中风病先兆证临床特征表现文献系统评价

Systematic evaluation on literature of clinical characteristics of antecedent sign in stroke

[目的]文献系统评价中风病先兆证的临床特征。[方法]运用循证医学文献系统评价方法,建立"文献信息采集表",对中风病先兆证文献进行研究。[结果]共纳入合格文献261篇,研究表明:1)危险因素:吸烟、饮酒、饮食过咸、冠心病、高血压病、糖尿病、高脂血症、动脉硬化、年龄、环境污染、体质量超重等。2)病因病机:气血津液紊乱、脏腑功能失调、内风旋动、饮食不节、七情失调、起居失调、年老体衰、烦劳过度、气候变化、腑实壅塞、体质不良、房事不节等。3)证候包括:风痰证、痰瘀证、痰湿证、痰热证,肝胆火旺证、肝风内动证、肝肾阴虚证、肝阳上亢证,气虚血瘀证、气血亏虚证、气阴两虚证、气滞血瘀证,肾精不足证,肾虚证等。4)主要临床症状从高到低依次排列为:头昏/头晕/目眩,肢体麻木,倦怠乏力,语言不利,头胀痛,黑蒙,肢体拘急/筋惕肉瞤闰,烦燥不安/性情易怒、胸闷/心悸、失眠/少寐多梦等。5)舌象:舌红、舌瘀点/舌瘀斑、舌暗/舌黯/舌暗红/舌暗淡、苔薄白等。6)脉象:脉弦、脉弦滑、脉涩/脉细涩等。[结论]以上结果与学会标准存在差异。

[Objective] To evaluate the clinical characteristics of antecedent sign in stroke with literature system. [Methods] Using sys-temic evaluation of evidence-based medicine, a ＂information collection table＂ was established to study the literature about precedent sign of stroke. [Results] The 261 pieces of qualified research literatures were used in the study altogether. The research showed： 1） the risk factors included smoking, drinking alcohol, super-salt diet, coronary hart disease, hypertension, diabetes, hyperiipemia, atheroma, age, environment pollution and heavy body weight. 2） etiology and pathogenesis： turbulence of gas, blood and body fluid, maladjustment of Zang-Fu function, endogenous wind, improper diet, incoordination of seven emotions, irregularity in daily life, body failure in elder per-son, physical strain, climate change, obstruction by Fu excess, worse constitution, intemperance in sexal life, etc. 3） The symptom： wind phlegm symptom, phlegm stagnation symptom, phlegm-damp symptom, phlegm-heat syndrome, excessive fire in liver and gallbladder, internal moving of liver wind, Yin deficiency in liver and kidney, excessive rising of liver Yang, gas deficiency and blood stasis, deficien-cy of gas blood, deficiency of both Qi and Yin, gas stasis and blood stagnation, deficiency of kidney essence, kidney deficiency. 4） main clinical symptoms for high to low occurrence： dizziness/giddiness/blurred vision, numbness of extremities, lassitude, barylalia, headache optic atrophy, eontracture of extremities/muscular witching and cramp, dysphoria/being irritable and irascible, oppressive feeling in the chest/palpitation, insomnia/little sleep disturbed by dreams. 5） tongue picture： red tongue, tongue petechia/tongue eeehymosis, dark tongue/dark and red tongue/light red tongue/white and thin fur, etc. 6） pulse picture： stringy pulse, stringy and rolling pulse, hesitant pulse/thready and hesitant pulse, etc. [Conclusion] There is a difference between the results above and the standards of academic committee.