中风病急性期中医证候分布分析

Analysis of the Distribution of TCM Syndromes of Apoplexy at Acute Stage

目的 探讨中风病急性期中医证候分布情况 ,以确认中风病急性期的临床证候表现形式。方法 共收集 12 2例中风病急性期住院病患 ,在发病 72h内 ,依《中风病辨证诊断标准》的 6大基本证候风证、火热证、痰证、血瘀证、气虚证、阴虚阳亢证加以辨证 ,并进行证候分布分析。结果 ①基本证候组合以两个基本证候组合诊断例数最多 ,其次是 3个基本证候的组合。②中风病最多见的临床证候为风瘀证 ,占 12 3% ;其次为风痰瘀证 ,占 8 9%。③中风病急性期的病患以虚实夹杂证最多 ,占 82 8% ;实证次之 ,占 16 4 % ;虚证最少 ,仅占 0 8%。④单一基本证候同时存在的出现频率以瘀证与风证最多 ,各占 79 5 %与 5 5 7%。 2证组合同时存在的出现频率以风瘀证与痰瘀证最多 ,各占 4 5 9%与 37 7%。结论 ①体现《中风病辨证诊断标准》临床应用的稳定性。②中风病临床证候表现复杂多变 ,依此基本证候的诊断标准应较常见证型与主要证型的表现形式为佳。③中风病证候诊断在中药新药开发试验过程中有其存在的必然性。

Objective To investigate the distribution of TCM syndromes of apoplexy at acute stage (AAS) in order to affirm the clinical manifestations of TCM syndromes of AAS. Method 122 In-patients of AAS were involved in the study,who were diagnosed according to the six principal syndromes included in the TCM Apoplexy Diagnostic Criteria,namely wind syndrome,fire-heat syndrome,Phlegm syndrome,blood stagnation syndrome,qi-deficiency syndrome,and yin-deficiency and yang-excess syndrome. And at the same time,analysis of the distribution of the syndromes was carried out. Results (1) Most patients were diagnosed as with two principal syndromes in combination,and patients diagnosed as with three principal syndromes in combination were less in number. (2) The mostly encountered clinical syndrome in apoplexy was wind-stagnation syndrome,making up 12.3%;the less encountered was wind-phlegm-stagnation syndrome,making up 8.9%. (3) Most patients of AAS manifested syndromes of deficiency mixed with excess,making up 82.8%;less patients manifested excess syndrome,making up 16.4%;still less patients manifested deficiency syndrome,only making up 0.8%. (4) The mostly encountered single principal syndromes coexisting in AAS were stagnation syndrome and wind syndrome,making up 79.5% and 55.7%,respectively;the mostly encountered two-syndrome-combinations coexisting in AAS were wind-phlegm syndrome and phlegm-stagnation syndrome,making up 45.9% and 37.7%,respectively. Conclusion (1) The reliability of the TCM Apoplexy Diagnostic Criteria has been proved in the clinical application. (2) Because the clinical TCM syndromes of AAS are complicated and changeable,only the commonly encountered syndromes and the principal syndromes best accord with the TCM Apoplexy Diagnostic Criteria. (3) The criteria for apoplectic syndrome diagnosis are necessary in the process of TCM new drug development.