建立急性缺血性中风气虚血瘀证诊断标准的方法学探讨

An Exploration on Methodology for Establishing Diagnostic Criteria of Qi_Deficiency Blood_Stasis Syndrome in Acute Ischemic Stroke

为探讨建立中风病证候诊断标准的方法 ,观察了 10 6例急性缺血性中风气虚血瘀证患者 ,对其证候指标 :舌、脉、症状进行了可靠性分析、主成分分析和聚类分析。根据统计分析结果并结合临床实际 ,初步提出急性期缺血性中风气虚血瘀证的诊断标准 ,包括辨病和辨证两个方面。辨病可见半身不遂、口舌歪斜、舌强语蹇或不语 ,CT检查符合缺血性中风改变 ;辨证必须有肢体瘫软、倦怠嗜卧、口唇紫暗 ,脉沉细等主症 ,并可兼见头痛而痛处不移、汗出、心悸、乏力、面色白 ,大便溏或二便自遗、舌背脉络瘀胀青紫或舌紫暗等次要症状。

To explore the methodology for establishing diagnostic criteria of TCM syndromes in stroke, 106 cases of acute ischemic stroke with qi_deficiency blood_stasis syndrome were accepted for the study. Their tongue pictures, pulse condition and clinical manifestations were observed systematically and the data were treated with reliability analysis, principal component analysis and cluster analysis. According to the statistical analyses and clinical practice, the diagnostic criteria should cover both disease differentiation and syndrome differentiation. The items of disease differentiation should include hemiparalysis, deviation of the eye and mouth, stiff tongue, dysphasia or aphasia and CT findings. Those of syndrome differentiation includes paralysis, fatigue, somnolence, cyanotic lips and sunken small pulse as the primary items, and localized headache, sweating, palpitation, weakness, pale complexion, loose stool or incontinence of stool and urine, engorged and purple sublingual veins or dark purplish tongue as the secondary items. This study may serve as a methodological basis for establishing the diagnostic criteria of stroke.