【作者】 马红霞；

【导师】 黄仲委；

【作者基本信息】 广州中医药大学 ， 中医眼科学， 2006， 硕士

【摘要】 目前生存质量的概念已经涉及到医学的各个领域,在眼科学却刚刚起步。眼科中视功能检查是临床工作中简便、快捷、重要的项目,许多眼疾的患者主要由于视功能的受损才就诊于眼科,而视功能的受损会明显影响患者的日常生活和工作。虽然目前眼科视功能的各项检测手段已经相当完善,但是在视功能和生存质量的相关性研究还是一个比较新的领域,本研究在明确前两者的关系的同时再进行中医的辨证分型,从而明确它们之间的相关性,本研究最终结论可能会涉及到医院社区以及家庭多个方面的改进和提高。 第一部分 文献研究 本文综述了医学领域对于健康,亚健康的概念,用于评定这些概念的量化指标多为生存质量量表。生存质量概念在医学的应用,并作为一种较全面体现新的健康观和医学模式的评价体系引入眼科领域,它是对传统视功能评价方法的补充。它与临床客观检查结果有机地结合,将为眼科工作者提供更全面信息,为眼科的临床试验和群体疾病干预评价提供新的综合评价指标。中医辨证施治重在明确辨证分型,从而调整全身脏腑经络气血功能。人体本身是一个和谐的整体,人体各脏腑组织之间在结构上不可分割,在功能上相互协调,从而维持机体正常的生理活动。健康是人与自然环境及社会之间的一种动态平衡,因而亚健康乃至疾病的产生即是阴阳动态平衡失调的结果。引起阴阳失调的原因主要有七情所伤、饮食劳倦、外邪侵淫等。中医眼科的辨证需要在全身辨证基础上再局部辨证辩病相结合。而全身的自觉症状,心理状态都可以给予相关的中医的辨证分型,所以从这个切入点可以将本研究观察的四种眼病与生存质量及中医辨证分型联系起来。通过翻译美国眼科研究所开发的国家眼科研究所视功能问卷(NEI-VFQ)来调查四种眼病视功能损害、中医辨证分型及生存质量的关系。 第二部分 临床资料统计和分析 1、研究目的:探讨视功能和生存质量以及中医辨证分型的相关性研究。 2、研究对象:本研究采用流行病学方法调查广州中医药大学第一附属医院眼科门诊及住院病例临床诊断明确患者263例,包括以下四种疾病:青光眼,白内障,黄斑变性,糖尿病视网膜病变。 3、研究方法:通过视功能问卷(NEI-VFQ—25)见附表1统计分析病情诊断明确,视功能不同程度受损的患者,计算生存质量平均得分,并予以中医辨证分型,并调查20例正常人得分情况得出结果。采用国际标准视力表得出双眼最好中心视力。分别按视功能分级、中医辨证分型、不同病症为标准分析生存质量平均得分的差异,并分析以上每两项的相关性。 第三部分 结论 被调查者的视功能不同程度受损其平均得分水平明显低于正常20例调查者的平更多还原

【Abstract】 At the present time, the concept of quality of life has been come down to various fields, but it develops lately in ophthalmology. The examinations of optical function are very simple, shortcut and important, lots of sufferers on eye disorders go to see doctors because of losing of eyesight, As we know, the losing of eyesight can obviously influence on the daily life and work. Although the examinational of methods on optical function are quite perfect, study on the relationship among the optical function and quality of life and TCM is a new researching field. This research are given Bianzhenfenxing of TCM in order to expound their relations, the finally conclusion may improve and heighten the reality of hospital, community, even family.Part one: Literature reviewThe part summarizes the concept of health and sub-health, now assessing these concepts of the measurement indexes are the tables using for quality of life. The concept of quality of life was turned into the ophthalmology field, acting as a kind of assessing system and acting as a completely embodying new the view of health and bio-psycho-social medical model. It is the complementarity to assessing the traditional optical function. The table of quality of life is combined with the results of impersonal clinical checks, which will supply with the full information to the eye doctors, which will supply with the new general assessing index for clinical experiments and controlling the epidemic disorders. The bianzhengshizhii of TCM is to study zheng, and adjust the function of body including zangfu and qixue. The human person is a tuneful integer no matter in function or structure, keeping the usual physiological activity. Health is a kind of homeostasis between natural condition and society, so the reason of sub-health ever disorders is that the homeostasis of the body is destroyed. There are many reasons, such as excessive strong feelings, too much eating or hungry, working hard or fatigue etc. The ophthalmology of TCM emphasize the combining the zheng of whole body with the local zheng of the eyes. Each one can be given bianzheng using TCM, no matter what the self-symptoms and mentality condition, so form this point we can relative the eye disorders with quality of life and biangzhengfenxing of TCM. According to translating The National Eye Institute 25-Item Visual Function Questionnaire, we can investigate the persons the relationship between the destroying of optical function and quality of life who suffer with the eye disorders.Part two: Statistic and analysis the clinical dataPurpose: to discus the relationship among optical function and quality of life and bianzhengfenxing of TCM. Objectives: the research using the methods of the epidemics to investigate the 263sufferers from the 1st hospital of Guangzhou TCM university, the eye disorders are glaucoma, cataract, age-related macular degeneration.Method: using the NEI-VFQ-25 statistic the final QOL scores of the sufferer, and give bianzhengfenxing of the TCM;Finishing and classifying the examination of the best eyesight between the 2 eyes, and analysis the relation between the random 2.Part 3 ConclusionThe final scores coming from the eyesight sufferers are below the ordinary persons’ scores. Among the 263 persons, even what kind of the 4 eye disorders, going with the optical function, the scores of QOL are downtrend. Statistic data show they are linear correlation. There are differences in the final scores because of the eyesight, bianzhengfengxing, disorders diagnosis, for example: eyesight<0.3,or between 0.4 and 0.6, the scores of pishengyangxu of TCM is the lowest;when the eyesight between 0.4 and 0. 6, and>0.9, the score of diabetic retinopahy is the lowest. When the eyesight is >0. 9, the score ganshenbuzu of TCM is the lowest.Between the 2 teams:gandanshire of TCM and ganshenbuzu of TCM, the score is the lowest which are diagnosed as AMD, and the other eye disorders have not any difference.Among the 4 eye disorder, the score of qizhixueyu of TCM is the lowest, and the score of pishengyangxu of TCM in diabetic retinopahy is also very low.更多还原