605例出血中风发病时阴阳类证辨证属性及其相关分析  

The Attribution Differentiated Yang-lei Symptom of 605 Cases with Acute Stage of Hypertensive Hemorrhage Stroke and its Influential Factor Analysis

作　　者：卢明[1] 杜宝新[1] 黄燕[1] 梁伟雄[1] 刘茂才[1] 黄培新[1] 

机构地区：[1]广东省中医院脑病专科,广东广州510120

出　　处：《辽宁中医杂志》2008年第8期1121-1123,共3页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家科技"十五"攻关课题(2001BA701A12B);国家科技"九五"攻关专题(96-906-06-02);广东省科技计划项目(2002C30602);国家中医药管理局课题(02-03LQ006)

摘　　要：目的:探讨出血中风发病时阳类证、阴类证辨证属性及其可能相关影响因素分析。方法:按照经征求专家意见后制定并经临床验证实施的出血中风急性期阳类证、阴类证辨证标准,对国家"九五"、"十五"攻关出血中风(中医药)综合救治研究课题单位脑出血患者进行辨证及对其相关因素进行分析。结果:共605例患者,中医辨证阳类证占绝大多数,为87.11%,阳类证比例男性(91.11%)显著高于女性(80.77%),差异有显著性(χ2=13.65,P=0.000);阳类证比例神昏者(91.76%)显著高于清醒者(79.48%),差异有显著性(χ2=18.00,P=0.000);发病24h内就诊者471例,占77.85%,阳类证比例病程24h以内者(88.54%)显著高于24h以上者(82.09%),差异有显著性(χ2=3.86,P=0.049);出血量>30mL者发生阳类证比例(90.10%)显著高于出血量小于30mL者(83.90%),差异有显著性(χ2=5.16,P=0.022);全部患者出血部位以基底节区最多,共467例,占88.43%,其阴阳类证辨证属性与出血部位(基底节或/和脑叶)关系比较,差异无显著性(χ2=2.84,P=0.238)。结论:出血中风发病时中医辨证阳类证占绝大多数,阳类证比例男性显著高于女性、神昏者显著高于清醒者、病程24h以内者显著高于24h以上者,出血量>30mL者有显著高于<30mL者,阴类证比例则相反,以上特点与阴阳本质、现代医学脑出血起病及其特点相一致。Objective： To approach the attribution differentiated Yang -lei symptom or Yin -lei symptom of Acute Stage of Hypertensive Hemorrhage Stroke （ASHHS） patients and its influential factor. Methods ： To judge the attribution of Yang - lei symptom or Yin - lei symptom in ASHHS patients in the multi - center hospitals of National key study. According to the Standard of Differentiation of Yang - lei syndrome and Yin - lei syndrome solicited from the nmional specialist and clinical verification. And to anlyse potential influential factor. Results： There are 605 cases of ASHHS be adopted ,527cases, 87.1% of them, at onset of illness are Yang - lei syndrome,and among Yang - lei syndrome cases, male is 91.11% , female is 80.77%. Conscious disturbance is 9 1.76% ,awake is 79.48% ,pathogenesis in 24h is 88.54% ,above 24h is 82.09%. Volume of blood above 30mL is 90. 10% , below 30mL is 83.90% ,there was all significant difference （ P 〈 0.05 ）. And bleeding part at basal ganglia are 467 cases, there was no significant difference （ P 〉 0.05 ） of the attribution of Yang - lei symptom or Yin - lei symptom between different bleeding part including basal ganglia and lobe of brain. Conclusions： Yang - lei symptom is majority at onset of illness in ASHHS, and among Yang -lei syndrome cases,the amount of male is more than female. Conscious disturbance more than awake, pathogenesis in 24h more than above 24h,volume of blood above 30mI more than below 30mL. And the characteristic of the cases with Yin - lei symptom is conversely. All those are with one accord to the essence of yin - yang in TCM and the onset and nature of Hypertensive Hemorrhage Stroke.

关 键 词：出血中风 阳类证 阴类证 性别 神识 病程 出血量 

分 类 号：R255.2[医药卫生—中医内科学]