脑梗死康复期患者中医证型与自我管理能力的调查研究  

Investigation of TCM Syndrome Types and Self-management Ability of Patients with Cerebral Infarction in Rehabilitation Period

作　　者：王彤[1] 王淼[1] 胡楠 WANG Tong;WANG Miao;HU Nan(Shengjing Hospital Affiliated to China Medical University,Shenyang 110134,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]中国医科大学附属盛京医院,辽宁沈阳110134 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《辽宁中医杂志》2020年第7期105-108,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81702623);辽宁省教育厅一般项目(201905507)。

摘　　要：目的探讨脑梗死康复期患者中医证型与自我管理能力的调查研究。方法将2016年1月—2018年3月本院脑梗死康复期患者116例作为观察对象,收集患者的基本资料,根据脑梗死康复期的中医辨证分型,记录入组患者的各项Fugl-Meyer评定量表、Barthel指数、标准吞咽功能评定量表(Standardized Swallowing Assessment,SSA)、成年人自我管理能力评定量表,比较脑梗死康复期患者中医证型与Fugl-Meyer分级、SSA量表、Barthel指数、自我管理能力的关系。结果脑梗死康复期中气虚血瘀证最多,占33.62%,其次分别为痰瘀阻络证(24.14%)、阴虚风动证(18.10%)、风火上扰证(15.52%)、痰热腑实证(8.62%)。在Fugl-Meyer分级上,气虚血瘀证和阴虚风动证、风火上扰证和痰热腑实证、痰瘀阻络证依次降低,差异有统计学意义(P<0.05)。在SSA量表上,痰瘀阻络证、风火上扰证和痰热腑实证、气虚血瘀证和阴虚风动证依次降低,在Barthel指数上,阴虚风动证和气虚血瘀证、风火上扰证和痰热腑实证、痰瘀阻络证依次降低,差异有统计学意义(P<0.05)。在饮食行为、心理调节上,气虚血瘀证和阴虚风动证高于痰瘀阻络证、风火上扰证、痰热腑实证;在服药依从性、自我监控上,气虚血瘀证和阴虚风动证、风火上扰证和痰热腑实证、痰瘀阻络证依次降低,差异有统计学意义(P<0.05)。结论脑梗死康复期患者中医证型与预后状况、自我管理能力有关,气虚血瘀证、阴虚风动证患者自我管理能力较佳,预后好;痰瘀阻络证、风火上扰证和痰热腑实证患者自我管理能力较差,预后欠佳。Objective To investigate the TCM syndromes and self-management ability of patients with cerebral infarction in convalescent stage.Methods A total of 116 patients with cerebral infarction in convalescent period in our hospital from January 2016 to March 2018 were observed.The basic data of the patients was collected.According to TCM syndrome differentiation in convalescent period of cerebral infarction,Fugl-Meyer scale,Barthel index and Standardized Swallow Assessment scale were recorded.The relationship between TCM syndrome types and Fugl-Meyer grade,SSA scale,Barthel index and self-management ability of patients with cerebral infarction in convalescent stage was compared by SSA and adult self-management ability scale.Results Qi deficiency and blood stasis syndrome was the most common syndrome in the rehabilitation period of cerebral infarction,accounting for 33.62%,followed by phlegm and blood stasis obstructing collateral syndrome(24.14%),Yin deficiency and wind disturbing syndrome(18.10%),wind-fire disturbance syndrome(15.52%)and phlegm-heat in Fu organs syndrome(8.62%).In Fugl-Meyer classification,Qi deficiency and blood stasis syndrome,Yin deficiency and wind disturbing syndrome,wind-fire disturbance syndrome,phlegm-heat syndrome and phlegm-blood stasis obstruction collateral syndrome decreased in turnwith statistical significance(P<0.05).On SSA scale,phlegm-blood stasis obstruction syndrome,wind-fire disturbance syndrome and phlegm-heat in Fu organs syndrome,Qideficiency and bloodstasis syndrome and Yindeficiency and wind disturbing syndrome decreased in turn.On Barthel index,Yindeficiency and wind disturbing syndrome,Qi deficiency and bloodstasis syndrome,wind-fire disturbance syndrome,phlegm-heat in Fu organs syndrome and phlegm-stasis obstruction syndrome decreased in turnwith statistical significance(P<0.05).In dietary behavior and psychological regulation,Qi deficiency and blood stasis syndrome and Yin deficiency and wind disturbing syndrome were higher than phlegm and blood stasis blocking collateral

关 键 词：脑梗死康复期 中医证型 自我管理能力 

分 类 号：R255.2[医药卫生—中医内科学]