儿童多动症发病因素与中医证型研究.pdf

2.1 中医证候分布情况··································11 2.2 病因分布情况 ······································12 2.3 病因与中医证型的关系 ······························13 3.讨 论 ··········································14 3.1 中医学对儿童多动症的认识 ····················14 3.1.1 中医学对儿童多动症病名的认识 ·············14 3.1.2 儿童多动症中医病因病机 ····················15 3.1.3 儿童多动症中医病位病性 ····················15 3.1.4 儿童多动症中医辨证分型 ······················16 3.2 现代医学对儿童多动症的认识 ··················17 3.2.1 儿童多动症的概念 ····························17 3.2.2 儿童多动症西医病因 ··························17 3.3 儿童多动症病因与证型的关系分析 ··················19 4.存在的问题和展望 ································21 结 论 ·············································22 参考文献 ············································23 附录 ·················································26 调查表 ················································26 综 述 ················································32 致 谢 ················································41 攻读学位期间发表的学术论文目录 ··················42 作者声明 ·············································43 个人简历 ·············································44 2 中 文 摘 要 目 的：通过对儿童多动症发病因素及中医主要证型分布的 调查, 探讨发病因素与中医证型之间的关系，以期提高辨证治疗水 平，为开展中医防治儿童多动症提供参考依据。 方 法：2008年6月至2009年4月在广西中医学院第一附属医 院儿科门诊, 选择符合多动症诊断标准的患儿60例，进行发病因素与 中医主要证候的回顾性调查。根据调查表收集数据，运用PEMS3.1统 计软件，对数据进行卡方检验处理，分析儿童多动症患儿发病因素和 中医证型之间关系。 结 果：遗传因素有7例，占调查总人数的11.7%；孕期分娩 因素有55例，占调查总人数的91.7%；行为心理因素有45例，占调查 总人数的75.0%；家庭-社会环境污染因素有26人，占调查总人数的 43.3%；按中医分型：肾虚肝亢型有28例，占调查总人数的46.7%；心 脾不足型有20例，占调查总人数的33.3%；痰火扰心型有12人，占调 查总人数的20.0%。纳入研究的60例患儿中，肾虚肝亢型所占比例最 大，此型中孕期分娩因素和行为心理因素相对于遗传因素和家庭社会 环境因素（P ＜0.05 ）有显著意义；心脾不足型中孕期分娩因素与其 他3个因素相比较（P ＜0.05 ）有显著意义；而痰火扰心型中各因素无 显著差异。 结 论：本调查提示多动症患儿的发病原因往往不是单一 的，是遗传因素、孕期分娩因素、行为心理因素和家庭社会环境因素 等因素中的几个因素共同影响。肾虚肝亢型与孕期分娩因素和行为心 理因素内在联系密切，心脾不足型与孕期分娩因素内在联系密切，痰 火扰心型与以上4 个方面因素均有关。在运用中医治疗儿童多动症过 程中，详细了解其病因对辨证分型有一定的帮助，但根据症状特点、 舌象和脉象进行辨证更为重要。此外，儿童多动症与孕期