围绝经期OSAHS中医证型分布特点研究  

Distribution characteristics of TCM syndrome types of obstructive sleep apnea-hypopnea syndrome in the perimenopausal period

作　　者：陈莹[1,2] 李红[1,2] 许培清 马坤[1,2] 吕绍光[1,2] 郑姜钦[1,2] CHEN Ying;LI Hong;XU Peiqing;MA Kun;LYU Shaoguang;ZHENG Jiangqin(School of Clinical M edicine, Fujian Medical University, Fuzhou 350001 , Fujian, China;Department of Traditional Chinese Medicine, Fujian Provincial Hospital, Fuzhou 350001 , Fujian, China;Jinjiang Hospital of Traditional Chinese Medicine, Quanzhou 362200 , Fujian , China)

机构地区：[1]福建医科大学省立临床医学院,福建福州350001 [2]福建省立医院中医科,福建福州350001 [3]福建省晋江市中医院,福建泉州362200

出　　处：《湖南中医杂志》2019年第4期4-8,共5页Hunan Journal of Traditional Chinese Medicine

基　　金：福建省卫生计生青年科研课题(编号:2016/1/6);福建省医学创新课题(编号:2016-CX-8)

摘　　要：目的:探讨围绝经期阻塞性睡眠呼吸暂停低通气综合征(OSAHS)中医证型分布及其特点,为临床诊疗提供部分依据。方法 :采集108例围绝经期OSAHS患者的中医四诊信息,采用聚类分析方法结合专家组辨证,确立中医证型名称,并对患者的临床指标进行统计分析。结果:围绝经期OSAHS频数分布居前10位的症状为打鼾、神疲乏力、头晕、困倦嗜睡、形体肥胖、失眠、腰膝酸软、胸闷、急躁易怒、口干口渴;舌象以淡红舌、白腻苔为主;脉象以弦脉、滑脉、细脉、沉脉为主。108例患者中痰湿阻滞证31例(28. 70%)、肝郁(旺)脾虚证28例(25. 93%)、痰瘀互结证24例(22. 22%)、气阴两虚证18例(16. 67%),另外有7例患者的中医辨证不属于上述4种中医证型。气阴两虚证患者的雌激素(E_2)水平最低,差异有统计学意义(P <0. 05);痰瘀互结证、痰湿阻滞证患者的体质量指数(BMI)高于气阴两虚证、肝郁(旺)脾虚证患者,差异有统计学意义(P <0. 05);痰瘀互结证、气阴两虚证患者每小时睡眠内呼吸暂停加上低通气次数(AHI)高于肝郁(旺)脾虚证、痰湿阻滞证患者,差异有统计学意义(P <0. 05)。结论:围绝经期OSAHS中医证型多为痰湿阻滞证、肝郁(旺)脾虚证、痰瘀互结证、气阴两虚证。气阴两虚证患者可适当补充雌激素,痰证患者注意控制体质量,瘀证、虚证患者病情较重。Objective: To investigate the distribution characteristics of traditional Chinese medicine( TCM)syndrome types of obstructive sleep apnea-hypopnea syndrome( OSAHS) in the perimenopausal period,and to provide a basis for clinical diagnosis and treatment. Methods: The information obtained by four TCM diagnostic methods were collected from 108 patients with OSAHS in the perimenopausal period,and cluster analysis combined with syndrome differentiation by experts was used to determine TCM syndrome types. A statistical analysis was performed for the clinical indices of these patients. Results: The top 10 symptoms of OSAHS in the perimenopausal period were snoring,fatigue and weakness,dizziness,somnolence,obesity,insomnia,soreness and weakness of the waist and knees,chest distress,impatience and agitation,and thirst. The common tongue manifestation was pink tongue and white greasy tongue coating,and the major pulse manifestations included wiry pulse,slippery pulse,thready pulse,and deep pulse. Of all 108 patients,31( 28. 70%) had phlegm-dampness stagnation syndrome,28( 25. 93%) had the syndrome of stagnation of liver Qi( hyperactivity) and spleen deficiency,24( 22. 22%) had the syndrome of intermingled phlegm and blood stasis,18( 16. 67%) had deficiency of both Qi and Yin,and 7 had other syndromes. The patients with deficiency of both Qi and Yin had the lowest level of estrogen( P < 0. 05). The patients with the syndrome of intermingled phlegm and blood stasis or phlegm-dampness stagnation syndrome had a significantly higher body mass index than those with deficiency of both Qi and Yin or the syndrome of stagnation of liver Qi( hyperactivity) and spleen deficiency( P < 0. 05). The patients with the syndrome of intermingled phlegm and blood stasis or deficiency of both Qi and Yin had a significantly higher apnea-hypopnea index than those with the syndrome of stagnation of liver Qi( hyperactivity) and spleen deficiency or phlegm-dampness stagnation syndrome( P < 0. 05).Conclusion: phlegm-dampness stagnation syndrome,the s

关 键 词：围绝经期 阻塞性睡眠呼吸暂停低通气综合征 中医证型 聚类分析 

分 类 号：R271.917.5[医药卫生—中西医结合]