脑出血患者中风急诊证型的探讨

Investigation of TCM Emergency Syndrome of Hemorrhage Patients

目的探讨脑出血性中风证型与颅脑CT影像的关系,以求指导临床治疗和预防。方法根据67例不同部位脑出血患者,入院24h内临床症状,体征,颅脑CT影像诊断和相应出现中风急症证型进行中医辨证。结果将脑出血超急期中风急诊证型诊断为:少数出血量少的病例诊断为中风中经络,绝大部分表现为中风中脏腑、肝阳暴张,风火夹痰,上蒙清窍,闭证、闭证脱证并见,相互演变。结论脑出血性中风证型特点是突然神昏,半身不遂,口眼歪斜,还可见瞳神大小变化,气粗痰鸣,四肢痉强或瘫软,舌强、舌短或汗出肢冷等显著的临床证型,CT可以及时确诊。

Objective：To investigate the relationship between the syndrome of brain hemorrhagic stroke and the image of craniocerebral CT in order to guide the clinical treatment and prevention.Methods：The differentiation of traditional Chinese medicine for the syndrome of stroke were performed,according to clinical symptoms,signs and the image of craniocerebral CT in 67 patients with different brain hemorrhagic positions at 24 hours after admission.Results：The stroke in TCM with brain hemorrhage during early ischemia was diagnosed as follows.The hyperactivity of stroke including apoplexy involving the channels and collaterals for few cases were with a small amount of hemorrhage.For the most,the hyperactivity of stroke involved the organs and liver-yang syndrome,the obstruction by wind-phlegm syndrome,the disturbing the seven orifices syndrome and the blockage syndrome or both blockage syndrome and protration syndrome.Conclusion：With CT diagnoses,the characteristics of the syndrome of brain hemorrhagic stroke are significant clinical syndromes such as unexpected mental confusion,hemiplegia,inclined mouth and eye,changing eyes,breathing stertorous,limb spasm or weak and limp,tongue shortness or spansm and so on.They could be diagnosed by CT in time.