原发性青光眼与中医肝郁体质关系的研究
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摘要
目的观察原发性青光眼与中医肝郁体质特征的关系,为原发性青光眼的早期预防和已发生青光眼视神经保护的治疗提供依据。方法研究对象为2014年3月—2017年3月就诊于黑龙江中医药大学附属第一医院眼科并确诊为原发性青光眼的患者265例,通过比较原发性青光眼类型、性别、年龄及肝郁程度的相互关系,探讨原发性青光眼体质及其内涵。结果原发性青光眼的类型比例分布为原发性闭角型青光眼(PACG)81.51%,原发性开角型青光眼(POAG)16.60%和正常眼压性青光眼(NTG)1.89%,三种类型均以肝郁证为主(≥60.00%);不同类型的原发性青光眼患病率均女性多于男性(P<0.05),女性比男性原发性青光眼患者中肝郁证占比更大(P<0.05);PACG以老年患者多见,POAG和NTG以中青年患者多见,三种类型均以中、轻度肝郁证占比较大;90.96%符合肝郁证的原发性青光眼患者从小性格急躁易怒。结论原发性青光眼的发生、发展与肝郁证密切相关,发病前既有肝郁体质,发病后也多表现为肝郁证的体质特征。肝郁证是原发性青光眼人群的主流体质。
OBJECTIVE To observe the relationship between primary glaucoma and liver depression constitution in Traditional Chinese Medicine in order to provide basis for the early pre-vention of primary glaucoma and protection of optic nerve in glaucoma. METHODS A total of265 primary glaucoma patients treated in first affiliated hospital, Heilongjiang University of Chinese Medicine from March of 2014 to March of 2017 were included in the study. The type of primary glaucoma, gender, age and the degree of liver depression were analyzed to study the body constitution of glaucoma and its connotation. RESULTS The distribution proportion of different primary glaucoma types was that primary angle closure glaucoma(PACG) accounted for 81.51%,primary open angle glaucoma(POAG) accounted for 16.60%, and normal tension glaucoma(NTG)accounted for 1.89%. Different types of primary glaucoma were dominated by liver depression syndrome(≥60.00%). The female morbidities of different types of primary glaucoma were all higher than male(p<0.05) and liver depression syndrome of different types of primary glaucoma was more common in female than in male(p<0.05). In PACG cases, the aged people was prevalent, while in POAG and NTG cases, young people and middle-aged people were most commonly groups. The moderate and mild liver depression syndrome were most common cases in the three types of glaucoma. The 90.96% of primary glaucoma patients with liver depression syndrome had bad temper from childhood. CONCLUSIONS The occurrence and development of primary glaucoma was closely related to liver depression syndrome. For the patients were in liver depression constitution before its onset and still showed features of liver depression after development of the disease. Liver depression syndrome was the most common body constitution in primary glaucoma.
OBJECTIVE To observe the relationship between primary glaucoma and liver depression constitution in Traditional Chinese Medicine in order to provide basis for the early pre-vention of primary glaucoma and protection of optic nerve in glaucoma. METHODS A total of265 primary glaucoma patients treated in first affiliated hospital, Heilongjiang University of Chinese Medicine from March of 2014 to March of 2017 were included in the study. The type of primary glaucoma, gender, age and the degree of liver depression were analyzed to study the body constitution of glaucoma and its connotation. RESULTS The distribution proportion of different primary glaucoma types was that primary angle closure glaucoma(PACG) accounted for 81.51%,primary open angle glaucoma(POAG) accounted for 16.60%, and normal tension glaucoma(NTG)accounted for 1.89%. Different types of primary glaucoma were dominated by liver depression syndrome(≥60.00%). The female morbidities of different types of primary glaucoma were all higher than male(p<0.05) and liver depression syndrome of different types of primary glaucoma was more common in female than in male(p<0.05). In PACG cases, the aged people was prevalent, while in POAG and NTG cases, young people and middle-aged people were most commonly groups. The moderate and mild liver depression syndrome were most common cases in the three types of glaucoma. The 90.96% of primary glaucoma patients with liver depression syndrome had bad temper from childhood. CONCLUSIONS The occurrence and development of primary glaucoma was closely related to liver depression syndrome. For the patients were in liver depression constitution before its onset and still showed features of liver depression after development of the disease. Liver depression syndrome was the most common body constitution in primary glaucoma.
引文
[1]王琦.中医体质学[M].北京:中国科技医药出版社,1995.
[2]WEINREB R,AUNG T,MEDEIROS F.The pathophysiology and treatment of glaucoma:a review[J].JAMA,2014,311(18):1901-1911.
[3]李春湘,彭清华.原发性闭角型青光眼患者A型行为及人格特征的调查[J].辽宁中医学院学报,2001,3(3):174-177.
[4]DINIZ-FILHON A,ABE RY,CHO HJ,et al.Fast visual field progression is associated with depressive symptoms in patients with glaucoma[J].Ophthalmology,2016,123:754-759.
[5]ZHOU C,QIAN S,WU P,et al.Anxiety and depression in Chinese patients with glaucoma:sociodemographic,clinical,and self-reported correlates[J].Psychosomatic Research,2013,75(1):75-82.
[6]ZHANG X,OLSON DJ,LE P,et al.The Association Between Glaucoma,Anxiety,and Depression in a Large Population[J].American Journal of Ophalmology,2017,183:37-41.
[7]中华医学会眼科学分会青光眼学组,中华医学会中华眼科杂志编辑委员会.我国原发性青光眼诊断和治疗专家共识(2014)[J].中华眼科杂志,2014,50(5):382-383.
[8]中华医学会眼科学分会青光眼学组,中华医学会中华眼科杂志编辑委员会.我国原发性青光眼诊断和治疗专家共识[J].中华眼科杂志,2008,44(9):862-863.
[9]李灿东.中医诊断学[M].4版.北京:中国中医药出版社,2016:170-171.
[10]周敬林.古今中医对青光眼的认识[D].济南:山东中医药大学,2010.
[11]陈达,梁远波,李杜军.原发性青光眼与中医体质学相关性初探[J].湖北中医杂志,2014,36(4):31-33.
[12]于静,桑景荭,王怀洲,等.原发性开角型青光眼患者的中医体质特征研究[J].中国中医眼科杂志,2016,26(5):298-301.
[13]NAKAGAMI T,YAMAZAKI Y,HAYAMIZU F,et al.Effect of ocular hypotensive medications in preventing the progression of visual field damage in patients with normal-tension glaucoma[J].Nippon Ganka Gakkai Zasshi,2004,108(7):408-414.
[14]FRIEDMAN M,ROSENMAN RH.Association of specific overt behavior pattern with increase in blood cholesterol,blood clotting time,incidence of arcus senilis and clinic coronary artery disease[J].JMAM,1959,2169:1286-1296.
[15]陈仲庚,张雨新.人格心理学[M].沈阳:辽宁人民出版社,1986.
[16]VIRTANEN R,JULA A.Anxiety and hostility are associated with reduced baroreflex sensitivity and increased beat-to-beat blood pressure variability[J].Psychosomatic Med,2003,65(5):751-756.
[17]孙河,刘吉年,王国贤.绿风内障的辨证分型及疗效观察[J].中医药信息,1992,(5):33-34
[18]THAM Y C,LI X,WONG T Y,et al.Global prevalence of glaucoma and projections of glaucoma burden through 2040:a systematic review and meta-analysis[J].Ophthalmology,2014,121:2081-2090.
[19]QU W,LI Y,SONG W,et al.Prevalence and risk factors for angleclosure disease in a rural Northeast China population:a populationbased survey in Bin County,Harbin[J].Acta Ophthalmol,2011,89(6):e515-20.
[20]HE M,FOSTER P,GE J,et al.Prevalence and clinical characteristics of glaucoma in adult Chinese:a population-based study in Liwan District,Guangzhou[J].Invest Ophthalmol Vis Sci,2006,47(7):2782-2788.
[21]文雯.青光眼住院病人构成及其变化[D].乌鲁木齐:新疆医科大学,2007.
[22]王银燕.535例青光眼门诊患者的构成及特点分析[D].济南:山东大学,2013.
[23]王济,王琦.中医体质研究与4P医学的实施[J].中国中西医结合杂志,2012,32(5):693-695.
[2]WEINREB R,AUNG T,MEDEIROS F.The pathophysiology and treatment of glaucoma:a review[J].JAMA,2014,311(18):1901-1911.
[3]李春湘,彭清华.原发性闭角型青光眼患者A型行为及人格特征的调查[J].辽宁中医学院学报,2001,3(3):174-177.
[4]DINIZ-FILHON A,ABE RY,CHO HJ,et al.Fast visual field progression is associated with depressive symptoms in patients with glaucoma[J].Ophthalmology,2016,123:754-759.
[5]ZHOU C,QIAN S,WU P,et al.Anxiety and depression in Chinese patients with glaucoma:sociodemographic,clinical,and self-reported correlates[J].Psychosomatic Research,2013,75(1):75-82.
[6]ZHANG X,OLSON DJ,LE P,et al.The Association Between Glaucoma,Anxiety,and Depression in a Large Population[J].American Journal of Ophalmology,2017,183:37-41.
[7]中华医学会眼科学分会青光眼学组,中华医学会中华眼科杂志编辑委员会.我国原发性青光眼诊断和治疗专家共识(2014)[J].中华眼科杂志,2014,50(5):382-383.
[8]中华医学会眼科学分会青光眼学组,中华医学会中华眼科杂志编辑委员会.我国原发性青光眼诊断和治疗专家共识[J].中华眼科杂志,2008,44(9):862-863.
[9]李灿东.中医诊断学[M].4版.北京:中国中医药出版社,2016:170-171.
[10]周敬林.古今中医对青光眼的认识[D].济南:山东中医药大学,2010.
[11]陈达,梁远波,李杜军.原发性青光眼与中医体质学相关性初探[J].湖北中医杂志,2014,36(4):31-33.
[12]于静,桑景荭,王怀洲,等.原发性开角型青光眼患者的中医体质特征研究[J].中国中医眼科杂志,2016,26(5):298-301.
[13]NAKAGAMI T,YAMAZAKI Y,HAYAMIZU F,et al.Effect of ocular hypotensive medications in preventing the progression of visual field damage in patients with normal-tension glaucoma[J].Nippon Ganka Gakkai Zasshi,2004,108(7):408-414.
[14]FRIEDMAN M,ROSENMAN RH.Association of specific overt behavior pattern with increase in blood cholesterol,blood clotting time,incidence of arcus senilis and clinic coronary artery disease[J].JMAM,1959,2169:1286-1296.
[15]陈仲庚,张雨新.人格心理学[M].沈阳:辽宁人民出版社,1986.
[16]VIRTANEN R,JULA A.Anxiety and hostility are associated with reduced baroreflex sensitivity and increased beat-to-beat blood pressure variability[J].Psychosomatic Med,2003,65(5):751-756.
[17]孙河,刘吉年,王国贤.绿风内障的辨证分型及疗效观察[J].中医药信息,1992,(5):33-34
[18]THAM Y C,LI X,WONG T Y,et al.Global prevalence of glaucoma and projections of glaucoma burden through 2040:a systematic review and meta-analysis[J].Ophthalmology,2014,121:2081-2090.
[19]QU W,LI Y,SONG W,et al.Prevalence and risk factors for angleclosure disease in a rural Northeast China population:a populationbased survey in Bin County,Harbin[J].Acta Ophthalmol,2011,89(6):e515-20.
[20]HE M,FOSTER P,GE J,et al.Prevalence and clinical characteristics of glaucoma in adult Chinese:a population-based study in Liwan District,Guangzhou[J].Invest Ophthalmol Vis Sci,2006,47(7):2782-2788.
[21]文雯.青光眼住院病人构成及其变化[D].乌鲁木齐:新疆医科大学,2007.
[22]王银燕.535例青光眼门诊患者的构成及特点分析[D].济南:山东大学,2013.
[23]王济,王琦.中医体质研究与4P医学的实施[J].中国中西医结合杂志,2012,32(5):693-695.