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溃疡性结肠炎中医证候分布研究

[Study on the Chinese medical syndrome distribution of ulcerative colitis].

作者信息

Lu Yong-Hui, Cong Long-Ling

机构信息

Department of Gastroenterology, Guangzhou Municipal Hospital of Traditional Chinese Medicine, Guangzhou 510130.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2012 Apr;32(4):450-4.

Abstract

OBJECTIVE

To study on the Chinese medicine (CM) syndrome distribution of ulcerative colitis (UC) and the distribution of CM syndrome types at different staging periods.

METHODS

From March 2007 to April 2010, 110 UC out- or inpatients at the Department of Digestive Diseases of Guangzhou Municipal Hospital of Traditional Chinese Medicine were recruited. The patients' symptoms were calculated. The systematic clustering was used. The symptom was taken as the variable in the clustering. The syndrome types were confirmed according to the clustering results. The syndrome typing was performed and its results were analyzed.

RESULTS

There were 64 main symptoms in UC patients, including diarrhea, mushy stool, watery stool, abdominal pain, and bloody stool. Seventy cases belonged to the active period and 40 to the remission period. The UC syndrome types were sequenced from high to low as the dampness-heat of Dachang syndrome, Pi-Wei qi deficiency syndrome, Gan depression and Pi deficiency syndrome, Pi-Shen yang deficiency syndrome, blood stasis in the intestinal collaterals syndrome, yin and blood deficiency syndrome. There was statistical difference in the case number among different syndrome types (P < 0.05). In the active period, dominated were the dampness-heat of Dachang syndrome (28 cases, 25.5%), Gan depression and Pi deficiency syndrome (14 cases, 12.7%), and blood stasis in the intestinal collaterals syndrome (10 cases, 9.0%). In the remission period, dominated were Pi-Wei qi deficiency syndrome (18 cases, 16.4%) and Pi-Shen yang deficiency syndrome (10 cases, 9.0%), showing statistical difference (P<0.05). The typical symptoms of patients of the dampness-heat of Dachang syndrome were sequenced from high to low as yellow tongue fur (31 cases, 28.1%), tenesmus (26 cases, 23.6%), mucopurulent bloody stool (25 cases, 227%), diarrhea (24 cases, 21.8%), anal burning (24 cases, 21.8%), watery stool (21 cases, 19.0%), abdominal pain (19 cases, 17.2%), red tongue (19 cases, 17.2%), and greasy tongue fur (19 cases, 17.2%). The typical symptoms of patients of Pi-Wei qi deficiency syndrome were sequenced from high to low as tastelessness (25 cases, 22.7%), fine pulse (25 cases, 22.7%), pink tongue (22 cases, 20.0%), eructation (21 cases, 19.1%), hypodynamia (21 cases, 19.1%), loss of appetite (20 cases, 18.2%), and white tongue fur (20 cases, 18.2%). The typical symptoms of patients of Pi-Shen yang deficiency syndrome were sequenced from high to low as abdominal pain (17 cases, 15. 5%), preference for warmth (17 cases, 15. 5%), diarrhea (16 cases, 14.5%), aggravation while encountering cold (15 cases, 13.6%), white tongue fur (15 cases, 13.6%), pale white tongue (14 cases, 12.7%). The typical symptoms of patients of Gan depression and Pi deficiency syndrome were sequenced from high to low as emotions inducing (18 cases, 16.4%), eructation (16 cases, 14.5%), white tongue coating (16 cases, 14.5%), dry stool before loose stool (15 cases, 13.6%), frequent break wind (15 cases, 13.6%), and frequent sigh (15 cases, 13.6%). The typical symptoms of patients of blood stasis in the intestinal collaterals syndrome were sequenced from high to low as abdominal pain (12 cases, 10.9%), sting (12 cases, 10.9%), soreness of the waist (12 cases, 10.9%), dark red tongue with petechiae (12 cases, 10.9%), thick fur (12 cases, 10.9%). There was statistical difference in the symptom ratio among each syndrome types (P<0.05). There was no statistical difference in other symptoms except yin and blood deficiency syndrome (P>0.05).

CONCLUSIONS

The dampness-heat of Dachang syndrome, Gan depression and Pi deficiency syndrome, and blood stasis in the intestinal collaterals syndrome were dominated in the UC active period. Pi-Wei qi deficiency syndrome and Pi-Shen yang deficiency syndrome were dominated in the remission period.

摘要

目的

研究溃疡性结肠炎(UC)的中医证候分布及不同分期的中医证型分布情况。

方法

选取2007年3月至2010年4月在广州市中医医院消化内科住院及门诊的110例UC患者,统计患者症状,采用系统聚类法,以症状为聚类变量,根据聚类结果确定证型,进行证型分类并分析结果。

结果

UC患者主要症状64项,包括腹泻、糊状便、水样便、腹痛、便血等。其中活动期70例,缓解期40例。UC证型由高到低依次为大肠湿热证、脾胃气虚证、肝郁脾虚证、脾肾阳虚证、肠道瘀血证、阴血亏虚证。不同证型病例数有统计学差异(P<0.05)。活动期以大肠湿热证为主(28例,25.5%),其次为肝郁脾虚证(14例,12.7%)、肠道瘀血证(10例,9.0%);缓解期以脾胃气虚证为主(18例,16.4%),其次为脾肾阳虚证(10例,9.0%),差异有统计学意义(P<0.05)。大肠湿热证患者典型症状由高到低依次为黄苔(31例,28.1%)、里急后重(26例,23.6%)、黏液脓血便(25例,22.7%)、腹泻(24例,21.8%)、肛门灼热(24例,21.8%)、水样便(21例,19.0%)、腹痛(19例,17.2%)、舌红(19例,17.2%)、腻苔(19例,17.2%)。脾胃气虚证患者典型症状由高到低依次为口淡(25例,22.7%)、脉细(25例,22.7%)、舌淡红(22例,20.0%)、嗳气(21例,19.1%)、乏力(21例,19.1%)、食欲不振(20例,18.2%)、白苔(20例,18.2%)。脾肾阳虚证患者典型症状由高到低依次为腹痛(17例,15.5%)、喜温(17例,15.5%)、腹泻(16例,14.5%)、遇冷加重(15例,13.6%)、白苔(15例,13.6%)、舌淡白(14例,12.7%)。肝郁脾虚证患者典型症状由高到低依次为情志诱发(18例,16.4%)、嗳气(16例,14.5%)、白苔(16例,14.5%)、先干后溏(15例,13.6%)、矢气频作(15例,13.6%)、善太息(15例,13.6%)。肠道瘀血证患者典型症状由高到低依次为腹痛(12例,10.9%)、刺痛(12例,10.9%)、腰酸(12例,10.9%)、暗红舌有瘀点(12例,10.9%)、厚苔(12例,10.9%)。各证型症状比例有统计学差异(P<0.05)。除阴血亏虚证外,其他症状差异无统计学意义(P>0.05)。

结论

UC活动期以大肠湿热证、肝郁脾虚证、肠道瘀血证为主;缓解期以脾胃气虚证、脾肾阳虚证为主。

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