【作者】 王姗姗；

【导师】 张福利；

【作者基本信息】 黑龙江中医药大学 ， 中医临床基础， 2010， 硕士

【摘要】 目的:目前中医对湿热体质界定主要依赖患者自述的症状表现和医生进行四诊。前者存在表现多样性及叙述主观性,后者亦存在表现复杂性和医生的经验及知识背景不同而造成的差异性,均有难以精确量化的缺陷。虽然已有研究人员进行了体质界定标准化、客观化研究,希冀用各种现代化检测方法给体质一个统一有效的“金标准”,但迄今为止收效甚微。而所涉及到的各种物理、生化、基因检测大都价格昂贵且费时费力,更限制了它们在临床的推广应用。这就使寻找一种临床切实可行且效果良好的体质界定方法成为当前中医体质研究的重中之重。方法:通过传统文献梳理与现代文献分析相结合的方法探讨中医湿热体质相关理论的源流、内涵和外延;对98例湿热体质患者的血压及脉压的测量、统计,分析湿热体质患者者血压及脉压的特征,以及对其中36例湿热体质患者经过清热化湿,理气升阳法治疗二个疗程前后血压、脉压变化以及症状体征的变化进行观察。验证测量血压及脉压是否可以应用于对湿热体质的界定和对湿热体质调治效果的衡量。结果:1.98例不同年龄段诊断为湿热体质的患者收缩压处于正常值下限水平(平均109.67±8.69mmHg),舒张压处于正常值水平上限(平均79.44±7.52mmHg),平均脉压处于正常值下限水平(30.33±5.21mmHg);2.36湿热体质患者经过两个疗程治疗后,患者的湿热状态解除,而血压及脉压的变化要先于患者的主观症状描述。结论:1.湿热体质患者普遍具有收缩压处于正常值下限、舒张压处于正常值上限而脉压处于正常值下限的特点;2.经中药行清热化湿,理气升阳法调治后患者湿热体质好转,同时收缩压可上升并接近正常值的平均水平,舒张压下降接近正常值的平均水平而使脉压也接近正常平均值;3.因此检测血压及脉压可作为界定湿热体质及衡量其调治效果的客观依据,具有准确、便捷的优势。更多还原

【Abstract】 Objective: At present, it mainly deponds on two ways to define muggy in Traditional Chinese Medicine. The first way is that patients describe the symp tom by t he mselves. But thi s way is subjective. The second way is that doctors diagnose s y mptom through tongue diagnosis and pulse-taking. But for this way, the symptom perfor ma nce is complicated and due to differe nt doctors have different experience and knowledge, so the diagnosis is different. The two ways al l have the defect to get accurate quantification. Though r esearch about defi ning muggy standarly and objectively has been done, researchers hope to find an e ffe ctive standard to define muggy through mo dern testing methods. So far the effection is less. And the various physical, biological and genetic testing methods are expensive and ti me-consuming, and are more li mited for the c linical application.So it is the most i mportant to find a practicable and effective method to define muggy for clinical application of Traditional Chinese Medicine.Method: Research the origin, connotation and extension of therories which are related to muggy in Traditional Chinese Medicine through reviewing the traditional and mo dern literature. Measure and record blood pressure and pp for 98 muggy patients. And 36 muggy patients were treated for two courses of treatment t hrough Traditional Chinese Medicine. Then observe differ ence of blood pressure, pp and s y mptom before treat ment a nd after t reatment. Prove if measur ing blood presure and pp ca n be appl ied to define muggy and measure the effection for adjusting muggy.Result:1.For the 98 muggy patients whose age groups were different, their SBP was in normal lower limit (average 109.67±8.69mmHg) , DBP was in nor mal upper limit (average 79.44±7.52mmHg) and pp was in norma l lower limit (average 30.33±5.21mmHg).2.For the 36 muggy patients, their muggy si tuation was relieved after two courses of treat ment. And the change of blood pressure and pp happened before subjective sy mptom description of pa tients.Conclution: 1. SBP of muggy patients was in normal lower limits, DBP of muggy patients was in nor mal uppe r limits, and PP of muggy patients was in the lower limits of nor mal. 2. Muggy patients have improvement after Traditional Chinese Medicine treatment. At the sa me ti me, their SBP and PP all reach the average normal value.3. So it is an objective reference to exa m blood pressure and PP for defi ning mu ggy and measuring treatment effection, which is accurate and convenient.更多还原