脓毒症胃肠功障碍中医证候分布规律探讨.pdf

提 要 目的：本研究旨在观察脓毒症胃肠功能障碍中医证候分布规律，了解其发病特点， 探讨其中医辨证规律。 方法：本研究共纳入脓毒症胃肠功能障碍患者80例，男性患者48例，女性患者 32 例。观察患者的临床症状体征，采集中医四诊信息，其中对患者症状体征分布采 用频次描述的方法进行研究，对证候分布运用聚类分析的方法进行研究。 结果：在统计的 80 例患者中，症状分布：腹胀、纳呆、便秘、泄泻、脘痞出现 频次最高，分别为78.8%、53.8%、50.0%、46.3%、43.8%；舌脉方面：黄苔、舌淡红、 薄苔、舌红、厚苔、腻苔出现频次最高，分别为65.0%、37.5%、36.3%、30.0%、30.0%、 28.8%，脉数、脉沉、脉弱、脉滑出现频次最高，分别为50.0%、26.3%、21.3%、17.5%。 证型分布：实证 63 例，占全部证型 78.8%，其中肠热腑实证 25 例，胃热气滞证 9 例，痰湿蕴脾证 23 例，瘀滞胃肠证 6 例，分别占全部证型的 31.3%、11.3%、28.8%、 7.5% 。虚证：脾胃气虚证 17 例，占全部证型 21.3% 。 结论：本研究结果表明脓毒症胃肠功能障碍的中医证候特点是实证与虚证并见， 以实证为主。实证以肠热腑实证、胃热气滞证、痰湿蕴脾证、瘀滞胃肠证多见，虚证 以脾胃气虚证多见。 关键词 脓毒症胃肠功能障碍；中医证候分布规律；聚类分析 Discussion of the Traditional Chinese Medical Syndrome of Sepsis with Gastrointestinal Dysfunction Speciality: Internal Medicine of TCM Author: Guo Qiyu Tutor: Professor Kong Li Abstract Objectives: This issue is to observe the TCM symptoms of sepsis with gastrointe- stinal dysfunction, to understand the disease characteristics and explore the laws of TCM syndrome differentiation. Methods: This study includes 80 cases, 48 males and 32 females.According to the four diagnostic methods of TCM,we gather all patients’ symptoms and analyze distribution of symptoms by frequency describing methods, syndrome by cluster analysis,to explore the laws of TCM syndrome differentiation of sepsis with gastrointestinal dysfunction. Results: Within the 80 cases in statistics, symptoms distribution: abdominal distension, nadai, constipation and diarrhea have the higher frequency, respectively taking up 78.8% 53.8%, 50.0%, 46.3%, 43.8% ；tongue and pulse: yellow moss, tongue reddish, thin moss and red tongue, thick moss, greasy moss have the higher frequency, respectively taking up 65.0%, 37.5%, 36.3%, 30.0%, 30.0%, 28.8%, rapid p