【作者】 蔡秋梅；

【导师】 李灿东；

【作者基本信息】 福建中医学院 ， 中医诊断学， 2007， 硕士

【摘要】 本文采用证素辨证方法，分年龄段深入探讨中老年女性生理病理基础、证素特点及各年龄段之间证素差异，以进一步完善中老年女性生理病理理论，为临床中老年女性保健，疾病预防以及诊断治疗提供基础研究和新思路。(一)研究方法采用流行病学调查研究方法，以323例健康体检者作为观察对象，进行四诊资料采集、证素辨证，并根据医学统计学原理进行统计分析。(二)结果1．323例调查对象中肝的证素频数最多，为56例，平均积分84.7±58.5，经检验，差异非常显著(P＜0.01)，证素属肾的频数次之，为33例，积分47.1±37.4，经检验，差异非常显著(P＜0.01)。2．五脏证素年龄分组研究中，35～41岁51例，42～48岁111例，49～55岁98例，56～63岁63例。各组按积分分级统计提示各分组中肝的证素积分均显著高于其它四脏，经检验，差异非常显著(P＜0.01)。肾的证素积分除35～41岁组与肺无显著差异外，其它各组肾与其它证素积分皆有显著差异(P＜0.01)。3．将五脏证素分别按年龄段分组统计其分级频数、均分，各年龄段间进行差异性分析。五脏之中肾的56～63岁组与第一、二组有显著差异(P＜0.05)，其它各脏年龄段间均无显著差异。4．在病性证素的描述性统计中将各病性证素中1级、2级频数高者进行进一步统计分析。其中阴虚证素积分最高，平均83.2±44.3分，经检验，差异非常显著(P＜0.01)。5、在证型组合分析中，肝阴虚比例最大，为33.9％，经检验，差异非常显著(P＜0.01)肝郁证比例次之，为17.4％，差异显著；肾病证素中，肾阴虚比例最大，为53.6％，经检验，差异非常显著(P＜0.01)。(三)结论(1)七七之前脏腑衰退主在肝；“七七”年龄段肝气衰退最明显。(2)七七之后脏腑衰退主在肝肾。(3)阴虚为中老年女性衰老的主要生理病理基础。通过临床研究，初步探讨了中老年女性证素分布的特点及各年龄段之间的差异，探讨了中老年女性的生理病理基础，应用证素积分方法进行辨证，为临床中老年女性保健，以及中老年女性疾病的预防、诊断治疗提供基础研究。更多还原

【Abstract】 In this paper, the pathology and distribution of symptom elements in different age gradesof mid-aged and old femme were studied by syndrome differentiation according to symptomelements differentiation, which supplementing the deficiency of physiological andpathological theory of mid-aged and old femme, and also providing a basic research and newidea for the prevention, health protection, diagnosis and treatment for women in this period.323 healthy mid-aged and old femme selected after medical examination were observedthrough epidemiological research whose symptoms and signs were collected and analyzed, bystatistics the results showed that:1. Of all the 323 cases, 56 were located in the liver with an average point of 84.7±58.5,followed by kidney, accounting 33 cases at an average point of 47.1±37.4(P＜0.01),which indicated that liver is the mainly disease location in those observed. 2.When analyzed according to different age grade, 51 cases distributed in 35～41 aged group,111 in 42～48 group, 98 in 49～55 group, and 63 in 56～63 group. Result turned out that the liverand kidney got a notable higher point than other four zang organs(P＜0.01) excepting in 35～41 aged group kidney had no significant different points with the lung’s, which directed thatliver and kidney act an important part in the aging process of mid-aged and old femme. 3. Inresearch of all the five zang organs according to different age grade, only kidney in 56～63group have significant difference point with its other three groups, indicating that liver issignificant in women’s senescence of all the age grade, while kidney enhancing its effectthrough aging but not measured up as symptom elements in the observed. 4.In the study of thecharacter of disease, cases with point higher than 70 were selected for a further statistic, and the result was that yin asthenia got the highest point of 83.2±44.3(P＜0.01), explaining thatyin asthenia is the principle character of disease in mid-aged and old femme. 5. Concernedboth the location and character of each object, deficiency of liver-YIN got the highest ratio of33.9％, followed by depression of liver-QI with 17.4％(P＜0.01) in syndrome differentiation.And of all the syndrome in kidney, deficiency of kidney-YIN got the highest ratio of53.6％(P＜0.01).This paper studied on the feature of symptom elements and its disparities among differentage grades, developed the physiological and pathological theory of mid-aged and old femmethrough syndrome differentiation according to symptom elements, and also set some sectionson the defect of the research, which providing a foundation for the prevention, healthprotection, diagnosis and treatment for women in this period.更多还原