脑梗死并发下肢深静脉血栓中医证候及辨证用药研究  

TCM syndrome and medication on symptoms differentiation for cerebral infarction complicated with deep venous thrombosis

作　　者：郑蔚慈 于成 王瑾 刘春梅[2] ZHENG Weici

机构地区：[1]山东中医药大学第一临床医学院,山东济南250014 [2]山东中医药大学附属医院,山东济南250014 [3]山东中医药大学中医学院,山东济南250014

出　　处：《中医临床研究》2023年第35期64-68,共5页Clinical Journal Of Chinese Medicine

基　　金：山东省中医药科技面上项目(2020M002)。

摘　　要：目的:探讨脑梗死并发下肢深静脉血栓的中医证候分布特点及辨证用药规律,为中医治疗该疾病提供客观依据。方法:回顾研究山东中医药大学附属医院中医经典科近3年来住院的41例脑梗死并发下肢深静脉血栓的患者资料;采集患者一般信息、中医辨证分型、方药应用等;并录入数据库;分析中医证候分布特点及用药规律。结果:41例患者临床辨证分型共有19种,其中痰瘀互结证、气虚血瘀证、阴虚血瘀证、痰热腑实证4型所占比例较多;按照虚实分类可归纳为实证17例、虚证4例及虚实夹杂证20例。病性证素共有8种,实性多见瘀、痰、热;虚性多见阴虚、气虚。辨证拟方包括加减成方29首,自拟方10首。共用中药133味,使用频次较高的中药为茯苓、麦冬、玄参、当归、丹参、黄芪、炙甘草、石菖蒲、清半夏等。结论:脑梗死并发下肢深静脉血栓中医证型以虚实夹杂证及实证多见。病性证素实性主要为瘀、痰、热;虚性主要为气虚、阴虚。临床施治以活血化瘀、清化痰热、益气养阴为主。Objective:To explore the distribution characteristics of TCM syndromes of cerebral infarction complicated with deep venous thrombosis and the rule of medication on syndrome differentiation,so as to provide an objective basis for TCM to treat the disease.Methods:A retrospective study was carried out in the 41 cerebral infarction complicated with deep venous thrombosisO patients admitted in Department of Traditional Chinese Medicine Classics of Affiliated Hospital of Shandong University of Traditional Chinese Medicine in recent 3 years.The general data,TCM syndromes,treatment of the included patients were input into the database for the analysis of TCM syndrome distribution and medication rule.Results:There were 19 types of clinical syndrome differentiation in 41 patients,of which 4 types accounted for a large proportion,including phlegm and blood stasis syndrome,Qi(气)deficiency and blood stasis syndrome,Yin(阴)deficiency and blood stasis syndrome,phlegm heat and Fu-organ(腑)excess syndrome.According to the classification of deficiency and excess,17 cases of excess syndrome,4 cases of deficiency syndrome and 20 cases of deficiency and excess mixed syndrome were summarized.There were 8 kinds of disease syndrome elements,most of which were blood stasis,phlegm,and heat.Deficiency was mostly Yin deficiency and Qi deficiency.The prescription based on syndrome differentiation included 29 modified prescriptions and 10 self-made prescriptions.There were 133 TCM medicines in common.The most frequently used TCM medicines were Fuling(Poria),Maidong(Radix Ophiopogonis),Xuanshen(Radix Scrophulariae),Danggui(Radix Angelicae Sinensis),Danshen(Radix et Rhizoma Salviae Miltiorrhizae),Huangqi(Radix Astragali),Zhigancao(Radix Glycyrrhizae),Shichangpu(Rhizoma Acori Tatarinowii),Qingbanxia(Rhizoma Pinelliae),etc..Conclusion:The TCM syndrome of cerebral infarction complicated with deep venous thrombosis is mostly seen in mixture type of deficiency and Excess and evidence-based system.TCM syndrome elements of cerebral infarction comp

关 键 词：脑梗死 下肢深静脉血栓 中医证候 辨证用药 

分 类 号：R743.33[医药卫生—神经病学与精神病学]