运动性疲劳中医肾虚证的辨证分型及其诊断标准

Sort and diagnostic standard of kidney deficiency syndrome of Traditional Chinese Medicine in exercise-induced fatigue

目的:阐明运动性疲劳中医肾虚证的主要证候及辨证标准。方法:于2003-07/2004-01选择湖南省水上运动训练基地的皮划赛艇运动员和省体工大队的田径运动员共199名为研究对象。将中医辨证理论方法与流行病学调研方法有机结合,统一诊断标准和资料处理方法,分析肾虚各证候构成比,进行聚类分析,观察单一症状出现频次、症状组合出现频次。结果:纳入受试对象199名,均进入结果分析。①肾虚常见证候有腰脊酸痛,头晕目眩,精神疲倦,四肢乏力,胫膝酸软,气短自汗,五心烦热,口干少津,畏寒肢冷,小便清长,夜尿频多,少寐多梦。②肾虚各证候构成比:肾气虚(51.26%)、肾阴阳两虚(37.69%)、肾阳虚(6.53%)、肾阴虚(4.52%)。③聚类分析:第一类为腰脊酸痛,精神疲倦,四肢乏力,气短自汗;第二类为头晕目眩,胫膝酸软,畏寒肢冷,小便清长,夜尿频多;第三类为五心烦热,口干少津;第四类为少寐多梦。④参与组合频次大于50%的症状主要是:精神疲倦、四肢乏力、腰脊酸痛、头晕目眩、气短,这5个症状也是单个症状频次大于80%的。结论:运动性疲劳中医肾虚证的常见证候为肾气虚、肾阴阳两虚、肾阳虚、肾阴虚。而肾气虚是运动性疲劳中医肾虚的主要证候。精神疲倦、四肢乏力、腰脊酸痛、头晕目眩、气短这5个症状可以作为运动性疲劳肾气虚辨证标准中的主要症状。

AIM： To define the main syndrome and differentiation standard of the kidney deficiency of traditional Chinese medicine （TCM） in exerciseinduced fatigue. METHODS： Totally 199 athletes were selected from rowing training center tor aquatic sports and field and track training team of Hunan Province between July 2003 and January 2004. Combining TCM theory of differentiation of syndromes with epidemiological, method, multivariate statistical analysis was used to unify the diagnostic standard and the methods of data processing. The constituent ratios of various syndromes of kidney deficiency were analyzed, then the clustering analysis was conducted, in addition, the presence frequencies of single and combined symptoms were observed. RESULTS： A toted of 199 cases were involved into the result analysis.① The usual syndromes of kidney deficiency were lumbago, dizziness, tired spirit, lassitude of limb, weakness and sore of the knees, shortness of breath, spontaneous perspiration, dysphasia with feverish sensation in chest, palms and soles, dry mouth, aversion to cold, cold limbs, frequency of micturition, insomnia and dreaminess.②The constituent ratios of various syndromes of kidney deficiency： kidney-qi deficiency （51.26%）, deficiency of both kidney-yin and kidney-yang （37.69%）, kidney-yang deficiency （6.53%）, kidney-yin deficiency （4.52%）.③Clustering analysis： Category Ⅰ was lumbago, tired spirit, lassitude of limb, shortness of breath and spontaneous perspiration; Category Ⅱ was dizziness, weakness and sore of the knees, aversion to cold, cold limbs, frequency of micturition; Category Ⅲ was dysphasia with feverish sensation in chest, palms and soles, dry mouth; Category Ⅳ was insomnia and dreaminess. ④The main symptoms with over 50% frequency of the combination of syndromes were spirit tired, lassitude of limb, aching pains of loins and knees, dizziness and shortness of breath. Their frequencies in single syndrome were more than 80%. CONCLUSION： The common syndromes of kidney deficiency in exerciseinduced fatigue are the kidney-qi deficiency, deficiency of both kidney-yin and kidney-yang, kidney-yang deficiency and kidney-yin deficiency, with the kidney-qi deficiency is dominant. The five symptoms such as tired spirit, lassitude of limb, aching pains of the loins and knees, dizziness and shortness of breatb may accredit as main symptoms of diagnostic standard of the kidney deficiency syndrome of TCM in exercise-induced fatigue.