神经衰弱与西北燥证病机关联性分析

Analysis on the Relationship between Neurasthenia and Northwest Dryness Syndrome

目的:揭示新疆地区神经衰弱与西北燥证的病机联系,为从异病同治角度制定新疆地区神经衰弱防治策略提供流行病学依据。方法:采用病例对照研究设计,收集83例神经衰弱病例组,168例无病对照组,对两组西北燥证罹患率及积分进行比较;对病例组一般辨证中医证情与西北燥证证情作聚类分析及典型相关分析,探求二者之间病机联系。结果:(1)神经衰弱组西北燥证罹患率为62.65%,对照组为17.26%,病例组高于对照组(χ2=52.363,P<0.01)。(2)神经衰弱组西北燥证总积分高于对照组(P<0.01)。病例组肺卫孔窍皮肤燥证、肝肾精血不足证、心肾阴虚证均高于对照组(P<0.01)。尤以心肾阴虚证明显(均数差9.04)。(3)聚类分析提示气滞痰阻证与脾胃阴虚证接近,肝阴亏虚证与肝肾精血不足证接近,气郁化火证与心肾阴虚证接近。(4)典型相关分析第一典型变量r1=0.8622,P<0.01。神经衰弱因变量组肝阴亏虚证载荷系数最大(0.4223),自变量组肝肾精血不足证载荷系数最大(0.5444)。结论:(1)西北燥证是新疆地区神经衰弱罹患者危险因素,并以西北燥证兼证3心肾阴虚证为突出临床表现。(2)西北燥证与神经衰弱病机关联性以肝阴亏虚证及肝肾精血不足证为决定性因素。肝肾精血不足证对神经衰弱证情影响最大。

Objective ：To explore the pathogenesis of relationship between Northwest Dryness Syndrome and Neurasthenia, to provide the epidemiological evidence for setting the development strategy for the prevention and treatment of neurasthenia in Xin- jiang region. Methods：By applying methods of philology analysis and clinical epidemiology ,on the basis of case -control, disease group（ 83 eases）and control group（ 168 cases）are set up to relationship the attack rate of northwest dryness syndrome（NDS） and NDS integration in disease group and control group. To explore the pathogenesis relationship in Neurasthenia and NDS by applying cluster analysis and canonical correlation analysis. Results ： 1 ） The attack rate of NDS in disease group（ 62.65% ） is higher than control group（17.26） （χ2 = 52. 363 ,P 〈 0.01 ）. 2）The total integration of NDS in Neurasthenia group is higher than control group（P 〈 0.01 ）, with yin deficiencies of the heart and kidney syndrome as a prominent feature. 3 ）Cluster analysis showed that stagnation of the eircul - ation of vital energy and damp obstructing syndrome is closed to Spleen deficiency syndrome. The Liver Yin deficiency syndrome is closed to the deficiencies syndrome of essence and blood of the liver and the kidney. The syndrome of depressed qi transforming into fire is closed to yin deficiencies of the heart and kidney syndrome. 4）The first typical variable（ rl ） is 0.8622, P 〈 0. 01. The loading coefficient of the Liver Yin deficiency syndrome of neurasthenia is the largest value （ 0.4223 ） in dependent variable group. The loading coefficient of the deficiencies syndrome of essence and blood of the liver and the kidney is the largest value （0. 5444 ） in independent variable group. Conclusion： 1 ） The northwest dryness syndrome, with yin deficiencies of the heart and kidney syndrome as a prominent feature,is one of risk factors and common accompanying status for Neurasthenia in Xinjiang Uygur Autonomous Region. 2） The Pathogenesis relevance of NDS and Neurasthenia is reflected in the Liver Yin deficiency syndrome and the deficiencies syndrome of essence and blood of the liver and the kidney. The deficiencies syndrome of essence and blood of the liver and the kidney make the greatest impact on Neurasthenia conditions.