脑卒中高危人群中医症状及舌脉特点分析

Analysis on TCM Symptoms, Tongue and Pulse of High-risk Group of Stroke

目的初步探讨脑卒中高危人群的中医症状及舌脉特点,为脑卒中的中医预防提供辨证论治依据,并为脑卒中高危人群辨证体系的建立奠定基础。方法设计前瞻性观察方法,通过多中心大样本筛查选取脑卒中高危人群2536例,分析其中医症状、舌脉、证类分布的频数特征,观察不同性别、年龄脑卒中高危人群中医症状分布特点的差异性。结果检出率前5位的中医症状按出现频率由高到低依次为:视物模糊(1670例,65.9%)、急躁易怒(1458例,57.5%)、腰膝酸软或痛(1445例,57.1%)、头晕(1286例,50.7%)、双目干涩(1274例,50.2%);检出率前5位的舌脉象按出现频率由高到低依次为:苔白(1401例,55.2%)、苔薄(1260例,49.7%)、脉弦(1201例,47.4%)、舌黯(1168例,46.1%)、舌红(1027例,40.5%)。头晕、失眠、苔白、苔薄等检出率女性显著高于男性(P<0.01),齿摇、苔腻、苔黄、脉弦等检出率男性显著高于女性(P<0.01);齿摇、双目干涩、口渴、舌黯、舌红、脉弦等的检出率老年组明显高于中年组(P<0.01),急躁易怒、麻木、气短、舌齿痕、苔薄、脉沉等检出率中年组明显高于老年组(P<0.01)。结论脑卒中高危人群临床表现复杂,既有肝脾肾亏损本虚之象,又有风火痰瘀的标实之征,多属虚实夹杂证。不同性别、年龄脑卒中高危人群症状分布具有一定差异性和规律性。

Objective To investigate characteristics of symptoms, tongue and pulse of high-risk group of stroke, and provide evidence of differential treatment for stroke prevention, diagnosis and treatment of stroke, thus laying a solid foundation on further study of differential treatment system of high-risk groups of stroke. Methods With prospective observational method, 2536 cases of stroke were selected by multi-center screening, and characteristics of TCM symptoms, tongue, pulse and syndrome distribution in different gender and age were observed. Results The top five symptoms were： blurred vision （1670 cases, 65.9%）, irritability （1458 cases, 57.5%）, limp or pain on waist and knees （1445 cases, 57.1%）, dizziness （1286 cases, 50.7%） and dry eyes （1274 cases, 50.2%）. The top five tongue and pulse were： white moss （1401 cases, 55.2%）, thin moss （1260 cases, 49.7%）, string pulse （1201 cases, 47.4%）, dark tongue （1168 cases, 46.1%） and red tongue （1027 cases, 40.5%）. The detection rate of dizziness, insomnia, white coating, thin coating, etc. were higer in women than that in man （P〈0.01）. The detection rate of teeth shaking, greasy fur, yellow fur, string pulse, etc. were higher in man than that in woman （P〈0.01）. The detection rate of teeth shaking, dry eyes, thirst, dark tongue, red tongue, string pulse, etc. in the elderly group were higher than the middle-aged one （P〈0.01）. The detection rate of irritability, numbness, shortness of breath, scalloped tongue, thin coating, deep pulse, etc. in the middle-aged group was higher than the aged one （P〈0.01）. Conclusion The clinical manifestations of high-risk group of stroke are complicated. There were root deficiency such as deficiency of spleen and kidney, and branch excess such as wind-fire and phlegm-stasis. Difference and regularity were showed in different gender and different age groups to some extent.