82例听神经瘤术后面瘫患者的中医证候特点和聚类分析研究  

Study on the Traditional Chinese Medicine Syndrome Characteristics and Cluster Analysis of 82 Patients with Facial Paralysis afterAcoustic Neuroma Surgery

作　　者：何冠蘅[1] 阮经文[1] HE Guanheng;RUAN Jingwen(Department of Acupuncture and Moxibustion,The First Affiliated Hospital of Sun Yat-sen University,Guangdong Province,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院针灸科,广东广州510080

出　　处：《中国中医药现代远程教育》2025年第3期81-84,共4页Chinese Medicine Modern Distance Education of China

基　　金：广东省中医药局中医药科研面上项目【No.20211069】。

摘　　要：目的 探讨听神经瘤术后面瘫患者的中医证候特点并初步确定辨证分型,从而为优化本病针灸治疗策略提供参考依据。方法 纳入82例听神经瘤术后面瘫患者,收集主要的临床症状和四诊信息,并运用系统聚类法对证候进行归类分析,探明此病中医证候特点和辨证分型。结果 82例患者中,除口眼歪斜、进食藏饭、不能鼓颊、眼裂变大等面瘫病主症外,出现频率居前10位的兼症依次是耳鸣或耳聋、头部刺痛、失眠、多梦、脉沉、噩梦、脉涩、舌淡暗、畏冷喜暖、舌有瘀点瘀斑。系统聚类分析结果显示,此病可初步划分为阳虚血瘀证、痰热内扰证、阴虚瘀阻证、气血亏虚证四种中医证型。结论 听神经瘤术后面瘫患者多有脑脉瘀阻和脑神不安之症,且证型多样,针灸治疗应注重在“通脑脉、安脑神”的基础上辨证施治,协同促进患者术后面神经功能和整体状态的恢复。Objective To explore the characteristics of TCM syndromes of patients with facial paralysis after acoustic neuroma surgery and preliminarily determine the syndrome differentiation types,so as to provide reference for the optimization of acupuncture treatment strategy of this disease.Methods Eighty-two patients with facial paralysis after acoustic neuroma surgery were included,and the main clinical symptoms and four diagnostic information were collected.Systemic cluster analysis was used to classify and analyze the syn-dromes,so as to find out the characteristics and dialectical classification of TCM syndromes of this disease,Results In the 82 patients,in addition to the main symptoms of facial paralysis,such as mouth and eye deviation,rice remains in the affected side of the mouth when eating,unable to bulge cheeks and wide eye fissure,the top 10 frequent concurrent symptoms were tinnitus or deafness,headache,insomnia,dreaminess,pulse numbness,nightmares,uneven pulse,pale tongue,afraid of cold and fond of warm,petechial ecchymosis on the tongue.The results of systematic cluster analysis showed that the disease could be preliminarily divided into four TCM syndrome types,namely yang deficiency and blood stasis syndrome,phlegm heat internal disturbance syndrome,yin deficiency and blood stasis syndrome,qi and blood deficiency syndrome.Conclusion Patients with facial paralysis after acoustic neuroma surgery often have stasis obstruction in brain meridians and brain uneasiness cerebral pulse stasis and cerebral reslessness,and the syndrome types are varied.The acupuncture treatment should focus on syndrome differentiation based on the principle of"dredging the brain meridians and nour-ishing the brain spirit",so as to promote the recovery of patients'neurological function and mental state after operation.

关 键 词：积聚 听神经瘤 面瘫 瘀血 证候特点 聚类分析 

分 类 号：R277.7[医药卫生—中医学]