425例排卵型功血患者证型分布的临床流行病学调查-马惠荣

200811316Nov.2008Vo.l31No.6JournalofShaanxiCollegeofTraditionalChineseMedicine#11#425*1**2222(1.河北医科大学,河北石家庄050091;2.湖南中医药大学,湖南长沙720501):目的调查有排卵型功血患者中医辨证分型的状况,为开展中医药防治提供科学依据和对策方法采用临床流行病学横断面调查的方法,对425例排卵型功血患者的中医证型进行问卷调查,了解排卵型功血的辨证分型情况结果425例排卵型功血患者中,证型构成比由大到小排列次序为:含肾虚证者含热证者含脾虚证者含肝郁证者含血瘀证者含血虚证者且2种证型组合的排卵型功血患者构成比最大结论在中医理论指导下,保护脾胃和肾的功能,将有助于防止和减少排卵型功血的发生:排卵型功血;临床流行病学调查;证型分布:R271.11R195.4:A:1002-168X(2008)06-0011-04ClinicalEpidemiologicalsurveyonContributionLawofTCMSyndromePatternof425OvulatoryDysfunctionalUterineBleedingPatientsMaHuirong1WangRuoguang2YinXianghua2ZhaoXinguang2YouZhaoling2(1.HebeiMedicalUniversity,Hebe,iShijiazhuang050091;2.HunanUniversityofTCM,Changsha,Hubei720501)Abstract:Aim:tostudycontributionlawofTCMsyndromepatternof425ovulatorydysfunctionaluterinebleedingpatientsandprovidescientificbasisandmeasurestocarryoutTCMpreventionandtreatment.Method:cross-sectionalsurveyofclinicalepidemiologywasusedandquestionnaireofTCMsyndromepatternswereinvestigatedon425ovulatorydysfunctionaluterinebleedingpatientstounderstandcontributionlawofTCMsyndromepatterns.Result:Among425ovu-latorydysfunctionaluterinebleedingpatients,constitutionalratiois:kidneydeficiencypatternheatpatternspleendef-iciencypatternliverstagnationpatternbloodstasispatternbloodstasispattern,andcombinationoftwopatternsaremorethananyoftheabove.Conclusion:UndertheguidanceofTCMtheory,protectionofspleen,stomachandkidneyfunctionwillbehelpfultopreventandreduceoccurrenceofvulatorydysfunctionaluterinebleeding.Keywords:vulatorydysfunctionaluterinebleeding,clinicalepidemiologysurvey,contributionlawofTCMsyn-dromepattern.(DUB),--,,,***:十一五国家科技支撑计划(2007BAI20B016),湖南省教育厅重点项目(05A031),湖南省博士后基金(2007RS4020),湖南中医药大学中诊教研室资助(ZD200705):马惠荣(1970-),女,副教授,湖南中医药大学博士后研究人员,主要从事中医妇科证候研究200811316#12#JournalofShaanxiCollegeofTraditionalChineseMedicineNov.2008Vo.l31No.6,2007425,11.1病例来源425(1),20071~121.2纳入排除标准1.2.1纳入标准,,1.2.2排除标准¹;º;»;¼;¼1.3中医辨证标准5##6[1]56[2]56[3]1.4调查方法1.4.1质量控制,,,;;1.4.2现场调查,,,,22.1425例有排卵型功血患者年龄分布状况42511~52,31.88,11~164,0.94%;16~2126,6.12%;21~2659,13.88%;26~31105,24.71%;31~3687,20.47%;36~4172,16.94%;41~4659,13.88%;4613,3.06%,26~3645.18%;21~4689.98%2.2425例有排卵型功血患者中医证型分布状况2.2.1425例有排卵型功血患者中医证型总体分布状况:23411425例排卵型功血患者的各证型分布状况证型频数构成比(%)单一证型12228.712种证型组合23555.293种证型组合6314.824种证型组合51.18合计425100.002.2.2425例有排卵型功血中单一证型分布状况122,28.71%:,(++)39,9.18%;38,8.94%22425例排卵型功血患者的单一证型分布状况证型频数构成比(%)证型频数构成比(%)脾气虚388.94实热92.12肾气虚153.53虚热51.18肾阴虚143.29肝郁40.94肝郁化热133.06湿热30.71肾阳虚102.35血虚10.24血瘀102.352.2.3425例有排卵型功血患者中2种证型的分布状况2235,55.29%:===(),()162,38.1%,()66,15.5%,(200811316Nov.2008Vo.l31No.6JournalofShaanxiCollegeofTraditionalChineseMedicine#13#)82,19.3%;42,9.88%;16,3.76%33425例排卵型功血患者的2证型组合的分布状况证型频数构成比(%)证型频数构成比(%)证型频数构成比(%)肾气虚肝郁化热378.71血虚实热51.18肾阳虚脾气虚20.47肾阳虚血瘀184.24肾气虚血瘀51.18肾气虚血虚20.47肾气虚脾气虚163.76肾气虚虚热51.18肝郁血瘀20.47脾气虚虚热163.76血瘀实热51.18肝郁血虚20.47肾阴虚血瘀133.06脾气虚肝郁化热51.18肾阴虚肝郁20.47肾阳虚血寒112.59脾气虚血虚40.94血瘀血寒10.24肾气虚肝郁102.35脾气虚痰湿40.94血虚血瘀10.24脾气虚肝郁102.35肾阴虚脾气虚40.94虚热痰湿10.24肾阴虚虚热92.12肾阳虚血寒30.71肾阴虚血虚10.24肾阴虚肝郁化热81.88脾气虚血瘀30.71肾阴虚痰湿10.24肾阴虚实(湿)热81.88血瘀肝郁化热20.47肝郁虚热10.24肾阳虚血虚71.65虚热肝郁化热20.47肝郁化热血寒10.24脾气虚实热61.41实热痰湿20.472.2.4425例有排卵型功血患者中3种证型组合的分布状况363,14.82%:===,351,12%;323,5.41%;323,5.14%;29,6.82%;33,7.76%44425例排卵型功血患者的3证型组合的分布状况证型频数构成比(%)证型频数构成比(%)证型频数构成比(%)肾气虚肝郁血瘀61.41肾阳虚脾气虚血虚20.47肾阴虚虚热血虚10.24肾阴虚肝郁血瘀61.41肾阳虚肝郁血虚20.47肾阴虚脾气虚肝郁10.24肾阴虚脾气虚血虚51.18肾气虚脾气虚肝郁20.47肾阴虚肝郁血虚10.24肾阴虚虚热脾气虚40.94肝郁脾气虚痰湿20.47肾阳虚肝郁血寒10.24肾阳虚血虚血瘀40.94血瘀实热痰湿10.24肾气虚血虚痰湿10.24脾气虚血虚血瘀40.94肝郁化热血虚血瘀10.24肾气虚脾气虚血虚10.24肾气虚血虚血瘀30.71血虚肝郁血瘀10.24肾气虚肝郁化热血瘀10.24肾气虚脾气虚实(湿)热30.71肾阴虚血虚血瘀10.24脾气虚血瘀实热10.24肾气虚肝郁血虚30.71肾阴虚虚热血瘀10.24肝郁脾气虚血瘀10.24肾阴虚血虚实(湿)热20.47肝郁脾气虚血虚10.242.2.3425例有排卵型功血患者中4证型组合的分布状况45,1.18%,5,4,2,4,352.2.4各证型中包兼有肾虚脾虚肝郁血瘀血虚热证证型的总体分布425,:265425例排卵型功血患者的4证型组合的分布状况证型频数构成比(%)肾气虚脾气虚肝郁血瘀10.24肾阴虚肝郁血虚血瘀10.24肾阳虚肝郁血虚血瘀10.24肾阳虚肝郁血瘀血寒10.24肾气虚脾气虚血虚痰湿10.24合计51.18200811316#14#JournalofShaanxiCollegeofTraditionalChineseMedicineNov.2008Vo.l31No.66排卵型功血患者各证型中含肾虚脾虚肝郁血瘀血虚热证的分布状况证型兼肾虚证者兼热证者兼脾虚证者兼肝郁证者兼血瘀证者兼血虚证者合计单一证型393038171011352种证型组合162111708245204903种证型组合5114272930311824种证型组合50244318合计25715513713289558253(),,--/0(),---,26~3642545.18%;21~4689.98%,21~46[1]:(),(),()/,,,,,,,,,,,,,0(56),/0/0/0/0,/,,0[5],,,/0,,,(),(),,,[6];,,[7];30,[8];()63,[9],,,,,,,,,,,,,,[1]国家技术监督局.中国人民共和国国家标准#中医临床诊疗术语#证候部分[M].北京:中国标准出版社,1997.[2]国家中医药管理局.中华人民共和国中医药行业标准#中医病证诊断疗效标准[M].北京:南京大学出版社,1994.[3]尤昭玲.中西医结合妇产科学[M].北京:中国中医药出版社,2006:425-441.[4]曹泽毅.中华妇产科学(下册)[M].2版.北京:人民卫生出版社,2007:2391,2396.[5]刘敏如,谭万信.中医妇产科学[M].北京:人民卫生出版社,2001:243.[6]李雯,赵雅萍,丁红香,等.有排卵型功能失调性子宫出血临床辨证研究[J].中医药学刊,2004,22(10):1842-1843.[7]杜惠兰,闫华,白凤楼,等.补肾调经系列方周期给药治疗功能失调性子宫出血的临床研究[J].中国中西医结合杂志,2003,23(3):178-181.[8]薛勤梅,马桂文.缩宫逐瘀汤治疗血瘀型月经不调的临床与实验研究[J].光明中医,2003,18(2):53-55.[9]刘华晓,张艳玲.举元煎加味治疗功能性子宫出血63例[J].陕西中医,2007,28(11):1524-1525.(收稿日期:2008-09-02)