660例老年性痴呆患者中医证候学研究  

Study on Traditional Chinese Medicine Syndrome of 660 Cases of Senile Dementia

作　　者：张玉莲[1] 张连城[1] 李强[2] 崔远武[1] 顾耘[3] 汪振宇 李柱 吴迪[6] 崔俊波[7] 

机构地区：[1]天津中医药大学第二附属医院,天津市河北区真理道816号300150 [2]天津中医药大学 [3]上海中医药大学附属龙华医院 [4]辽宁省营口市中医院 [5]河南省开封市中医院 [6]天津市环湖医院 [7]天津市武清中医院

出　　处：《中医杂志》2015年第3期235-239,共5页Journal of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划("973计划")(2010CB530405)

摘　　要：目的探究老年性痴呆的中医证候学特征。方法利用多中心横断面流行病学调查方法收集660例老年性痴呆患者。建立老年性痴呆中医证候信息采集表,对患者的一般资料、病因病机、脉症资料、证型等进行信息收集。对四诊信息出现的所有症状、舌象、脉象、证型进行频数统计,对老年性痴呆出现的主要症状进行因子分析,总结分析老年性痴呆的主要症状及证候分布特点。结果老年性痴呆痴呆最常见的10个症状是善忘、失算、齿脱、发白、腰膝酸软、反应迟钝、步履迟缓、乏力、转盼遗忘、神情呆滞。老年性痴呆的主要证候要素为精亏、阳虚、阴虚,次要证候要素为瘀、痰,病位主要在肾,亦与心、肝、脾相关。证型以肾虚为主(占86.36%),其次为气滞血瘀证(5.15%)、痰浊阻窍证(3.94%)。结论老年痴呆发病与肾关系密切,肾虚为老年性痴呆发病的基础,瘀、痰为其发展和加重的关键因素。Objective To explore the features of the traditional Chinese medicine（ TCM） syndromes of senile dementia. Methods Totally 660 senile dementia patients were collected with multi-center cross-sectional epidemiological survey. TCM syndrome information form of senile dementia including general information,etiology and pathogenesis,pulse diagnostic information,syndromes and other related information was completed. Frequency of all symptoms,tongue diagnosis,pulse diagnosis and syndromes was calculated. Factor analysis was done on the main symptoms of senile dementia. Main symptoms and distribution features of TCM syndromes were summerized. Results The top 10 symptoms of senile dementia were forgetfulness,miscalculation,avulsed tooth,grey hair,weakness and soreness in the waist and knees,retarded responses,slowness in walking,fatigue,forgetting things in a glance,dullness in expression. The main syndrome elements were essence deficiency,yang deficiency and yin deficiency. The secondary syndrome elements were blood stasis and phlegm. The location of the disease was mainly kidney,while related to heart,liver and spleen. As for the distribution of syndromes,kidney deficiency took up 86. 36%,followed by qi stagnation and blood stasis（ 5. 15%） and phlegm obstructing orifices（ 3. 94%）. Conclusion The onset of senile dementia was closely related to the kidney. Kidney deficiency was the basis of senile dementia,and blood stasis and phlegm were the key factors of its development and aggravation.

关 键 词：老年性痴呆 流行病学调查 证候要素 肾虚 

分 类 号：R277.7[医药卫生—中医学]