982例心脑合病患者证型分布横断面调查

A Cross-Sectional Study on Syndrome Distribution of 982 Patients With Cardio-Cerebral-Vascular Diseases

目的基于临床流行病学调查法初步探讨心脑合病(冠心病心绞痛合并动脉粥样硬化性血栓性脑梗死)的证候分布规律。方法采用横断面调查法,于全国11家三级医院采集982例心脑合病患者的四诊信息,对患者证型、证候虚实、证素、四诊信息分布情况进行统计分析。结果 982例心脑合病患者实证最多,其次为虚实夹杂证,再次为虚证,构成比>5%的证型有痰瘀互结证、风痰阻络证、气虚血瘀证及气阴两虚证;频率>10%的病性证素有痰、瘀、阴虚、气虚、风及阳亢。证素分布中痰多见于男性,阴虚和气虚则多见于女性;各年龄段均为痰>瘀>阴虚,随年龄的增长,痰和风有比较明显的下降,阴虚和气虚在65岁以后略有上升。在心脑合病高发的4个证型中出现频率较高的症状有半身不遂、肢体不遂、胸闷、身体困重、乏力、头晕、神疲、胸痛及少气懒言,出现频率均高于60%。结论心脑合病多见实证和虚实夹杂证,痰、瘀、虚在心脑合病的病性证素中占有重要地位,且各证素与性别、年龄有一定关系。

Objective To research the syndrome distribution of cardio-cerebral-vascular diseases （ angina pecto ris complicated by infarction due to atherosclerosis and thrombosis） based on clinical epidemiology survey. Methods The diagnostic information of 982 patients with cardio-cerebral-vascular diseases was collected in 11 hospitals with a cross-sectional survey. The syndromes, syndrome elements and distribution of diagnostic information were analyzed. Results The most common syndrome was excess syndrome, followed by syndrome of intermingled deficiency and ex- cess and deficiency syndrome was the least. The common syndromes were syndrome of intermingled phlegm and blood stasis, syndrome of wind-phlegm blocking collaterals, syndrome of qi deficiency and blood stasis and syndrome of de ficiency of both qi and yin, with a ratio greater than 5%. The common syndrome elements were phlegm, stasis, yin deficiency, qi deficiency, wind and yang hyperactivity, with a frequency higher than 10%. In the distribution of syn drome elements, phlegm was frequently seen in men and yin deficiency and qi deficiency was frequently seen in women. For all ages, the syndrome elements in descending order were phlegm, stasis and yin deficiency. There was a significant decrease of phlegm and wind and a slight increase of yin deficiency and qi deficiency with age. The com- mon symptoms were hemiplegia, limb movement disorder, chest tightness, chest pain, dizziness and fatigue, with a frequency higher than 60%. Conclusion The common syndromes of cardio-cerebral-vascular diseases are excess syndrome and syndrome of intermingled deficiency and excess. The common syndrome elements are phlegm, stasis and deficiency, with a certain relationship with gender and age.