【作者】 袁晓春；

【导师】 李方洁；

【作者基本信息】 中国中医科学院 ， 中西医结合临床， 2009， 硕士

【摘要】 目的目前全世界吸烟人数约有13亿,每年有490万人死于烟草相关疾病。中国是世界最大的烟草生产和消费国,现有烟民约3.5亿。每年死于烟草相关疾病的人数为100万,超过因艾滋病、结核、交通事故以及自杀死亡人数的总和。长期或大量吸烟者多数有或多或少的躯体不适症状,成瘾后戒烟还会出现戒断症状,明显影响了吸烟人群的工作、生活质量。因此研究吸烟与动脉硬化的关系,及吸烟人群的中医证候分布特征。方法对相关文献进行查找、整理与对539例临床观察相结合。具体方法是根据纳入排除标准、疾病诊断标准纳入539例观察对象,在调查员的协助下填写一般情况和证候调查表,进行动脉硬化检测,采用动脉硬化的评价指标对吸烟与不烟人群进行对比观察,并进行中医证候分类的对比观察。结果在CAVI阳性的人群中,吸烟者占86.7%,不吸烟者占13.3%。吸烟组CAVI阳性率显著高于不吸烟组。吸烟组CAVI测量值高于不吸烟组,且两组存在显著差异,并且在每个年龄段中都是如此。但是日吸烟量未见对CAVI有明显影响,而随烟龄、吸炯指数增加,CAVI的阳性率增加。在全部观察人群中,51例无明显证候表现者,都在不吸烟组,而吸烟组的332例中,全部有阳性证候表现。吸烟与不吸烟人群的证候分布明显的不同,吸烟组以气血津液及五脏失调为主要表现,但不吸烟组却没有特别明显的倾向。长期吸烟的人较瘦,烟龄越长体重指数越低。吸烟组津液不足、痰证、胃阴亏虚、气虚、血瘀、气滞证较多。不吸烟组见到寒湿困脾、脾阳虚、脾气虚、气血两虚、气虚血瘀等,但证候分布较分散,以虚寒证为主。结论吸烟使动脉硬化指标CAVI测量值发生改变,吸烟时间与吸烟量的综合因素与动脉硬化关系更密切;吸烟人群存在明显的亚健康状态;长期吸烟对人体造成持久的刺激,导致人的体质改变;长期吸烟,对人体有灼伤津液,耗气伤阴及助湿蕴热的作用。更多还原

【Abstract】 ObjectivesThe number of smokers around the world about 13 million people at present,who died of tobacco related diseases about 4.9 million people each year. Our countory is the largest producer and consumer of tobacco in the world about 350 million current smokers.Each year,about 1000000 people who died from tobacco-related diseases,Beyond AIDS,tuberculosis,traffic accidents,as well as the sum of the number of suicide deaths.There is a greater or lesser degree of physical symptoms in the majority of long-term or heavy smokers,post-addiction withdrawal symptoms will appear to stop smoking,It is influenced the work and the quality of life of the smoking crowd significantly,So,began the study of the relationship between smoking and atherosclerosis,and smoking population distribution characteristics of TCM Syndrome.MethodsFind and settle the relevant literature of smoking with the combination of 539 cases clinical observation.The specific method is based on the criteria of inclution and exclusion and disease diagnostic criteria included in 539 cases of observed objects,Filled out the questionnaire of the members of the general situation and Syndrome TCM in the assistance of investigation,and for detection of atherosclerosis.Observation and compared with smoking and non-smoking crowd use the evaluation maker of atherosclerosis,and classification of traditional Chinese medicine syndromes.ResultsIn the population who is positive CAVI,smokers accounted for 86.7%,non-smokers accounted for 13.3%,The positive rate was significantly higher in smoking group.smoking group is higher than non-smokers group in the measured value of CAVI,and there was a significant difference between the two groups,in each age group with the same consult.But the amount of smoking per day have not significant impact on the CAVI,with the time of smoking and smoking index increase,the positive rate of CAVI increased.In all observed groups,51 cases who are non-smoking group,show no obvious TCM syndrome,332 cases in smoking group all have shown positive TCM syndrome. There is significantly different TCM syndrome distribution in smoking and non-smoking crowd,The main manifestation in smoking group is the TCM syndrome categorical identification in terms of Qi,Blood and Fluids and five internal organs.but there is no obvious distributed tendency in the no-smoking group.Long-term smokers is thinner,smoking longer lower body mass index,the longer the smoking time is,the lower body mass index will be.A situation there TCM syndrome of deficiency of body fluid and phlegm syndrome and deficiency of gastric yin and deficiency of vital energy and stagnation of blood and qi stagnation prevail in the smoking group.But there are more TCM syndrome of cold-damp invasion of spleen and insufficiency of spleen-YANG and deficiency of spleen-QI and deficiency of both QI and blood and qi asthenia causing blood stasis in the no-smoking group,but TCM syndrome distribution more dispersed,The main manifestation in no-smoking group is the TCM syndrome of asthenia cold syndrome.ConclusionSmoking change the indicators of atherosclerosis of CAVI measurements,A factors combinated the amount of smoking and smoking time relationship with atherosclerosis;smokers under sub health condition obviously;There is a long-lasting stimulation on the human body by long-term smoking,lead to physical change;The effection of long-term smoking are three aspects,including damaged body fluid and consumpted QI and yin and helpted Dampness and rised Heat更多还原