46例胶质瘤患者手术前后中医核心病机及主要证型分析  

Analysis of TCM Core Pathogenesis and Major Syndrome Types of 46 Cases of Glioma Patients Before and After Surgery

作　　者：周莉[1] 谢坚[1] 杨宝[1] 樊永平[1] 

机构地区：[1]首都医科大学附属北京天坛医院,北京100050

出　　处：《辽宁中医药大学学报》2014年第7期82-84,共3页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：北京市中医药科技发展资金资助项目(JJ2013-07)

摘　　要：目的:探讨胶质瘤患者手术前后核心病机及主要中医证型的变化规律。方法:对我院神经外科近期诊治的46例胶质瘤住院患者分别于手术前、后进行中医辨证,观察指标包括手术前后临床症状、舌象、脉象及中医证型,对四诊信息进行总结归纳分析,观察胶质瘤手术前后中医证候的不同及变化规律。结果:手术前最主要症状为头痛17例(37%)和癫痫18例(39%),舌象以舌紫红苔薄为主,脉象以细弦数为主,证候以阴虚生风10例(22%)、气滞血瘀10例(22%)、气阴不足6例(13%)为主;手术后最主要症状为乏力气短、眩晕头痛、口干口苦、纳呆呕恶、失眠健忘,舌象以舌淡紫胖大有齿痕苔白滑为主,脉象以细濡数为主,证候以心脾两虚12例(26%)、气阴不足11例(24%)、肝肾阴虚10例(22%)为主。结论:胶质瘤病位在脑,与肝、心、脾的功能有关,术前核心病机为肝阴血不足,化风挟瘀壅脑;术后核心病机为心脾两虚,水饮瘀血内阻。Objective：To explore the variation of TCM core pathogenesis and major syndromes of glioma patients before and after surgery. Method： We observed clinical symptoms, tongue, pulse and TCM syndromes before and after surgery of 46 cases of glioma inpatients in our hospital neurosurgery department and summarized information of four diagnostic methods, and analyzed variation of different TCM syndromes before and after surgery. Result： Before surgery, the main symptoms were headache in 17 cases （ 37% ） and epilepsy in 18 cases （ 39% ）. The main appearance of tongue was purple and red with thin moss. The main pulse was Xi, Xian, Shuo. And the main TCM syndromes were Yinxushengfeng in 10 cases （ 22% ）, Qizhixueyu in 10 eases （ 22% ）and Qiyinbuzu in 6 cases （ 13% ）. After surgery, the main symptoms were fatigue, shortness of breath, dizziness, headache, thirsty, anorexia, nausea, insomnia and forgetfulness. The main appearance of tongue was pale, purple, fat and scalloped with white lubricating moss. The main pulse was Xi, Ru, Shuo. And the main TCM syndromes were Xinpiliangxu in 12 cases （ 26% ）, Qiyinbnzu in 11 eases （ 24% ） and Ganghenyinxu in 10 cases （ 22% ）. Conclusion ： Glioma locates in brain, related with functions of liver, heart and spleen. The main TCM core pathogenesis of glioma before surgery is Ganyinxuebuzu, Huafengxieyuyongnao. The main TCM core pathogenesis of glioma after surgery is Xinpiliangxu and Shuiyinyuxueneizu.

关 键 词：胶质瘤 中医核心病机 中医证型 

分 类 号：R730.264[医药卫生—肿瘤]