慢性脑缺血患者中医证候临床调查分析

Clinical investigation and analysis of traditional Chinese medical syndromes in patients with chronic cerebral ischemia

目的分析慢性脑缺血患者中医证候及临床相关情况,为今后辨证论治提供临床研究依据。方法选择慢性脑缺血患者259例,将临床证候归纳为气虚证、血瘀证、痰浊证、肝阳证、肾虚证5个基本证候进行中医积分评定,同时对基础疾病、年龄、病程进行相应分析。结果慢性脑缺血患者60岁以上居多,年龄越大、病程越长者,气虚证、血瘀证和肾虚证占的比率越高,气虚证和肾虚证患者年龄、病程均长于其他证候患者;气虚证多见于冠心病患者,血瘀证多见于冠心病和糖尿病患者,痰浊证多见于糖尿病和高血脂症患者,肝阳证多见于高血压病患者,肾虚证虽以高血压病和冠心病为主,但均见于各种基础疾病患者;慢性脑缺血证候分布频率以气虚证所占比例最多,其次为肾虚证、血瘀证、痰浊证、肝阳证;慢性脑缺血可出现2种证候、3种证候、4种证候及4种以上证候等多种类型,其中2种证候组合最多131例(50.57%),3种组合97例(37.46%),4种组合27例(10.43%),4种以上组合仅4例(1.54%)。结论气虚证、血瘀证、痰浊证、肝阳证、肾虚证5种证候基本概括了慢性脑缺血患者的证候,以气虚证、肾虚证、痰浊证为多见,并与年龄和基础疾病相关。

Objective It is to analyze traditional Chinese medical syndrome and clinical correlated situation in patients with chronic cerebral ischemia,for providing future clinical study evidences of treatment based on syndrome differentiation.Methods Two hundred and fifty-nine cases of patients with chronic cerebral ischemia were collected,and their clinical syndromes were sum up to 5 basic syndromes including Qi-deficiency syndrome,blood stasis,reduce phlegm,liver Yang syndrome,kidney deficiency syndrome to evaluate TCM scores,while the basis of disease,age,disease course were analyzed accordingly.Results Most of the patients with chronic cerebral ischemia were over 60 years old,and the more their age and disease course increase,the higher ratios of Qi-deficiency syndrome,blood stasis,and kidney deficiency syndrome.Ages and disease courses of the patients with Qi-deficiency syndrome and kidney deficiency were longer than that of the ones with other syndrome.Qi-deficiency syndrome was mainly found in coronary heart disease patients,blood stasis in coronary heart disease and diabetes patients,sputum turbid in diabetes and hyperlipidemia patient,liver Yang syndrome in hypertension patients respectively.Although kidney deficiency was with hypertension and coronary heart disease,but it was found in all patients with underlying disease.Chronic cerebral ischemia syndrome distribution frequency and proportion to that most was followed by kidney deficiency,blood stasis and phlegm,liver Yang syndrome.Chronic cerebral ischemia syndrome had 2 kinds of syndromes,3 types of symptom,4 kinds of syndrome and more than 4 kinds of TCM syndrome types,of which 2 kinds of syndromes combination were 131 cases which were the most（50.57%）,3 kinds of syndromes combination were 97 cases（37.46%）,4kinds of syndrome combination were 27 cases（10.43%）,more than 4 kinds of combination were only 4 cases（1.54%）.Conclusion Five kinds of syndromes including Qi-deficiency syndrome,blood stasis,reduce phlegm,liver Yang syndrome,kidney deficiency syndrome mainly represent the syndromes of chronic cerebral ischemia,of which Qi-deficiency syndrome,reduce phlegm,kidney deficiency syndrome are more common,and are related to age and underlying disease.