动脉瘤性蛛网膜下腔出血患者围手术期中医证候演变规律研究  

Analysis of Perioperative Syndrome Patterns in Patients with Aneurysmal Subarachnoid Hemorrhage

作　　者：张燕婷[1] 陈锦华[1] 赵俊捷[1] 白小欣[1] 林浩[1] 陈锐聪[1] 黎劭学[1] 黄胜平[1] 黄燕[1] 

机构地区：[1]广东省中医院大学城医院神经五科,广东广州510006

出　　处：《广州中医药大学学报》2013年第1期19-22,共4页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广州中医药大学创新基金(编号:K0080063)

摘　　要：【目的】研究动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,ASAH)患者行颅内动脉瘤栓塞术或颅内动脉瘤夹闭术围手术期中医证候的演变规律。【方法】对117例ASAH患者进行一般资料分析和中风病中医证候评分,然后对围手术期的中医证候进行分析。【结果】(1)ASAH患者围手术期中医基本证候分析结果显示:手术前及术后第1周中医证候以风证、火热证、痰湿证、血瘀证为主,术后第2周中医证候以火热证、血瘀证、气虚证为主,风证、痰证、气虚证有动态变化(与术前和术后1周比较,P<0.01)。(2)ASAH患者围手术期中医证候组合形式研究结果显示:手术前证候组合形式二证、三证、四证组合均可见,证候形态中以风痰证、风火痰证、风火痰瘀证为主。术后第1周证候组合形式与术前大致相同,二证、三证、四证组合均可见,证候形态中以痰瘀证、火热痰瘀证、风火痰瘀证为主。术后第2周证候组合形式以二证和三证为主,四证较少,证候形态以痰瘀证、气虚血瘀证、气虚痰瘀证为主。【结论】ASAH患者术前及术后早期的中医证候主要表现为实证,以风火痰瘀证为主;术后后期主要表现为本虚标实证,以气虚痰瘀证为主。Objective To investigate the changes of traditional Chinese medical syndromes in aneurysmal subarachnoid hemorrhage（ASAH） patients before and after the intracranial operation of aneurysmal embolization and aneurysmal occlusion.Methods Scoring of general data and clinical manifestations was performed in 117 ASAH patients for the analysis of traditional Chinese medical syndromes.Results The elemental syndrome patterns were characterized as wind syndrome,fire-heat syndrome,phlegm-dampness syndrome,and blood stasis syndrome before the operation and one week after the operation,and then were characterized as fire-heat syndrome,blood stasis syndrome and qi deficiency syndrome 2 weeks after the operation（P〈0.01）.The complex syndrome patterns were characterized as wind phlegm syndrome,wind-fire phlegm syndrome,and wind-fire phlegm and blood stasis syndrome before the operation,characterized as phlegm and blood stasis syndrome,fire-heat phlegm and blood stasis syndrome,and wind-fire phlegm and blood stasis syndrome one week after the operation,and dominated by phlegm and blood stasis syndrome,qi deficiency and blood stasis syndrome,and qi deficiency,phlegm and blood stasis syndrome 2 weeks after the operation.Conclusion ASAH is characterized as the excess syndrome of wind-fire phlegm and blood stasis syndrome before the operation and at the early postoperative stage,and then develops as deficiency in the root and excess in the branch in the late postoperative stage,which is dominated by qi deficiency,phlegm and blood stasis syndrome.

关 键 词：动脉瘤性蛛网膜下腔出血 动脉瘤栓塞术 动脉瘤夹闭术 中医证候 

分 类 号：R743.35[医药卫生—神经病学与精神病学]