中药的频数分析表中,得出使用次数排在前三位的方剂分别为柴胡疏肝散、大柴胡汤、柴芩温胆汤；6、用药使用次数做多的前十为位柴胡、黄芩、郁金、清半夏、白芍、陈皮、元胡、香附、枳壳、枳实。研究结论：1、68例慢性胆囊炎(非结石性)的中医证型分布以肝胆湿热证和肝郁气滞证为多见。2、68例慢性胆囊炎(非结石性)的处方以柴胡疏肝散、大柴胡汤、柴芩温胆汤为主。3、68例慢性胆囊炎(非结石性)的处方用药使用次数做多的前为位柴胡、黄芩、郁金、清半夏、白芍、陈皮、元胡、香附、枳壳、枳实。更多还原

【Abstract】 Research purposes:Through a retrospective analysis of the subject method,68 cases were diagnosed as chronic non-calculous cholecystitis hospitalized cases is the cause of Chinese medicine, disease syndromes and prescription drug analysis, a preliminary study of chronic non-calculous cholecystitis characteristics of TCM etiology of disease characteristics, clinical syndrome and distribution of prescription drug law for clinical therapy.Methods:Selection from 1989-2008,68 cases diagnosed as chronic non-calculous cholecystitis inpatients in Dongzhimen Hospital, using epidemiological investigation, in strict accordance with"Herbal drug treatment of chronic cholecystitis and cholelithiasis, as the disease and clinical research guidelines"from《The herbal medicine and clinical research guidelines (2002)》and according with Diagnosis Case selection criteria and exclusion criteria, objective and careful clinical observation forms completed, observation of their age, incentives, food Preference of, and apply the data of observations to establish a database, using statistical methods to anylise to find the relationship between chronic cholecystitis and sex,age, incentives, symptoms of distribution,And the laws of syndromes and clinical prescription principles in using herbal drugs.Results:1. Chronic cholecystitis inducement to improper diet and go rather then the situation is most common; 2. Chronic cholecystitis clinical symptoms in patients with anorexia to cat less, nausea, right upper quadrant pain, Youxie pain, stool dry, oily anorexia, vomiting, epigastric full of nausea, loose stools, belching, red yellow urine, insomnia, drowsiness, fatigue, heavy feels in head and body are most frequently trapped; 3.Chronic non-stone cholecystitis syndromes distribution for the first common is the syndrome of dampness-heat of liver and gallbladder, pattern of liver depression and qi stagnation and Chronic superficial gastritis are aiso very common, qi stagntion and blood stasis is less, liver yin deficiency and liver depression and spleen deficiency are much uncommon; 4 syndromes of different gender distribution did not differ significantly (P> 0.05); 5 Through 68 cases of chronic non-calculous cholecystitis cases,for the first time the frequency of use of traditional Chinese medicine in the table are obtained using the number of greater than 10% of the prescriptions are Bupleurum Liver-Soothing Powder,, Major Bupleurum Decoction, Chaiqin wendan decoction; 6.The frequency of uses of Herbal drugs in the top ten are Radix Bupleuri, Radix Scutellariae, Radix Curcumae, Rhizoma Pinelliae, Paeoniae Lactiflorae, Pericarpium Citri Reticulatae, Rhizoma Cyperi, Fructus Aurantii, Fructus Aurantii Immaturus, Corydalis Ambigua。Conclusions:1. In 68 cases of chronic non-calculous cholecystitis syndromes distribution to syndrome of dampness-heat of liver and gallbladder, pattern of liver depression and qi stagnation and Chronic superficial gastritis is common. 2.In 68 cases of chronic non-calculous cholecystitis prescription Bupleurum Liver-Soothing Powder,, Major Bupleurum Decoction, Chaiqin wendan decoction are often used.3. The frequency of uses of Herbal drugs in the top ten are Radix Bupleuri, Radix Scutellariae, Radix Curcumae, Rhizoma Pinelliae, Paeoniae Lactiflorae, Pericarpium Citri Reticulatae, Rhizoma Cyperi, Fructus Aurantii, Fructus Aurantii Immaturus, Corydalis Ambigua.更多还原