成都地区缺血性脑卒中急性期患者中医证候规律分析——1341例横断面调查  

Research on Traditional Chinese Medicine Syndrome Regularity in Acute Stage of Ischemic Stroke Patients in Chengdu Area: A Cross-Sectional Study of 1341 Cases

作　　者：王成伟[1] 刘梦阅[1] 文谦[1] 李佳[1] 赵雨[1] 吕建琴[1] 杨扬[1] 潘慧[1] 李宁 

机构地区：[1]四川大学华西医院

出　　处：《中医杂志》2015年第12期1038-1042,共5页Journal of Traditional Chinese Medicine

摘　　要：目的探讨成都地区缺血性脑卒中急性期患者的中医证候分布规律。方法对2012年1月至2013年12月来自四川大学华西医院1341例缺血性脑卒中急性期患者(成都市行政区域内的常住人口,且居住时间≥5年)采用横断面调查,填写调查表,数据收集包括患者一般资料及中医证候诊断要素相关资料,统计患者主要中医症状与体征分布、主要证候分布情况,并以性别(男、女)、偏瘫侧肢体(左、右)、年龄段(≤40岁、>40岁但≤70岁、>70岁)及病程(≤72 h、>72 h)分类探讨影响证候分型的相关因素。结果 40种中医症状与体征可分为风、火、痰、气虚、瘀和阴虚6类,其中包含症状与体征数最多的是气虚证,包含症状与体征数最少的是瘀证。1341例患者中中经络1073例,中脏腑268例。中经络的证候分型频数从高到低依次为风痰阻络、阴虚风动、痰瘀阻络、气虚血瘀和痰热腑实;中脏腑的证候分型频数从高到低依次为痰蒙清窍、痰热内闭。不同性别、年龄段患者中医证候分布差异无统计学意义(P>0.05)。病程≤72 h患者多以风痰阻络证候为主,而>72 h患者多以阴虚风动证候为主。右侧肢体偏瘫多以痰蒙清窍、痰瘀阻络与痰热内闭3种证候为主;而左侧肢体偏瘫多以风痰阻络与阴虚风动两种证候为主。结论成都地区缺血性脑卒中患者急性期以风痰阻络、痰蒙清窍、阴虚风动证候为主,病程长短及肢体瘫痪偏侧部位可能对中医证候分布有影响。Objective To explore Traditional Chinese Medicine（ TCM） syndrome regularity in acute stage of ischemic stroke patients in Chengdu area. Methods Cross-sectional study was conducted on 1341 patients（ permanent residents in Chengdu area for more than 5 years） with acute stage of ischemic stroke in West China Hospital of Sichuan University from January,2012 to December,2013. The questionnaire was answered. Data contained patients’ general information and related information of syndrome diagnosis elements was collected. Patients’ TCM symptoms,signs and main syndromes,the related factors of typing syndromes by gender（ male or female）,hemiplegic limbs（ left or right）,age（ younger than 40,40 to 70 or more than 70）,and course of disease（ less than 72 h or more than 72 h） were analysed. Results 40 TCM symptoms could be divided into categories of wind,fire,phlegm,Qi deficiency,blood stasis and Yin deficiency. Qi deficiency syndrome contained the most symptoms and signs,while blood stasis syndrome contained the less. Among 1341 patients,there were 1073 cases with attack on meridians and 268 cases with attack on Zang-Fu organs. The order from the most frequency syndrome to the least frequency syndrome in the category of attack on meridians syndromes were wind-phlegm obstructing collateral,Yin deficiency and wind formation,phlegm-stasis obstructing collateral,Qi deficiency and blood stasis,and phlegm-heat and Fu-organ excess. The order from the most frequency to the least frequency syndrome in the category of attack on Zang-Fu organs syndromes were the upper orifices stagnation by phlegm and internal block due to phlegm-heat. There was no significant difference in TCM syndromes distribution in patients of different gender and age（ P 〉 0. 05）.Patients whoes course ≤ 72 h were mainly with wind-phlegm obstructing collateral syndrome,while those whoes course 〉 72 h were mainly with Yin deficiency and wind formation syndrome. Patients with right hemiplegic limbs were mainly with the upper orifi

关 键 词：缺血性脑卒中 成都地区 中医证候 横断面调查 

分 类 号：R277.7[医药卫生—中医学]