【作者】 刘光辉；

【导师】 李志英；

【作者基本信息】 广州中医药大学 ， 中医眼科学， 2006， 硕士

【摘要】 视神经炎(optic neuritis)指能够阻碍视神经传导功能,引起视功能一系列改变的视神经病变,如炎症、退变及脱髓鞘疾病等。祖国医学则根据其视力下降急缓程度归为“暴盲”或“视瞻昏渺”范畴。 视神经炎是临床常见的眼科疾病,治疗难度大,易致视神经萎缩而损害视功能。其病因十分复杂,迄今为止,发病机制尚不十分清楚,治疗上存在疗效不确切、易复发等缺点。目前研究认为,该病发病与情致有关。随着社会的发展,生活节奏的加快,压力的加大,视神经炎中心身性疾病有趋多之势。因此除对原发病进行治疗外,同时需对病人进行积极的心理干预,以促进疾病的康复。 本研究在综述眼科心身医学文献、视神经炎中西医文献,了解国内外视神经炎研究现状的基础上,观察了视神经炎的临床表现,量测了视神经炎患者的人格特征、行为类型,初步探讨了视神经炎患者的人格特征、行为类型的特点及其与中医证型的关系。 文献研究 参考国内外文献,综述了中医学对心身医学的认识,及中医学、心身医学、现代医学对视神经炎的研究现状。中医学认为本病的发生与七情、饮食、劳倦、热病、撞击伤目等有关,治疗上按辨证治疗规则,或分期论治,或分型论治,或者验方加减论治,但目前证候分型尚未统一,多以全身辨证作为辨证的依据。现代医学对本病病因病机认识尚不十分清楚,治疗上存在疗效不确切易复发的缺点,疾病的过程中与心身因素存在较大的联系。为探讨视神经炎患者的人格特征、行为类型及其与中医证型之间的联系,设计了本研究。 临床研究 目的:探讨视神经炎患者的人格特征、行为类型及其中医证型的特点,探讨其人格特征、行为类型与中医证型的关系,为视神经炎的临床防治提供依据。 方法:本研究采用组间对照、相互对照方法,对纳入本研究的89例视神经炎患者,按照视神经炎临床观察调查表登记患者的证候信息,测验视神经炎患者的人格特征和行为类型,结合视神经炎的证型,对比健康对照组30例,进行临床研究分析。 结果: 1、视神经炎证型中以肝经火盛、肝郁气滞两型为主,肝经火盛、肝郁气滞两证型累计占65.2%。性别构成中女性稍多于男性,男女比例约为1/1.34,男性占42.7%,女性占57.30%。在文化程度分布上,以初中高中文化为主,初高中文化段累计占62.9%。 2、视神经炎各证型在临床症状得分上存在显著性差异(P<0.05),肝经火盛、肝郁气滞两型得分较阴虚火旺型、气血两虚型两型均要高,但是肝经火盛型与肝郁气滞更多还原

【Abstract】 Optic neuritis is one kind of optic neuropathy that can interfere optic nerve conduct function and cause damage to optic nerve visual function, such as inflammation, cataplasia, demyelination. It belongs to the category of "sudden blindness" or "Shizhanhunmiao" in Tradition Chinese Medicine (TCM) according to pathogenetic condition.Optic neuritis, a familiar ophthalmologic disease in clinic, is difficult to cure. Because optic neuritis causes to optic nerve atrophy easily, it can damage visual function. Its cause is very complicated and pathogenesis is still not very clear up to now. Therapeutic effect is uncertain in treatment and the disease relapse easily. Study indicate optic neuritis relate with emotion adjustment. With the development of society, rhythm of life accelerating, more stress, optic neuritis gets more and more relation with emotion adjustment. Many doctor advice to give patient energetic mental intervention as well as drug treatment to primary disease, and help to cure optic neuritis.This research is based on referring a lot of references of optic neuritis from home and abroad, and being familiar with status quo of optic neuritis study. After have an observation of clinical manifestation of optic neuritis, measuring the patient’s personality characteristics, behavior type, we get an approach of relationship between the patient’s personality characteristics, behavior type and pattern of syndrome in traditional Chinese syndrome.Literature reviewBy referencing literature from home and abroad, we overview psychosomatic medicine in traditional Chinese medicine, treatment of optic in traditional Chinese medicine, psychosomatic medicine, modern medicine. TCM think optic neuritis may be caused by seven modes of emotions, food and drink, weary, pyreticosis, wound. And should be treated by dialectical, stages , groupingor effective medical prescription. But pattern of syndrome in traditional Chinese syndrome isn’ t united at present. Dialectical treatment is mostly based on symptoms all over the body. Optic neuritis’ s Etiopathogenisis and pathogenesis is uncertain in, modern medicine up to now, optic neuritis’ s therapeutic effect is also certain, so it is easily recrudescent after treatment. Now researcher find it that there is something connect optic neuritis with mind and physique in course of the disease,, To discovery the association in the patient’ s personality characteristics, behavior type and pattern of syndrome in traditional Chinese syndrome, we design this research.Clinic studyPurpose: Discovery optic neuritis patients’ personality characteristics, behavior type, characteristics of pattern of syndrome in traditional Chinese syndrome and the association in these three to offer help to prevention and cure of optic neuritis in clinic.Methods: The research is based on a contrast between optic neuritis group and healthy group. The authors have got the information of 89 optic neuritis patients’ personality characteristics, behavior type and pattern of syndrome in traditional Chinese syndrome compared with 30 healthy people through a clinical observation. Then the authors have made a clinical research above the information.Result:K "Hyperactivity of fire in the liver meridian" and "stagnation of QI due to depression of the liver" are the main types of syndrome of optic neuritis in Traditional Chinese Medicine. They take a percentage of 65. 2%. The proportion of female patients who take a percentage of 57. 30% is a little higher than male patients who take a percentage of 42. 7%. The ratio between male and female is 1/1. 34. Most of the optic neuritis patients who take a percentage of 62. 9% only have educational background of high school .2> There is a significant difference in scores between each clinic patternof syndrome of optic neuritis(P<0.05), the scores of "hyperactivity of firein the liver meridian" and "stagnation of QI due to depression of the liver"are higher than of "hyperactivity of fire caused by deficiency of YIN" and"deficiency of both QI and blood" .However, there is no difference in"hyperactivity of fire in the liver meridian" and "stagnation of QI dueto depression of the liver" , "hyperactivity of fire caused by deficiencyof YIN" and "deficiency of both QI and blood" .3> The scores of the patients of P, E, N, L in EPQ measuring scale are higher than health control group to some degree. Compared with healthy control group, the score of N, L of "hyperactivity of fire in the liver meridian" and "stagnation of QI due to depression of the liver" is in highly significant difference (P<0. 01);the score of N of "hyperactivity of fire in the liver meridian" and "stagnation of QI due to depression of the liver" is in highly significant difference (P<0. 01);the score of N of "hyperactivity of fire in the liver meridian" and "stagnation of QI due to depression of the liver" is in significant difference (P<0.05) .But there is no difference in each pattern of syndrome of optic neuritis (P>0.05) , in the score of P, E in EPQ measuring scale of patient group and healthy control group (P>0.05) .4, There is a significant difference in constituent ratio of behavior typeA and behavior type B in the group of optic neuritis and health control group(P<0. 05) . Most of the patient groups are characterized with behavior typeA. However, there is no significant difference inside the patient group(P>0. 05)5n The scores of behavior type A in measuring scale rise in different degrees in the syndrome of optic neuritis group contrasted with the healthy control group. Of them, people who have "hyperactivity of fire in the liver meridian" , "hyperactivity of fire caused by deficiency of YIN" and "deficiency of both QI and blood" have obvious differences in TH value, CH value, TH+CH value (P<0.05);people who have "stagnation of QI due to depression of the liver" have very obvious differences in TH value and TH+CH value (P<0. 01) and obvious in (P<0. 05). Each type of syndrome of optic neuritis group has no obvious difference in TH value, CH value and TH+CH value (P>0. 05) .6> There is a positive correlation between the score of optic neuritis and the behavior type A of syndrome of optic neuritis patients at the level of P=0. Ol.Of them the coefficient correlation with TH value is 0.672, 0.701 with CH value and 0.752 with TH+CH value.Conclusion:K Middle-aged and youths are susceptible because the heavy psychological burden they bear is a dangerous factor of the onset of the optic neuritis.2> "Hyperactivity of fire in the liver meridian" and "stagnation of QI due to depression of the liver" are the main types of syndrome of opticneuritis. Simultaneously, it is also with "hyperactivity of fire caused by deficiency of YIN" and "deficiency of both QI and blood" and "disproportion of liver" during the whole process of optic neuritis.3> Optic neuritis group are easy to be irrated , nervous, anxious and annoyed.They have serious psychological burden as well. Of them people who have "hyperactivity of fire in the liver meridian" and "stagnation of QI due to depression of the liver" have more psychological burden than the others .These are the dangrous factors of the onset of the optic neuritis4> The group of optic neuritis patients are ill-tempered and have more consciousness of competition than normal people. Optic neuritis has an obvious relation with behavior type A. These are the dangerous factors of the optic neuritis.5, Behavior type of optic neuritis has relation with subjective sensory symptoms of optic neuritis patients, which has a certain effect on the degrees of subjective sensory of symptoms. The patient with behavior type A has serious symptoms and psychological burden.更多还原