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肠易激综合征与体质的相关性研究
A Research for the Relations of TCM Constitution and Irritable Bowel Syndrome
【作者】 葛国艳；
【导师】 周晓虹；
【作者基本信息】 南京中医药大学 ， 中医内科学， 2010， 硕士
【摘要】 目的：通过对2009年3月-2010年1月江苏省中医院消化科门诊及住院肠易激综合征(IBS)病例资料收集分析,初步探讨IBS患者与中医体质类型的相关性,进而总结出IBS的易感体质类型,为IBS的预防和治疗提供借鉴。方法：采用问卷调查的方法,收集肠易激综合征患者247例,按中医体质量表分别判定为平和质、气虚质、阳虚质、阴虚质、痰湿质、湿热质、瘀血质、气郁质、特禀质等9种体质类型。采用Microsoft Excel建立数据库,使用SPSS13.0统计软件,分析肠易激综合征患者的性别、年龄、居住地、职业、病程、西医分型与中医体质类型的关系。结果：1、肠易激综合征患者中医体质类型出现的频率依次为气郁质(34.8%)>阳虚质(28.0%)>平和质(10.1%)>气虚质(8.9%)>湿热质(7.7%)>痰湿质(6.1%)>阴虚质(2.0%)>特禀质(1.6%)>瘀血质(0.8%)。2、肠易激综合征西医分型与中医体质类型密切相关：腹泻型患者中体质出现频率分别为：阳虚质>气郁质>平和质>气虚质>痰湿质>湿热质>特禀质>瘀血质=阴虚质；便秘型患者中体质出现频率分别为：气郁质>湿热质>阳虚质>平和质=阴虚质>气虚质=特禀质>痰湿质=瘀血质；混合型患者中体质出现频率分别为：气郁质>阳虚质>平和质=气虚质>湿热质=特禀质>瘀血质=阴虚质=痰湿质；不定型患者中体质出现频率分别为：气郁质>平和质=气虚质=湿热质>阳虚质=阴虚质=瘀血质>痰湿质=特禀质。中医体质类型分布在不同IBS西医分型中的差别有统计学意义(P<0.05)。3、未发现患者的性别、年龄、居住地、职业及病程与中医体质类型的相关性。结论：1、肠易激综合征与中医体质存在一定的相关性,多见于气郁质、阳虚质,与肠易激综合征的病机基本一致,即以肝郁脾虚,肝脾不和为主。2、肠易激综合征分型与中医体质类型密切相关：腹泻型患者以阳虚质及气郁质为主；便秘型患者以气郁质及湿热质为主；混合型及不定型患者均以气郁质为主。3、本研究启示肠易激综合征患者体质有一定的偏颇,因此通过调整体质,可以达到防治疾病的目的。
【Abstract】 Objective:To analyze the distribution of TCM Constitution in irritable bowel syndrome patients who diagnosed and treated in Gastrointestinal Department of jiangsu provincial TCM Hospital from March 2009 to January 2010; explore the relationship between irritable bowel syndrome and TCM Constitution; summarized the popular tendency of IBS, and hence to provide a new ideas for the prevention and treatment of IBS.Methods:By means of question investigations,247patients with irritable bowel syndrome are gathered. They are categorized into nine constitution types, namely, gentleness type, qi-deficiency type, yang-deficiency type, yin-deficiency type, phlegm-wet type, wetness-heat type, blood-stasis type, qi-depression type, and special inherited type. Data base was established, the relationship of TCM constitution with gender, age, residence, occupation, course of disease and IBS sub-types were analyzed by SPSS 13.0 statistical software.Results:1.The frequency of TCM Constitution types in irritable bowel syndrome in descending order is:qi-depression type(34.8%)>yang-deficiency type(28.0%)>gentleness type(10.1%)>qi-deficiency type(8.9%)>wetness-heat type(7.7%)>phlegm-wet type(6.1%) >yin-deficiency type (2.0%)>special inherited type (1.6%)>blood-stasis type(0.8%).2. IBS sub-types differences existed in the constitution in Chinese medicine of the patients with IBS. The frequency on the patients who suffered IBS diarrhea in descending order is: yang-deficiency type>qi-depression type>gentleness type>qi-deficiency type>phlegm-wet type>wetness-heat type>special inherited type>blood-stasis type=.yin-deficiency type. The frequency on the patients who suffered IBS constipation in descending order is:qi-depression type>wetness-heat type>yang-deficiency type>gentleness type=yin-deficiency type>qi-deficiency type-special inherited type>phlegm-wet type=blood-stasis type. The frequency on the patients who suffered IBS-Mixed in descending order is:qi-depression type>yang-deficiency type>gentleness type=qi-deficiency type>wetness-heat type=special inherited type>blood-stasis type=yin-deficiency type=phlegm-wet type. The frequency on the patients who suffered IBS-Unclassifiable in descending order is:qi-depression type>gentleness type=qi-deficiency type=wetness-heat type>yang-deficiency type=yin-deficiency type= blood-stasis type>phlegm-wet type=special inherited type. There was statistic difference between IBS sub-types differences and the constitution in Chinese medicine (P<0.05).3. No correlation is found between TCM Constitution types in irritable bowel syndrome and the patients’gender, age, residence, occupation and course of the disease.Conclusion:1. Irritable bowel syndrome is correlated with TCM Constitution types; abnormal constitution is common in qi-depression type, yang-deficiency type, which conforms to the pathogenesis of irritable bowel syndrome:liver stagnation and spleen deficiency.2. IBS sub-types differences existed in the constitution in Chinese medicine of the patients with IBS. The biased constitution in the patients who suffered IBS diarrhea were yang-deficiency type and qi-depression type; the biased constitution in the patients who suffered IBS constipation were qi-depression type and wetness-heat type; the biased constitution in the patients who suffered IBS-Mixed and IBS-Unclassifiable were qi-depression type.3. It is indicative by this study that the patients with irritable bowel syndrome have a certain bias TCM constitution. Therefore, by means of adjusting to the biased constitution, the effects of prevention and treatment of IBS can be attained.