【作者】 赵立凝；

【导师】 周福生；

【作者基本信息】 广州中医药大学 ， 中西医结合临床， 2005， 硕士

【摘要】 研究目的:慢性浅表性胃炎为临床常见病,多发病,在中医辨证分型上以脾虚证多见,鉴于脾虚证诊断标准的多样性,通过对慢性浅表性胃炎脾虚证患者的临床症状调查,初步建立慢性浅表性胃炎脾虚证诊断标准,以规范临床对慢性浅表性胃炎脾虚证的诊断,进而探讨病、证(症)的相关性。并以反证法即通过以药测证证明所建立的慢性浅表性胃炎脾虚证诊断标准的可行性。 研究方法:本研究在文献研究及前期预试调查分析的基础上,结合有关诊断标准及临床实际,确立慢性浅表性胃炎脾虚证临床症状调查问卷,并采用调查研究和判别分析的方法对123例慢性浅表性胃炎患者进行研究,初步建立慢性浅表性胃炎脾虚证的诊断标准。同时,采用以药(方)测证的研究方法,对42例慢性浅表性胃炎脾虚证患者的治疗疗效观察,分别对脾胃所脾虚证诊断标准、中药新药脾虚证诊断标准和慢性浅表性胃炎脾虚证诊断标准进行比较,以进一步验证所建立的慢性浅表性胃炎脾虚证诊断标准的正确性、可行性。 成果: 1、建立了慢性浅表性胃炎脾虚证与非脾虚证鉴别诊断标准 将所有72例脾虚证与51例非脾虚证患者的症状量化积分,进行判别分析,得出鉴别慢性浅表性胃炎脾虚证与非脾虚证的主要因素判别函数方程。 D=—1.349+1.816(食后胀满)+1.252(脉细)+1.681(舌胖大齿痕)+0.902(脉细弱)+0.745(胃脘疼痛)+0.558(肢体倦怠)+0.464(口淡)+0.234(面色萎黄)+0.206(大便溏)+1.497(舌质淡)+0.783(舌苔薄白)+0.139(脉细弦)—0.247(胃脘胀满)—1.602(神疲懒言)—0.250(口泛清涎) 由判别函数方程可知:食后胀满、脉细或细弱、舌胖大齿痕、胃脘疼痛、肢体倦怠、口淡、面色萎黄、大便溏、舌质淡、舌苔薄白、脉细弦权重系数为正值,在脾虚证的诊断中占重要地位;而胃脘胀满、神疲懒言、口泛清涎则为负值,在非脾虚证的诊断中占重要地位。 2、建立了慢性浅表性胃炎脾虚证诊断标准 根据判别方程式中各症状积分的权重系数,提取主要因素,进行进一步的判别更多还原

【Abstract】 Purpose: Chronic superficial gastritis is a common and frequently-encountered disease in clinic. The deficiency of spleen is a familiar syndrome in TCM .Whereas the diagnostic criterions about the deficiency of spleen are multifarious. By investigating to the clinic symptom, the diagnostic criterion was established on deficiency of spleen about chronic superficial gastritis. And the relativity among disease, syndrome and symptom was discussed.Methods: The method of combination disease with syndrome (symptom) was adopted. In base of literature research and pre-investigation and analysis to chronic superficial gastritis of deficiency of spleen, and according to the interrelated diagnostic criterion and clinical practice, the survey questionnaire was established about clinical symptom of deficiency of spleen about chronic superficial gastritis. By the survey and the method of distinguish analysis about 123 cases of chronic superficial gastritis sufferers, the diagnostic criterion was primarily established on deficiency of spleen about chronic superficial gastritis. The method of syndrome controlling by TCM was adopted. By being observed the curative effect of 42 cases of chronic superficial gastritis patients and comparing the three different criterions on deficiency of spleen validated the diagnostic criterion on deficiency of spleen about chronic superficial gastritis which is correct and feasible.Results:1. The differentiating diagnostic criterion between deficiency and adequacy of spleen in chronic superficial gastritis has been established.By quantity and integral to symptom of the 72 cases of deficiency of spleen and the 52 cases of adequacy of spleen, the method of distinguish analysis was adopted to educe equation of distinguish function equation.D=-1. 349+1. 816 (fullness in the stomach after meal) +1. 252(slender pulse)+1.681 (corpulent tongue) +0.902 (slender and fragile pulse) +0. 745(stomachache) +0. 558 (myastheniaof limbs) +0.464(bland taste in the mouth) + 0.234(fade and primary complexion) + 0.206(loose stool) + 1.497(pale tongue)+0. 783(thin and white fur)+0.139 (slender and string pulse) —0.247 (fullness in the stomach) — 1.602 (tired and lazy) — 0.250(clear saliva in the mouth)According to the distinguish function equation we can draw the conclusion that all the coefficient of the symptoms of fullness in the stomach after meal, slender pulse or slender and fragile pulse, corpulent tongue, stomachache, myasthenia of limbs, bland taste in the mouth, fade and primary complexion, loose stool, pale tongue, thin and white fur and slender and string pulse is positive number. So they are on the important place. But the coefficient of the symptoms of fullness in the stomach, tired and lazy and clear saliva in the mouth is negative, so they are on the unimportant place in deficiency of spleen.2. The diagnostic criterion about deficiency of spleen in chronic superficial gastritis has been established.According to the coefficient of the distinguish function equation we drew the important factors to do the more distinguish analysis and educe the distinguish function equation of deficiency of spleen in chronic superficial gastritis.Y=-13.973+6.655 (fullness in the stomach after meal) + 3.497(corpulent tongue)+3. 267 (pale tongue) +2.293 (slender pulse) + 2.115(slender and fragile pulse)+1. 775(thin and white fur) +1. 575(stomachache)+1. 139 (myasthenia of limbs) +1.086 (bland taste in the mouth) +1.058(fade and primary complexion)+0.983 (loose stool) +更多还原