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題 名 | 系統性紅斑狼瘡患者體質研究 |
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作 者 | 蘇奕彰; | 書刊名 | 中醫藥年報 |
卷 期 | 15:1 1997.05[民86.05] |
頁 次 | 頁178-265 |
分類號 | 414.5 |
關鍵詞 | 系統性紅斑性狼瘡; 中醫; 體質; SLE; Chinese medicine; Physical constitution; |
語 文 | 中文(Chinese) |
中文摘要 | 本研究乃利用統計方法分析250位在台中榮民總醫院所記錄之系統性紅斑狼瘡患者 及 141 位正常對照組之資料。 主要目的在研究系統性紅斑狼瘡患者之中醫體質特性,及體 質類型與西醫臨床特徵之關係,同時也嘗試建立本病患者中醫體質問診診斷標準。結果以 t 檢定、卡方檢定及多變量分析中之多元尺度法,探討中醫體質類型與西醫臨床特徵之關係 ; 以因子分析及群落分析法,探討患者西醫臨床特徵分群與中醫體質類型之關係; 以及以潛 在變數模型,探討該病中醫體質分型的問診標準。本研究之結果顯示,在體質特性的探討上 ,本地一般國人之體質頻率以痰濕質及除處質患者最高; 系統性紅斑狼瘡患者之體質傾向為 陰虛質、瘀滯質和血虛質。我們亦發現,腎病症候群與血虛體質之關係最密切; 光敏感和陰 虛體質最密切; 口瘡與氣虛體質最密切; 而胸腹部症狀及神經症狀則與陽虛體質較相關。此 外,蝴蝶斑、口乾眼乾、雷諾氏現象及關節炎等症狀,歸於中醫病理性產物造成之痰濕與瘀 滯體質,在關係上並與陰虛及血虛質較接近。此外隨著合併體質類型複雜性之增加,疾病臨 床活動疫指數也隨之增加。在雙鏈抗核抗體 (anti-dsDNA)、補體三 (C3)、補體四 (C4) 上 ,單純瘀滯質患者表現較為正常,與其它體質類型比較 p<0.05 有統計差異。而在抗心脂抗 體 (Anticardiolipid antibody, ACA) 上, 陰虛質與瘀滯質的指標較高,兩者合併出現之 指數更高,但陰虛質合併瘀濕質之指數則較低,兩種合併型體質間 p<0.05 有統計上差異。 然而在比較患者西醫臨床體質分群上,並未能發現與中醫體質類型之規律性。最後在該病中 醫體質分型的問診標準上,我們修正了大陸學者之指標,並提出對診斷六種體質分型之問診 新基準。同時也發現:在本病患者中,若無失眠症狀,可排除為陰虛體質;無疼痛症狀,也 大約可排除瘀滯體質。這些研究結果,不僅有助於了解系統性紅斑狼瘡患者之體質特性,同 時對中醫跨越經驗醫學進入科學研究上,也是一項重要的嘗試。 |
英文摘要 | In this paper , we apply statistic method to analysis inquiring data of 250 systemic lupus erythematosus (SLE in short) patients and 146 normal people. Data of SLE patients were collected from Taichung Veterans General Hospital, Taiwan. We focus on the reationship ~etween clinical characteristic of West Medicine and physical constitutional types of Chinese Medicine. The results is analyzed with t-test,Chi-square test and multidimentional Scaling. The result indicates that: on the study of constitutional characteristic the distribution tendency of constitution for general public is predominant by Phlegm-Wetness type and Yin- Deficiency type; the constitution for SLE patients is more likely to be Yin- Deficiency type, Stasis type and Blood-Deficiency type. We also discover that patients with nephrotic syndrome are related to Blood-Deficiency type; patients with photosensitivity are related to Yin-deficiency; oral ulcer are related to Chi-Deficiency type;symptoms of chest, abdomen and nervous system are related to Yang-Deficiency type. Moreover, the symptoms of malar rash, dry mouth and eyes, raynaud phenomenon and arthritis are related to Phlegm-Wetness type and Stasis type of pathological constitution, they are also more close related to Yin-Deficiency type and Blood-Deficiency type. On top of that, as the complexity of mixture constitutional type increases, the Disease Activety Index increases as well. The behavior reflected on the anti-dsDNA, C3 and C4 serum levels for those single Stasis type SLE patients is more normal than other types, it also shows obvious differences on the serum levels from other constitutional types patients. As far as the anticardiolipid antibody level, the index is higher for Yin-Deficiency type and Satsis type; it is even higher with the combination of these two types. But the index is lower with the combination of Yin-Deficiency type and Phlegm-Wetness type These study results not only can help us understanding the constitutional characteristic of SLE patients, but also serve as a stepping stone for the integration of Chinese Medicine and modern West medicine. |
本系統中英文摘要資訊取自各篇刊載內容。