多发性硬化与视神经脊髓炎的临床特点和中医证候比较研究  

Comparative study on clinical characteristics and TCM syndromes between multiple sclerosis and neuromyelitis optica

作　　者：吴畏[1] 樊永平[2] 胡蕊[2] 

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]首都医科大学附属天坛医院中医科,北京100050

出　　处：《北京中医药》2013年第7期506-509,共4页Beijing Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81072765);首都医学发展基金(2005-SF-Ⅰ-001);北京市中西医结合神经病学重点学科基金(2004京中重Ⅳ14)

摘　　要：目的比较多发性硬化(MS)与视神经脊髓炎(NMO)患者的临床特点、中医证候证素分布的差异。方法采用横断面调查方法,收集MS患者133例、NMO患者63例,比较2组患者的临床特点、舌苔脉象和中医证候。结果 MS与NMO主要以女性患者为主,NMO组尤其明显,NMO组患者复发次数明显多于MS组。NMO组发病起始较易侵犯视神经,MS组发病起始影响感觉功能较为常见,NMO组就诊时症状肢体无力、感觉异常或肢体疼痛、视力下降、眼痛、二便障碍、Lhermitte征、疲劳、不自主运动出现率高于MS组,NMO组肝肾阴虚和血瘀证表现多于MS组。结论肝肾阴虚和痰瘀内阻的病理机制在NMO与MS患者中具有普遍性和代表性,NMO较MS更易于复发,且病变累及神经更广泛。Objective To compare the difference in clinical characteristics and TCM syndrome/syndrome elements distribution between multiple sclerosis （MS） and neuromyelitis optica （NMO）. Methods With the cross-sectional survey method, 133 patients with MS （MS group） and 63 with NMO （NMO group） were selected to compare the clinical characteristics, fur and pulse manifestation, as well as the TCM syndrome. Results Female patients were more seen with both MS and NMO, especially NMO, and the recurrence times were apparently more in the NMO group than those in the MS group. At the beginning of onset, optic nerve was involved easier in the NMO group, whereas sensory function was affected more often in the MS group; the occurrence rates of symptoms patients suffering, including limb weakness, paresthasia or llmb pain, decreased vision, eye pain, bowel and bladder dysfunction, Lhermitte＇ s sign, fatigue, and involuntary movement, in the NMO group were higher than those in the MS group. The manifestation of liver-kidney yin deficiency syndrome and blood stasis syndrome was more seen in the NMO group. Conclusion The pathological mechanism of liver-kidney yin deficiency syndrome and syndrome of internal obstruction of phlegm with blood stasis possesses universality and representativeness in patients with NMO and MS, and NMO is more easy to relapse than MS, moreover the lesions involve nerve more widely.

关 键 词：多发性硬化 视神经脊髓炎 临床特点 中医证候 

分 类 号：R277.7[医药卫生—中医学]